Why we need effective deimplementation strategies to reduce the costs by ineffective and potentially harmful therapies.

Abstract

The provision of unsupported, proven ineffective, and potentially harmful therapies is a persistent problem in mental health care. Multiple reasons at the provider, system/policy, and public levels can help explain why practitioners are drawn to use poorly supported and pseudoscientific treatments. The example of posttraumatic stress disorder demonstrates how past attempts to implement evidence-based practice have failed, underlining the limits of an overly strong focus on traditional implementation strategies. This continuing science-practice gap comes at a cost not only for the individual but also for society, thereby wasting valuable resources and reducing their public health impact. Proceeding in parallel with implementation efforts to increase access to well-supported treatment, implementation science must also develop and deploy deimplementation strategies to tackle this challenge. Deimplementation science studies methods to systematically remove non-evidence-based practices from routine clinical care. The longitudinal prescription practice trend for posttraumatic stress disorder medication showed the benefits of targeted deimplementation efforts (e.g., reducing medication overprescription), but there is less evidence for successfully deimplementing psychological therapies. To fill this research gap, we propose a potential deimplementation framework targeting low-value and inappropriate care. Prioritizing deimplementation (e.g., removing ineffective and harmful treatments) may prevent wasting resources in research and health care, thereby exerting a public health impact equally large as the uptake of evidence-based innovations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).