Effective Psychiatric Medication Use & Suicide Prevention: A Conversation With Christine Yu Moutier, MD

CLINICAL CONVERSATIONS

At a MAHA Institute summit on mental health on May 4, 2026, the US Department of Health and Human Services (HHS) announced plans to tamp down on the “inappropriate use and overuse” of psychiatric medications.^1,2 In the wake of this announcement, several major psychiatric organizations, including the American Foundation for Suicide Prevention (AFSP), issued follow-up statements clarifying the importance of proper psychiatric medication use. Christine Yu Moutier, MD, the chief medical officer of the AFSP, in her released statement, specifically noted that, “A robust body of scientific evidence demonstrates that antidepressants are effective in treating acute depressive episodes, preventing future episodes, and reducing suicidal thoughts and behaviors.”³

Moutier expanded on this statement, sharing how psychiatric medications contribute to the prevention of suicide, in an exclusive Q&A with Psychiatric Times.

Psychiatric Times: Talk to us about the potential consequences of misinformation about the treatment of depression. How could this impact mental health outcomes, specifically suicide?

Christine Yu Moutier, MD: Misinformation about psychotropic medications can have very real and dangerous consequences.⁴ Depression and other mental health conditions are the most prevalent risk factors for suicide,⁵ yet millions of people remain undiagnosed or untreated each year. When inaccurate or fear-based narratives undermine confidence in evidence-based treatments, people may delay seeking care, discontinue treatment prematurely, or never engage in treatment at all.

We have seen this before. Public discourse that overemphasizes risk without acknowledging the full body of scientific evidence has previously been associated with declines in diagnosing and treating depression, which may have negatively impacted population suicide rates.⁶ During the US Food and Drug Administration (FDA)’s consideration of a black box warning for antidepressants in 2003-2004, the review process was heavily influenced by highlighting negative patient stories and testimony from parents who had lost children to suicide, alongside selective data that called medications into question (especially for pediatric use), while the full data on selective serotonin reuptake inhibitors were not actually included in the FDA’s evaluation. Moreover, the media added a layer of sensationalized fear, further distorting the narrative with headlines such as: “Will your antidepressant kill you?” The warnings, coupled with this intense media hype, led to a more than 20% drop in antidepressant use among young people, and a corresponding 22% increase in suicide attempts by overdose in adolescents in the same period. There was also a bleed over effect leading to decreased diagnosis and treatment of depression in adults during the same period.

In fact, a body of evidence is clear: decades of clinical trials, population studies, and health-system data demonstrate that antidepressants—when thoughtfully prescribed and monitored—reduce depressive symptoms and suicidal thoughts and behaviors overall. For many individuals, especially those with moderate to severe depression, medication combined with psychotherapy provides the best outcomes short and longer-term, which for those with other suicide risk factors, can be life-saving.⁷

When misinformation leads people to avoid psychiatric care, the impact can be serious— not only on symptoms continuing or worsening in the short run, but longer-term impact on morbidity and mortality can be serious. These including recurrence of illness, negative impacts on physical illness, and suicide risk increases. The impact of misinformation is especially noted for marginalized communities, where access to care is even more challenging and where stigma, distrust, and barriers to care can make it harder to access treatment. In that light, public discourse informed by research and clinical guidance are not neutral issues; they are a critical part of a public health approach to the mental health crisis as well as for suicide prevention.

PT: Let’s discuss the appropriate discontinuation of medications. How does abrupt discontinuation or inappropriate “deprescribing” ultimately impact patients? In your opinion, how can psychiatrists and clinicians appropriately address polypharmacy?

Moutier: The term “deprescribing” is not new, but is now being used by MAHA to imply a sense of wide sweeping inappropriateness of psychotropic medications, also questioning the validity of psychiatric illness and DSM nosology in general. The MAHA Summit last week promoted several unscientific messages that reframed illness as “healthy responses to bad environments,” overstated the prevalence and severity of adverse effects, blamed illness on treatment, and overplayed issues of overdiagnosing and overmedicating patients (children in particular) without acknowledging the greater problem of unaddressed, untreated mental illness for about half of people in the US with a diagnosable psychiatric condition. So, the term “deprescribing” used in this context distorts reality—including the fact that appropriate discontinuation of psychotropic medications is already an important component of high-quality, individualized care. While polypharmacy is a real issue that must be addressed, a generic message encouraging discontinuation is dangerous. Psychiatrists are trained to regularly, routinely evaluate and reassess medication regimens with their patients; there may also be a need for more training and reminders, keeping in mind that the majority of psychotropic medications are prescribed by primary care and other providers.

To that end, the American Society of Clinical Psychopharmacology (ASCP) conducted a rigorous review to identify clinical scenarios that should signal to the clinician to carefully evaluate discontinuation of medication.⁸ There are many valid reasons, such as lack of efficacy, adverse effects, changes in clinical status, drug-drug interactions, overlap in mechanisms of action, or unnecessary polypharmacy. Ultimately a clinical evaluation with patient input (and family’s input when possible), and chart review, aiming for determination of the risk/benefit ratio of any given medication and full discussion with the patient is the goal.

