The Department of Veterans Affairs announced new measures on Monday that will require written informed consent by patients before they are prescribed certain psychiatric drugs.
The shift reflects a growing disenchantment with psychotropic medications that has animated the Make America Healthy Again movement and its chief standard-bearer, Health Secretary Robert F. Kennedy Jr.
The new policy will require veterans under age 30 to sign consent forms before receiving antidepressants, and it mandates documented discussions about the risks and benefits of the treatments, including how to safely discontinue them.
The guidance also requires a signed consent form when patients are concurrently prescribed opioids and benzodiazepines. The measure will go into effect in 2027.
“America’s veterans should get as much information as possible as they are deciding what treatment is best for them,” said Doug Collins, the secretary of Veterans Affairs, in a statement announcing the changes. “The guidance we’re announcing today will ensure that happens.”
The new requirements are far-reaching — the department provides mental health care to nearly 1.7 million veterans. They have a significantly higher suicide rate than the general population and experience high rates of serious mental health challenges like post-traumatic stress disorder and depression.
The agency’s new measures came after sustained pressure from some veterans’ groups to establish more stringent informed consent policies for psychotropic medications. The groups argue that veterans have been prescribed powerful medications without being fully informed of their risks.
“This is not to deter treatment,” said Derek Blumke, a policy fellow focused on medication safety at Irreverent Warriors, a suicide prevention group for veterans. “This is to ensure patient safety and to ensure that patients are able to make decisions about their own health.”
“These treatments are not benign,” he added.
But psychiatrists and major medical groups said they were concerned that the new policy would increase stigma and dissuade veterans from using medications that might be lifesaving.
“This is discouraging people from getting appropriate treatment for serious mental health conditions,” said Dr. Anita Clayton, a psychiatrist at the University of Virginia School of Medicine and president of the American Society of Clinical Psychopharmacology.
Dr. Clayton noted that although the new policy requires signed consent before concurrent prescription of opioids and benzodiazepines, the two drugs are rarely, if ever, prescribed together.
Facing pressure from Mr. Kennedy and his allies in the MAHA movement, psychiatrists with the A.S.C.P. issued their first consensus guidelines for doctors in May to help patients and their doctors safely transition off psychiatric drugs, or “deprescribe,” when they are no longer deemed necessary or helpful.
And in July, the Department of Health and Human Services convened an expert panel to develop its own official guidance on deprescribing selective serotonin reuptake inhibitors, the main class of medications used to treat depression.
While the statement from the V.A. noted that doctors already conduct “a full discussion of the risks, side effects, benefits and alternatives to psychotropic medications” with their patients, it did not explain what the new signed informed consent documents would say.
“I would enormously hope that the informed consent process is balanced and includes the risks of forgoing treatment for a serious mental health illness,” said Dr. Joseph Goldberg, a psychiatrist at the Mount Sinai Icahn School of Medicine who co-authored the A.S.C.P.’s deprescribing guidelines.
Jared Smith, legislative manager of the veterans’ group With Honor, said the new guidance had been highly anticipated by advocates. In June, Mr. Smith, Mr. Blumke and representatives from 20 veterans’ groups met with Mr. Collins to discuss their concerns about informed consent at V.A. hospitals.
The groups are also pressing legislators to pass the Written Informed Consent Act, a bill introduced in the House of Representatives in 2025 that would impose even stricter standards on the hospitals.
“We’re very supportive of the core principle that veterans are entitled to the same standards of care that every patient deserves, which is well-informed, voluntary decisions that they can make about their own health,” Mr. Smith said.
“The onus should not be on the patient to ask questions,” he added. “It’s about being informed from the get-go.”
During Mr. Kennedy’s confirmation hearings last year, he suggested that reducing the use of antidepressants would be a central aim of his tenure. In testimony, he claimed without evidence that antidpressants like S.S.R.I.s have contributed to a rise in shootings and that they can be harder to quit than heroin.
A growing number of patient advocacy groups aligned with Mr. Kennedy have been increasingly vocal about the downsides of antidepressant treatment, like decreased sexual function.
Some patients have reported being “parked” on the medications for years, or experiencing debilitating withdrawal symptoms with little oversight or support from their doctors.
Psychiatric organizations have been alarmed by the mounting hostility to the medications, and say their use in treating depression, mania and psychosis has undergone decades of rigorous testing and analysis.
If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.