Interventional psychiatry: Why an umbrella term is useful?

To the Editor

The term ‘interventional psychiatry’ was coined for the first time in 2014 to describe the growing field of psychiatry based on neuroscience-informed brain modulation devices (Williams et al., 2014). Since then, new interventional treatments have emerged and have been the subject of a large amount of encouraging published and ongoing trials. Some of these treatments were subsequently approved by the US Food and Drug Administration, the European Medicines Agency for Europe and the French Haute Autorité de Santé. Transcranial focused ultrasound stimulation, botulinum toxin injection devices, subcutaneous implants for prolonged psychotropic drugs delivery, infusion and intranasal therapies (Ketamine, Brexanolone) are among the most innovative interventional techniques that have been developed in the last few years. A growing use and demand for interventional approaches in clinical practice has led to individualization and labeling of ‘Interventional Psychiatry Centers’ in many countries, including the United States, Canada, Australia, Germany and Switzerland. Hereby, we strongly support the development and implementation of the ‘Interventional Psychiatry’ label for units that offer a range of services and expertise about these treatment options. We posit that the use of this umbrella term will lead to two following advances.

First is stigma and misinformation reduction around interventional approaches with a special focus on neuromodulation techniques. Despite safe and ethical practice frameworks, these techniques continue to be stigmatized resulting in restriction and reduced accessibility. As an example, the name of electroconvulsive therapy has been demonstrated as having itself an impact on both its acceptability and effectiveness (Andrade and Thyagarajan, 2007). Systematization of the ‘Interventional Psychiatry’ label would better meet the challenges of the underutilization of interventional – stigmatized – techniques by moving closer to the general, less-stigmatized, framework of interventional medicine. This is likely to improve the credibility and acceptability of interventional approaches in the eyes of patients, caregivers and health workers.

Second, the use of interventional psychiatry umbrella term might lead to harmonized improvement of interventional psychiatric practice to a level of innovation and excellence that is recognized internationally. In this perspective, specialty tracks in interventional psychiatry including both neuroscience didactics and hands-on experiences must be generalized within residency curricula. Currently, most psychiatrists who use interventional techniques are trained in a very inconsistent manner. Few programs exist, but to our knowledge, such training is not mandatory to practice this subspecialty. Generalizing these programs will facilitate the identification of highly specialized practitioners, the implementations and visibility of specific Intervention Psychiatry Units and resources, and promote better improvement of interventional techniques (Nikayin et al., 2022).