Claim: Psychiatric Medications are “Overprescribed” in the US

Verdict: Likely inaccurate, and highly misleading.

“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”

WTAS: HHS Launches MAHA Action Plan to Curb Psychiatric Overprescribing

This week, RFK Jr. and his Department of Health and Human Services announced a plan to curb “overprescribing” of psychiatric medications, with a particular focus on youth.

Ignoring more outlandish previous statements made by RFK Jr. on this topic, the key issue here is simple: are psychiatric medications “overprescribed” in the US?

What is “Overprescribing,” Anyway?

“Overprescribing” refers to people being prescribed a treatment that they didn’t technically “need,” likely because other, non-medication approaches would have been effective.

This is a legitimate issue, but it should be immediately clear that this is a decision that can only realistically be made on a case-by-case basis by a qualified healthcare provider. Simply looking at rising prescriptions for psychiatric medications is not enough to say there is “overprescribing.”

Prescription vs. Prevalence Rates for Psychiatric Conditions

Although we can’t definitively prove or disprove overprescribing with less granular data, we can still broadly address it. If prescriptions broadly move with the prevalence of the condition, widespread overprescribing is unlikely.

One study from 2018 tackled this exact issue, for stimulants, antipsychotics and antidepressants prescribed to young people. The study found that prescriptions for antidepressants and stimulants are broadly in line with the underlying rates of ADHD, depression and anxiety. For antipsychotics, it’s harder to estimate due to off-label medication use, but it also seems in line with prevalence estimates.

More recent data shows a continued increase in depression prevalence, so it would be expected that prescription rates would continue to increase.

Overprescribing or Underprescribing? It Depends Where You Look

Other data reveals another fundamental issue with the logic here. Rates of antidepressant prescriptions vary drastically by demographic group, as shown in the attached image. Should we conclude that antidepressants are underprescribed among men but overprescribed among non-binary people?

The reality is that a complex interplay of factors influences prescribing. Simply reducing this to “psychiatric medications are overprescribed” ignores between-group differences, the changing need for psychiatric medications and the overall reality that many people with mental health issues don’t receive any treatment at all.