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Psychiatry in the USA is at a crossroads: economic pressures have narrowed practice away from psychotherapy toward medication management while rapid growth in procedural treatments is reshaping the field. In this Comment, we argue that this shift requires a new identity, proposing interventional psychiatry that integrates psychiatric judgment with procedural care.
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Competing interests
W.M.S. is an employee of Osmind. T.R.I. is a co-founder and board member of Vanna Health, Benchmark Health and NeuraWell Therapeutics; is an advisor to Alto Neuroscience, Ellipsis, Slingshot AI and Sword Health; and holds equity in Compass Pathways, Alto Neuroscience and Osmind. B.B.A. is the founder of Sweetgrass Psychiatry; has served on advisory boards for AbbVie, Bristol Myers Squibb, Compass Pathways, Definium Therapeutics, Eli Lilly, Johnson & Johnson, Neurocrine Biosciences and Vistagen; has served as a consultant for AbbVie, Aidvance, Almatica, Axsome, Definium Therapeutics, Johnson & Johnson, Osmind and Precision Genetics; and has participated in speakers bureaus for AbbVie, Alkermes, Axsome, Bristol Myers Squibb, Johnson & Johnson and Tonix Medicines. M.K. is an employee and co-founder of Your Behavioral Health, a medical advisor for Osmind and a speaker for the Clinical TMS Society, and has previously served as a consultant for Wave Neuroscience. R.M.B. is a shareholder of and consultant for Biohaven Pharmaceuticals, Syndeio, Firebird Therapeutics, Lighthouse Pharma, MindImmune Therapeutics, Osmol Therapeutics, Gilgamesh Pharma and GabaRx, and a consultant for Draig Therapeutics and Bristol Myers Squibb. S.S. has served as a consultant to Acadia, AbbVie, AdhereTech, Alkermes, Axsome, Autobahn, Aytu, Bristol Myers Squibb, Clexio, Delix, Intra-Cellular/Janssen, LivaNova, Lundbeck, Neurocrine, Otsuka, Supernus, Tonix and Vanda; holds options in Genomind, Lipidio, NeuraWell and Delix; has served as a speaker for Intra-Cellular/Janssen; and has received no research or grant support. H.K.M. is a member of the board with stock options at Alto Neuroscience; is a strategic advisor with stock options at Apollo Therapeutics; is chair of the scientific advisory board with stock options at Empyrean Neuroscience; is a member of a scientific advisory board with financial remuneration at Dolby Family Ventures; has received consulting fees within the past 36 months (not currently) from Boehringer Ingelheim, Freedom Biosciences, Lundbeck, Otsuka, PsychoGenics and Sanofi, outside the submitted work; was formerly global head of neuroscience research and development at Johnson & Johnson and retains stock options from that employment; and serves without financial remuneration on the boards of McLean Hospital, the Dana Foundation, the Stanley Center, the Foundation for OCD Research and Rugen Therapeutics. R.S.M. has received research grant support from CIHR/GACD/National Natural Science Foundation of China (NSFC) and the Milken Institute, and speaker/consultation fees from Lundbeck, Janssen, Alkermes, Neumora Therapeutics, Boehringer Ingelheim, Sage, Biogen, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, NeuraWell, Sunovion, Bausch Health, Axsome, Novo Nordisk, Kris, Sanofi, Eli Lilly, Eisai, Intra-Cellular, NewBridge Pharmaceuticals, Viatris, AbbVie, Bristol Myers Squibb, Teva, AdhereTech, GH Research, Autobahn Therapeutics and Atai Life Sciences. J.J.Q. is a co-founder and employee of Osmind.
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Nature Mental Health thanks Lorena Catarina del Sant and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.
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Sauvé, W.M., Insel, T.R., Albright, B.B. et al. Defining interventional psychiatry: a framework for professional identity and practice evolution. Nat. Mental Health (2026). https://doi.org/10.1038/s44220-026-00708-3
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DOI: https://doi.org/10.1038/s44220-026-00708-3

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