The key points made by the ASCP Task Force led by Joseph F. Goldberg, MD, include: deprescribing: (1) should not occur without first assessing medication adherence; (2) merits consideration if less than partial therapeutic response is apparent, or if treatment goals have been reached and relapse prevention is not a long-term objective; (3) involves psychological ramifications that warrant attention; (4) should be followed by close clinical monitoring; and (5) risk-benefit decisions should ideally involve active patient participation within a shared decision-making model.

Conversely, abrupt discontinuation or inappropriate “deprescribing,” particularly outside of doctor-patient care, can significantly increase risk of harms. Sudden medication cessation can lead to discontinuation symptoms, relapse of the illness, destabilization of comorbid conditions and psychosocial functioning, and for some individuals, an increase in suicidal ideation or behavior.

From a clinical standpoint, safe discontinuation of medications starts with individualized assessment, shared decision-making, and depending on its half-life, should occur by tapering the medication, followed by close monitoring. Importantly, treatment should also include some form of psychotherapy, safety planning for patients with a history of suicidal ideation or attempts, and other nonpharmacologic supports and self-care strategies to help ensure care is comprehensive, patient-centered, and focused on long-term recovery.

PT: How does AFSP plan to continue supporting patients and clinicians?

Moutier: AFSP plans to continue supporting patients and clinicians by promoting evidence‑based, patient‑centered care while also addressing the broader systems that shape suicide risk and prevention. This includes promoting accurate, science‑informed public education about mental health, psychiatric illnesses including substance use disorders, and the importance of treatment; supporting clinician training in suicide risk assessment, safety planning, and lethal means counseling, and advocating for access to comprehensive, affordable mental health care. As the largest private funder of suicide research globally, we invest in and advance research to better understand what treatments work best, for whom, and under what circumstances.

At the same time, we consistently emphasize that suicide prevention certainly does not rest on medication alone. Our goal is to ensure that both clinicians and patients feel informed and confident in a more holistic approach to preventing suicide, and that they understand that optimizing treatment and family and social supports leads to the best possible outcomes for any given person. Managing mental health conditions including substance use disorders is critically important in reducing suicide risk. And for many people, remission and recovery are possible.

PT: AFSP recently shared plans to join with The JED Foundation. Can you talk to us about how this combined organization might help expand education, access, and resources to clinicians and patients alike?

Moutier: Our planned merger between AFSP and the JED Foundation represents an important opportunity to expand suicide prevention efforts across the lifespan by increasing reach and impact.⁹ By bringing together AFSP’s strengths that include research, public policy advocacy, loss support and our chapter network, and JED’s 4-year comprehensive model providing technical support to campuses and youth serving organizations,¹⁰ we foresee strengthening suicide prevention across the US through a systems approach and through partnerships, like AFSP’s partnership with Bechtel aiming to reduce suicide in the construction industry.^11,12 We see the need to continue to expand our funding of suicide research, especially during these times when federal research funding is less certain. We will continue to strongly advocate at federal, state and local levels for parity, expansion of 988 and crisis services, expansion of and support for the health care workforce, for reducing access to lethal means, and for addressing populations with disproportionate impacts on suicide rates and trends.¹³

For clinicians, AFSP/JED will offer expanded clinical education and patient resources grounded firmly in evidence‑based practice.¹⁴ The new merged organization will aim for greater integration across community settings, campuses, and health systems, allowing for a stronger public health approach. We foresee work toward connecting upstream, prevention‑focused efforts and clinical care. For patients and families, the impact is broader awareness, reduced stigma, and more accessible pathways to timely, effective support—often before distress escalates into crisis.

PT: In 2024, there was a 2% decrease in suicides from 2023, a hopeful turn in a previously negative trend. What can psychiatrists and mental health clinicians do to continue that positive trend? What strategies do you think are helping to decrease the rate of suicides? Is there any observable data?

Moutier: Last month, the CDC released WISQARS 2024 data actually showing a 2% decrease in the national suicide rate year over year (14.1 to 13.7 per 100,000), and a 4% decrease from 2022 to 2024.¹⁵ This is a hopeful and encouraging signal, particularly after several years of relatively stable rates since 2018. However, the 2024 suicide rate is still 32% higher than in 2000. While no single factor can explain these changes, sustained investments in proven prevention and care may be starting to make a difference. For example, a recent study found that the launch of 988 has been associated with fewer youth suicide deaths, likely by expanding timely access to crisis support proven to help callers and texters feel less overwhelmed, more hopeful, and connected to care.¹⁶

Psychiatrists and mental health clinicians are central to continuing and strengthening this progress. Early identification and effective treatment of psychiatric conditions including substance use problems remain among the most powerful risk reducing strategies. Routine use of safety planning and lethal means counseling is also critical, particularly given that firearms continue to account for the majority of suicide deaths and are at an all-time high. Building a continuum of care—where people are screened for depression or suicide risk in primary care, receive effective treatment, can get help in moments of crisis, and connect to community‑based supports like peer support groups, and receive ongoing care—helps build protective factors and reduce suicide risk factors. Engaging patients and families as active partners in care is also crucial to strengthen trust, adherence, and long‑term recovery.

