In Response to The “Dear Colleague” Letter on Psychiatric Prescribing

Research Institute Statement No. 02-2026-06-05

 

On May 4th, 2026, the U.S. Department of Health and Human Services and its associated agencies put forth an advisory letter to their federally funded colleagues regarding the topic of “Psychiatric Medication and Non-Pharmacological Treatments.” This letter was released on the same day as the MAHA Institute’s Mental Health & Overmedicalization Summit and the announcements made by the U.S. Department of Health and Human Services Secretary Robert F. Kennedy, Jr. 
 

The Dear Colleague letter, authored by SAMHSA, Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA), and the ACF, offers a clear and constructive framework to follow the summit and announcement. It emphasizes the importance of non-pharmacological help within the continuum of care, shared decision-making, informed consent, regular medication review for continued necessity and benefit, and, when appropriate, individualized deprescribing with close monitoring. 

The Dear Colleague letter recommends “evidence-based non-pharmacological interventions including psychotherapy, social connection, behavioral approaches, sleep-focused treatments, physical activity interventions, and dietary and nutrition-related strategies.” We believe that those non-pharmacological alternatives have been lacking or absent for many individuals seeking respite from distress.

If medications are started, the Dear Colleague letter recommends robust informed consent on “the purpose of the medication, expected benefits, possible adverse effects, monitoring needs, potential discontinuation symptoms, the risks of abrupt cessation when relevant, the possibility of relapse or recurrence, and the availability of evidence-based non-pharmacological interventions.” This is at the crux of why the Inner Compass Research Institute was founded: to provide evidence-based information so patients can make authentic choices. We do not believe in banning antidepressants; we believe in allowing individuals the right to make more informed choices.

Additionally, the letter addresses the need for “regular and deliberate review of psychiatric medication regimens to ensure that each medication remains necessary.” Our experience and the research indicate that psychotropic medications are used for much longer periods than they were studied. We are encouraged to see the administration highlight the need for providers to review the continued use of those medications, which have now often become lifelong. 

Inner Compass Research Institute welcomes the Dear Colleague letter. It is a meaningful step toward a balanced, patient-centered approach to mental health care. We recognize that psychiatric medications can provide relief. However, we think medication should be an option within a continuum of care. Medications should be provided with informed consent, shared decision-making, and reassessment of treatment needs. We hope this letter represents not only a shift in federal guidance but a cultural shift in how we approach mental health: with humility about what we do and do not know, with respect for patient autonomy, and with a commitment to offer a full range of tools and support.

Inner Compass Research Institute 
June 2026