AFSP Statement on the Importance of Antidepressants and Evidence-Based Treatment for Suicide Prevention

NEW YORK, May 5, 2026 /PRNewswire/ -- On May 4, 2026, the U.S. Department of Health and Human Services (HHS) released an action plan aimed at addressing concerns about psychiatric overprescribing following the MAHA Institute's Mental Health and Overmedicalization Summit. As this action plan is considered, it is essential that public discussion and resulting guidance reflect the full body of scientific evidence—recognizing both the risks and the well-established, life-saving benefits of evidence-based mental health treatment—to avoid unintended consequences that could place lives at risk.

The following statement is from the American Foundation for Suicide Prevention's Chief Medical Officer Dr. Christine Yu Moutier.

AFSP strongly supports access to comprehensive, research-informed treatment for depression and other mental health conditions. This includes psychotherapy, medications, and proven interventions for suicide prevention such as safety planning and lethal means counseling. For many people, these treatments are life-changing and lifesaving.

Depression is one of the most prevalent risk factors for suicide, yet millions of people in the United States go undiagnosed and untreated each year¹ and half of those with a mental health condition are not receiving any treatment. Evidence-based treatment of depression and other mental health conditions—whether through psychotherapy, psychotropic medications or a combination—remains one of the most actionable ways to reduce suicide risk. Optimizing evidence-based care, with the goal of symptom remission and prevention of recurrence, saves lives. On the other hand, misinformation and fear of these treatments have led to decreased identification and treatment of depression, with serious public health consequences.^2,3

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. While all medications carry potential risks, decades of research—spanning clinical trials, population-level studies, and health system data—show that the judicious use of antidepressants reduces suicide risk overall.^4-11 Research also consistently demonstrates that for people with moderate to severe Major Depressive Disorder, the most effective treatment is often psychotherapy, such as cognitive behavioral therapy, in combination with an antidepressant.¹²

Appropriate discontinuing of medications can play a role in high-quality care when guided by careful, individualized clinical assessment—such as when medications are ineffective, cause concerning side effects, or involve unnecessary use of multiple medications. However, abrupt discontinuation or inappropriate "deprescribing," particularly outside a collaborative patient-provider process, can increase risk, including the potential for symptom relapse and elevated suicide risk for some individuals. Individualized and customized clinical assessment, patient-centered communication, and follow-up are essential to avoid unintended harm.

Research also highlights the need for broader education and access to care. While three of four individuals who die by suicide have contact with a primary care clinician in the year prior to death, only about one-third have contact with mental health services.^13,14 This gap underscores the importance of equipping all points of care, as well as the public, with the knowledge and resources needed to recognize depression early and ensure timely, holistic treatment.

Major Depressive Disorder is the leading cause of disability contributing to the global burden of disease and a major driver of suicide when left untreated or undertreated.^15,16 Evidence shows that antidepressants, when used with appropriate adjustments and monitoring—especially during treatment initiation, dose changes, periods of life stress, or when symptoms worsen—can be a critical component of care that reduces both depressive symptoms and suicide risk.

AFSP supports clinicians in working collaboratively with patients and families to tailor treatment plans that reflect individual needs, preferences, and values. Remission and recovery are possible, and more investment is needed to ensure awareness of and access to available help. We urge policymakers, clinicians, and the public to support evidence-based mental health care, expand access and affordability, and address misinformation that may deter people from seeking or continuing mental health treatments. By prioritizing accurate education, comprehensive care, and thoughtful clinical decision making, we can strengthen suicide prevention efforts and save more lives.

The American Foundation for Suicide Prevention is dedicated to saving lives and bringing hope to those affected by suicide, including those who have experienced a loss. AFSP creates a culture that's smart about mental health through public education and community programs, develops suicide prevention through research and advocacy, and provides support for those affected by suicide. Led by CEO Robert Gebbia and headquartered in New York, with its Policy and Advocacy Office in Washington, D.C., AFSP has local chapters in all 50 states, D.C., and Puerto Rico, with programs and events nationwide. Learn more about AFSP in its latest Annual Report and join the conversation on suicide prevention by following AFSP on Facebook, Twitter, Instagram, YouTube,  LinkedIn and TikTok. 

Media interested in speaking with AFSP on this news are encouraged to fill out this press request form and review AFSP's Ethical Reporting Guidelines.

References:
1. Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report.
2. 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):884-91.
3. Friedman R. Antidepressants' black-box warning – 10 years later. N Engl J Med. 2014; 371:1666-1668.
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5. Zisook S, Moutier CY, Rush AJ, Johnson GR, Tal I, Chen PJ, et al. Effect of next-step antidepressant treatment on suicidal ideation: findings from the VAST-D trial. Psychol Med. 2024 Apr;54(6):1172–83.
6. Zisook S, Trivedi MH, Warden D, Lebowitz B, Thase ME, Stewart JW, et al. Clinical correlates of the worsening or emergence of suicidal ideation during SSRI treatment of depression: an examination of citalopram in the STAR*D study. J Affect Disord. 2009 Sept;117(1–2):63–73.
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8. Gibbons RD, Hur K, Bhaumik DK, Mann JJ. The relationship between antidepressant medication use and rate of suicide. Arch Gen Psychiatry. 2005 Feb;62(2):165–72. 
9. Gusmão R, Quintão S, McDaid D, Arensman E, Van Audenhove C, Coffey C, et al. Antidepressant Utilization and Suicide in Europe: An Ecological Multi-National Study. PloS One. 2013;8(6):e66455.
10. Baldessarini RJ, Tondo L. Psychopharmacology for suicide prevention. Cambridge, MA, US: Hogrefe Publishing; 2011. 243 p. (Evidence-based practice in suicidology: A source book.).
11. Simon GE, Savarino J, Operskalski B, Wang PS. Suicide risk during antidepressant treatment. Am J Psychiatry. 2006 Jan;163(1):41–7.
12. 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. 2023;176:239-252. doi:10.7326/M22-2056
13. Luoma JB, Martin CE, & Pearson JL. Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psychiatry. 2002; 159(6), 909–916. 
14. Ahmedani BK, Penfold RB, Frank C, Richards JE, Stewart C, Boggs JM, et al. Zero Suicide Model Implementation and Suicide Attempt Rates in Outpatient Mental Health Care. JAMA Netw Open. 2025 Apr 1;8(4):e253721.
15. Chen XD, Li F, Zuo H, Zhu F. Trends in Prevalent Cases and Disability-Adjusted Life-Years of Depressive Disorders Worldwide: Findings From the Global Burden of Disease Study From 1990 to 2021. Depress Anxiety. 2025 Apr 24;2025:5553491. doi: 10.1155/da/5553491
16. Mann JJ, Michel CA & Auerbach RP. Improving suicide prevention through evidence-based strategies: a systematic review. Am J Psychiatry. 2021; 178(7), 611-624.

SOURCE American Foundation for Suicide Prevention