Increasingly, data suggest that comprehensive, system‑level approaches are associated with reductions in suicide attempts and improved patient outcomes.¹⁷ The Collaborative Care Model now has data from at least 3 studies showing strong evidence for reducing suicide attempts and deaths.¹⁸ These include expanding access to timely treatment, integrating suicide prevention practices into primary care and mental healthcare, and implementing trainings such as AFSP’s Clinical Approach to Preventing Suicide: An Introduction (CAPS) to educate health care professionals about steps that can reduce patients’ risk.¹⁴

Taken together, the takeaway is clear: suicide is often preventable, and when clinicians are prepared and supported by strong systems, and able to deliver evidence‑based care consistently, lives can be saved.

Dr Moutier is Chief Medical Officer, American Foundation for Suicide Prevention, New York, NY.

References

1. HHS launches MAHA action plan to curb psychiatric overprescribing. HHS. News release. May 4, 2026. Accessed May 5, 2026. https://www.hhs.gov/press-room/hhs-launches-maha-action-plan-curb-psychiatric-overprescribing.html

2. Kuntz L. HHS launches action plan to promote “appropriate psychiatric prescribing.” Psychiatric Times. May 5, 2026. https://www.psychiatrictimes.com/view/hhs-launches-action-plan-to-promote-appropriate-psychiatric-prescribing

3. AFSP statement on the importance of antidepressants and evidence-based treatment for suicide prevention. AFSP. News release. May 5, 2026. Accessed May 12, 2026. https://www.prnewswire.com/news-releases/afsp-statement-on-the-importance-of-antidepressants-and-evidence-based-treatment-for-suicide-prevention-302762738.html

4. Libby AM, Brent DA, Morrato EH, et al. Decline in treatment of pediatric depression after FDA advisory on risk of suicidality with SSRIs. Am J Psychiatry. 2007;164(6):884-891.

5. 2021 NSDUH Annual National Report. SAMHSA. January 4, 2023. Accessed May 12, 2026. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report

6. Friedman RA. Antidepressants' black-box warning — 10 years later. N Engl J Med. 2014;371(18):1666-1668.

7. Qaseem A, Owens DK, Etxeandia-Ikobaltzeta I, et al. Nonpharmacologic and pharmacologic treatments of adults in the acute phase of major depressive disorder: a living clinical guideline from the American College of Physicians. Ann Intern Med. 2026.

8. Goldberg JF, McIntyre RS, Swartz HA, et al. Recommendations for the deprescribing of psychotropic medications: a consensus statement from the American Society of Clinical Psychopharmacology Task Force. JAMA Netw Open. 2026;9(2):e260043.

9. American Foundation for Suicide Prevention and The Jed Foundation announce intent to merge as equals; becoming the nation’s largest nonprofit organization dedicated to suicide prevention across the lifespan. News release. April 21, 2026. Accessed May 12, 2026. https://afsp.org/story/american-foundation-for-suicide-prevention-and-the-jed-foundation-announce-intent 

10. MacPhee J, Modi K, Gorman S, et al. A comprehensive approach to mental health promotion and suicide prevention for colleges and universities: insights from the JED Campus Program. NAM Perspect. 2021;2021:10.3147/202106b.

11. Bechtel and the American Foundation for Suicide Prevention partner to prevent construction worker suicides. News release. March 5, 2024. Accessed May 12, 2026. https://afsp.org/story/bechtel-and-the-american-foundation-for-suicide-prevention-partner

12. Confronting suicide in construction. Hard Hat Courage; AFSP. Accessed May 12, 2026. https://hardhatcourage.com

13. 2025-2026 public policy priorities. AFSP. Accessed May 12, 2026. https://afsp.org/public-policy-priorities/

14. Clinical approach to preventing suicide: an introduction. AFSP. Accessed May 12, 2026. https://afsp.org/clinical-approach-to-preventing-suicide-an-introduction/

15. National suicide rate remains stable, rates decrease across most racial groups and youth/young adults between 2023 and 2024. AFSP. April 29, 2026. Accessed May 12, 2026. https://afsp.org/story/national-suicide-rate-remains-stable-rates-decrease-across-most-racial-groups

16. Patel VR, Liu M, Jena AB. Suicide mortality among adolescents and young adults after launch of a suicide and crisis lifeline. JAMA. 2026:e265157. 

17. Ahmedani BK, Penfold RB, Frank C, et al. Zero suicide model implementation and suicide attempt rates in outpatient mental health care. JAMA Netw Open. 2025;8;(4):e253721.

18. Large reductions in suicide risk, attempts and deaths demonstrated by three “real world” studies in primary care. The JED Foundation. April 10, 2025. Accessed May 12, 2026. https://jedfoundation.org/large-reductions-in-suicide-risk-attempts-and-deaths-demonstrated-by-three-real-world-studies-in-primary-care/