“Today, we take clear and decisive action to confront our nation’s mental health crisis by addressing the overuse of psychiatric medications—especially among children,” said Secretary Kennedy. “We will support patient autonomy, require informed consent and shared decision-making, and shift the standard of care toward prevention, transparency, and a more holistic approach to mental health.”

In the days that followed, professional organizations pushed back against the claim that the overuse of psychiatric medications is driving the mental health crisis. The American Psychiatric Association argued instead that the crisis stems from systemic failures: limited access to care, workforce shortages, a lack of psychiatric beds, barriers to psychotherapy, and fragmented treatment systems. The organization maintained that deprescribing alone cannot resolve these structural problems and warned that broad skepticism toward psychiatric medication risks deepening stigma around treatment.

Similarly, the American Foundation for Suicide Prevention cautioned that abrupt or noncollaborative deprescribing can trigger symptom relapse and increase suicide risk. The group emphasized the importance of individualized assessment, patient-centered communication, and close clinical follow-up when considering medication changes.

Shared decision-making and patient autonomy are not new concepts; they are foundational principles of primary care. But when appeals to “personal choice” are used to cast doubt on evidence-based treatment recommendations, the result is greater confusion for providers, patients, and parents already navigating difficult and deeply personal decisions. When federal agencies issue guidance suggesting that evidence-based psychiatric treatments are broadly “overutilized,” they risk fueling medication hesitancy. That hesitancy may delay—or altogether prevent—people from accessing treatments that could meaningfully improve their quality of life.

What is especially concerning in this debate is the emerging narrative that America’s mental health crisis is primarily the result of psychiatric medication overuse. The administration’s letter to providers strongly implies that patients, collectively, are taking too many psychiatric medications and that clinicians should focus on reducing or discontinuing them. Embedded within that message is an assumption that providers routinely overprescribe: that they simply authorize refills month after month without monitoring side effects, reassessing risks and benefits, or considering deprescribing when appropriate. That characterization does not reflect the reality of most clinical practice.

Certainly, there may be isolated cases of careless prescribing or inadequate follow-up. But the overwhelming majority of clinicians approach psychiatric prescribing thoughtfully and cautiously. They engage patients in informed decision-making, monitor for adverse effects, weigh risks against benefits, and continually reassess treatment plans. Far from prescribing casually, most providers are working diligently to relieve suffering while minimizing harm.

Framing the mental health crisis as an overprescribing “problem” also creates a false and unnecessary dichotomy: prescribe medications or avoid them altogether; recommend medication or recommend nonpharmacologic treatment; continue medications that are providing benefit or prioritize broad deprescribing efforts. In reality, clinicians and patients do not have to choose between these opposing camps. The most effective treatment plans are often multimodal, combining medication with evidence-based nonpharmacologic interventions such as cognitive behavioral therapy (CBT) or problem-solving therapy (PST). Behavioral Health care is rarely an either-or proposition; it is about tailoring treatment to the individual patient’s needs, preferences, and clinical circumstances.

America’s mental health crisis is not being driven by an excess of psychiatric medications. It is being driven by systemic failures: limited access to care, workforce shortages, and fragmented delivery systems that leave providers without the resources they need. Too often, primary care clinicians lack access to integrated behavioral health professionals who can deliver evidence-based nonpharmacologic interventions, as well as psychiatric consultants who can provide additional expertise in complex medication management.

From where I stand—working every day with patients and families—the solution to the mental health crisis is not to point fingers at pediatricians and family physicians and accuse them of prescribing too many psychiatric medications. A more constructive approach is to support those clinicians in delivering comprehensive, team-based care and to ensure patients and providers are fully supported in the treatment decisions they make.

That approach already exists: it’s called Integrated Care. Integrated Care is an evidence-based, team-based approach backed by more than three decades of research demonstrating improved patient outcomes and lower overall healthcare costs. The challenge now is not whether the Integrated Care works, but whether policymakers and payers are willing to make it broadly accessible. National leaders should focus on creating the infrastructure and reimbursement mechanisms necessary to make Integrated Care the standard of care, rather than fueling narratives that deepen stigma and discourage treatment.

From the vantage point of primary care, this recent push to address the mental health crisis by “curbing overprescribing” misses the larger issue. Rather than pointing fingers at clinicians or casting doubt on evidence-based treatments, this moment should direct our attention toward models of care that are proven to work- such as Integrated Care.

Integrated Care allows clinicians to work more effectively as part of a coordinated team, where evidence-based medications and nonpharmacologic interventions are both available as treatment options—not competing ideologies. Within this model, care is guided by shared decision-making, patient-centered communication, and individualized treatment planning. That is the conversation we should be having.

Photo by Sophia Kunkel on Unsplash