The U.S. Department of Health and Human Services (HHS) recently announced efforts to curb psychiatric overprescribing at a MAHA Institute summit on mental health and overmedicalization. Per the press release, “HHS agencies are bringing together their collective expertise and aligning to evaluate prescription patterns for psychiatric medications, their benefits and potential harms, and elevate the role of nonmedication treatments and scalable, evidence-based solutions to improve mental health.” In a Dear Colleague Letter (PDF | 322 KB), HHS encourages providers to prioritize informed consent and shared decision-making, and to regularly review the risks and benefits of psychiatric medications with patients. The letter highlights nonmedication approaches, such as family support, psychotherapy, nutrition, and physical activity when clinically appropriate. Providers can also find information in the letter on billing codes that can be used to support the delivery of evidence-based nonmedication treatments.
AAPP is monitoring this plan and its implementation alongside its coalition partners. Action items include:
- Distribution of a press release in coalition with the Mental Health Liaison Group supporting the evidence-based use of psychiatric medications such as SSRIs when prescribed, monitored, and supported as part of a comprehensive care plan. The harms of misinformation and the support of increased research are also highlighted in the release.
- Participation in a SAMHSA led Technical Expert Panel intended to gather input from health professionals, patients and family, government agencies, and professional societies to inform the development of formal HHS clinical guidance on the appropriate use of psychiatric medications and tapering and discontinuation. Danielle Stutzman will be representing psychiatric pharmacy and evidence-based practice on this panel which meets virtually leading up to an in-person meeting in July.
- A meeting request submitted to Dr. Oz, CMS Administrator, in conjunction with APhA and ASHP, to encourage changes in incident to billing to pay psychiatric and other pharmacists for their contributions to patient care through the evidence-based recommendations psychiatric pharmacists make to prescribers on discontinuation, substitution, tapering, and monitoring.
- Coming this week! A new policy brief combatting misinformation on SSRIs and violence.
AAPP will continue to monitor and advocate around this and other access to care issues to elevate the importance of the psychiatric pharmacist, cite challenges with payment for services, and to combat misinformation.