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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
The guidance also requires a signed consent form when patients are concurrently prescribed opioids and benzodiazepines. The measure will go into effect in 2027.<\/p>\n
\u201cAmerica\u2019s veterans should get as much information as possible as they are deciding what treatment is best for them,\u201d said Doug Collins, the secretary of Veterans Affairs, in a statement<\/a> announcing the changes. \u201cThe guidance we\u2019re announcing today will ensure that happens.\u201d<\/p>\n The new requirements are far-reaching \u2014 the department provides mental health care to nearly 1.7 million veterans. They have a significantly higher suicide rate<\/a> than the general population and experience high rates of serious mental health challenges like post-traumatic stress disorder and depression.<\/p>\n The agency\u2019s new measures came after sustained pressure from some veterans\u2019 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.<\/p>\n \u201cThis is not to deter treatment,\u201d said Derek Blumke, a policy fellow focused on medication safety at Irreverent Warriors, a suicide prevention group for veterans. \u201cThis is to ensure patient safety and to ensure that patients are able to make decisions about their own health.\u201d<\/p>\n \u201cThese treatments are not benign,\u201d he added.<\/p>\n 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.<\/p>\n \u201cThis is discouraging people from getting appropriate treatment for serious mental health conditions,\u201d said Dr. Anita Clayton, a psychiatrist at the University of Virginia School of Medicine and president of the American Society of Clinical Psychopharmacology.<\/p>\n 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.<\/p>\n Facing pressure from Mr. Kennedy and his allies in the MAHA movement, psychiatrists with the A.S.C.P. issued their first consensus guidelines<\/a> for doctors in May to help patients and their doctors safely transition off psychiatric drugs, or \u201cdeprescribe,\u201d when they are no longer deemed necessary or helpful.<\/p>\n 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.<\/p>\n While the statement from the V.A. noted that doctors already conduct \u201ca full discussion of the risks, side effects, benefits and alternatives to psychotropic medications\u201d with their patients, it did not explain what the new signed informed consent documents would say.<\/p>\n \u201cI would enormously hope that the informed consent process is balanced and includes the risks of forgoing treatment for a serious mental health illness,\u201d said Dr. Joseph Goldberg, a psychiatrist at the Mount Sinai Icahn School of Medicine who co-authored the A.S.C.P.\u2019s deprescribing guidelines.<\/p>\n Jared Smith, legislative manager of the veterans\u2019 group With Honor, said the new guidance had been highly anticipated by advocates. In June, Mr. Smith, Mr. Blumke and representatives from 20 veterans\u2019 groups met with Mr. Collins to discuss their concerns about informed consent at V.A. hospitals.<\/p>\n 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.<\/p>\n \u201cWe\u2019re 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,\u201d Mr. Smith said.<\/p>\n \u201cThe onus should not be on the patient to ask questions,\u201d he added. \u201cIt\u2019s about being informed from the get-go.\u201d<\/p>\n During Mr. Kennedy\u2019s confirmation hearings last year, he suggested that reducing the use of antidepressants<\/a> would be a central aim of his tenure. In testimony, he claimed without evidence<\/a> 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.<\/p>\n