In light of global debates on mental health and medication, such as the recent launch of the WHO mental health policy guidelines, I recently proposed to the International Institute for Psychiatric Drug Withdrawal (IIPDW) the creation of a working group to reflect on policy and support collective action in this critical area. IIPDW is a global network promoting safe, person-centered psychiatric drug withdrawal, grounded in medical science. I now share this reflection more widely with my network, as I believe it’s a conversation we must open across disciplines and countries.
In Spain, a major public debate is underway as the government seeks to approve a new national Mental Health Action Plan. One of its main goals is promoting deprescribing and reducing psychotropic medication use nationwide. The initiative is widely supported by psychological and many psychiatric professionals, along with most user-led organizations. Still, it faces resistance from some psychiatric sectors and aligned institutions. This reflects a broader concern: without structured, rights-based, person-centered withdrawal pathways, reforms remain fragile - symbolic at best, harmful at worst. A fine line separates overprescription from self-medication, especially when proper education and safeguards are lacking. This includes not only clinical training, but public health literacy for users, families, and especially policymakers.
Today, where legal and illegal substances - from ketamine and alcohol to prescription benzodiazepines and stimulants - are increasingly offered as shortcuts to complex problems, we risk institutionalizing the illusion of treatment. Real solutions - often slower, relational, systemic - remain underfunded or ignored. The result is mounting harm: to individuals, those around them, and the systems meant to support life and health. This is not just a clinical or ethical issue - it is economic, social, and deeply human. Lives are lost, and trust erodes, when we delay what truly works. For this reason, I’ve proposed the creation of an open working group and task force to focus on:
• Collaboratively drafting policy briefs and supporting materials •Sharing international models of good practice and user-led approaches to safe withdrawal •Building educational and legislative awareness to promote meaningful, systemic change •Supporting each other in efforts to influence national policy environments constructively and ethically
If you are working in this space, have lived or professional experience to contribute, or are interested in helping shape this initiative, please feel free to reach out. This is a shared responsibility, and I believe we can offer something better, together. I end up this post sharing an invitation by Professor John Read, chairperson of the IIPDW, to join us in an event with Professor David Taylor and Dr. Mark Horowitz, who will present their Maudsley Deprescribing Guidelines, as well as a new instrument by myself on the topic (the problem I tackled during all my PhD research), which I am about to use to survey key relevant professionals all over Spain. I will be happy to get your feedback on how to improve it, if possible: