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Executive Order 14401
Accelerating Medical Treatments for Serious Mental Illness
Signed April 18, 2026, printed at 91 FR 21709. 5 sections of substance, 1,056 words.
This order is about serious mental illness. It speeds up review of some new drugs. That includes psychedelic drugs in trials.
Sec. 1. Purpose and Policy
Policymakers and the medical field have long struggled to address the burden of suicide and serious mental illness rates in America. Today, over 14 million American adults have a serious mental illness, defined as having a diagnosable mental, behavioral, or emotional disorder that substantially interferes with a person's life and ability to function, and about 8 million are on prescription medication for these conditions. Suicide rates tragically increased by 37 percent from 2000 to 2018. During my first term, we made historic progress in helping those struggling with some of the most insidious mental illnesses, and suicide rates decreased by 5 percent from 2018 to 2020. The COVID-19 pandemic and the Biden Administration's prolonged shutdown stunted this progress and suicide rates rebounded upwards again to their peak rate in 2022. Critically, veterans often suffer in greater measure
Policymakers and the medical field have long struggled to address the burden of suicide and serious mental illness rates in America. Today, over 14 million American adults have a serious mental illness, defined as having a diagnosable mental, behavioral, or emotional disorder that substantially interferes with a person's life and ability to function, and about 8 million are on prescription medication for these conditions. Suicide rates tragically increased by 37 percent from 2000 to 2018. During my first term, we made historic progress in helping those struggling with some of the most insidious mental illnesses, and suicide rates decreased by 5 percent from 2018 to 2020. The COVID-19 pandemic and the Biden Administration's prolonged shutdown stunted this progress and suicide rates rebounded upwards again to their peak rate in 2022. Critically, veterans often suffer in greater measure
This states the case the order makes. It says suicide and serious mental illness remain a heavy burden. It counts over 14 million adults with such an illness. It says about 8 million take medicine for it. It says suicide rose 37 percent from 2000 to 2018. It says the rate fell 5 percent to 2020. It says it rose again by 2022.
Sec. 2. FDA Review Prioritization and Right to Try
(a) The Commissioner of Food and Drugs shall provide Commissioner's National Priority Vouchers to appropriate psychedelic drugs that have received a Breakthrough Therapy designation and are in accordance with the criteria of the National Priority Voucher Program. (b) The FDA and Drug Enforcement Administration shall facilitate and establish a pathway for eligible patients to access psychedelic drugs, including ibogaine compounds, under the Right to Try Act (21 U.S.C. 360bbb-0a), including any necessary Schedule I handling authorizations for treating physicians and researchers, consistent with 21 U.S.C. 823, and any applicable waiver authority under the Controlled Substances Act.
(a) The Commissioner of Food and Drugs shall provide Commissioner's National Priority Vouchers to appropriate psychedelic drugs that have received a Breakthrough Therapy designation and are in accordance with the criteria of the National Priority Voucher Program. (b) The FDA and Drug Enforcement Administration shall facilitate and establish a pathway for eligible patients to access psychedelic drugs, including ibogaine compounds, under the Right to Try Act (21 U.S.C. 360bbb-0a), including any necessary Schedule I handling authorizations for treating physicians and researchers, consistent with 21 U.S.C. 823, and any applicable waiver authority under the Controlled Substances Act.
This speeds review of psychedelic drugs. The drug agency must grant priority vouchers. Only drugs with a breakthrough label qualify. A voucher program sets the tests. The drug agency and the drug enforcement agency must open a path for patients. A right to try law allows that. Doctors may need special clearance. The law provides for it.
Sec. 3.
Department of Health and Human Services Funding for Federal-State Collaboration. The Secretary of Health and Human Services shall, [[Page 21710]] through the Advanced Research Projects Agency for Health, allocate at least $50 million from existing funds to support and partner with State governments that have enacted or are developing programs to advance psychedelic drugs for serious mental illnesses, including through Federal funding, technical assistance, and data sharing as appropriate and consistent with applicable law.
Department of Health and Human Services Funding for Federal-State Collaboration. The Secretary of Health and Human Services shall, [[Page 21710]] through the Advanced Research Projects Agency for Health, allocate at least $50 million from existing funds to support and partner with State governments that have enacted or are developing programs to advance psychedelic drugs for serious mental illnesses, including through Federal funding, technical assistance, and data sharing as appropriate and consistent with applicable law.
This puts money behind the work. The health secretary must act. A research agency inside it does the work. At least $50 million comes from funds on hand. It goes to states with such programs. States building one qualify too. Federal money is one form of help. Technical advice is another. So is sharing data.
Sec. 4.
Department of Health and Human Services and FDA Collaboration with the Department of Veterans Affairs and the Private Sector. The Department of Health and Human Services (HHS) and FDA shall collaborate with the Department of Veterans Affairs (VA) and, as appropriate and consistent with applicable law, including any privacy restrictions from the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996, with the private sector, to increase clinical trial participation, data sharing, and real-world evidence generation regarding psychedelic drugs, and shall prioritize drugs that have received a Breakthrough Therapy designation. The HHS, FDA, and VA are directed to sign data-sharing memoranda as appropriate to ensure that data from relevant clinical studies conducted by other executive departments and agencies is made available to FDA to facilitate the timely
Department of Health and Human Services and FDA Collaboration with the Department of Veterans Affairs and the Private Sector. The Department of Health and Human Services (HHS) and FDA shall collaborate with the Department of Veterans Affairs (VA) and, as appropriate and consistent with applicable law, including any privacy restrictions from the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996, with the private sector, to increase clinical trial participation, data sharing, and real-world evidence generation regarding psychedelic drugs, and shall prioritize drugs that have received a Breakthrough Therapy designation. The HHS, FDA, and VA are directed to sign data-sharing memoranda as appropriate to ensure that data from relevant clinical studies conducted by other executive departments and agencies is made available to FDA to facilitate the timely
This links the agencies. The health department and the drug agency must work with Veterans Affairs. Private firms may take part. Privacy laws still hold. The aim is more people in trials. Data sharing is a second aim. Real world evidence is a third. Breakthrough drugs come first. The three must sign data sharing deals.
Sec. 5. Timely Rescheduling
The Attorney General shall, in consultation with HHS, initiate and complete review of any product containing a Schedule I substance that has successfully completed Phase 3 clinical trials for a serious mental health disorder, so that rescheduling, if appropriate under 21 U.S.C. 811, may proceed as quickly as practicable for such specific products that are ultimately approved under section 505 of the Federal Food, Drug, and Cosmetic Act.
The Attorney General shall, in consultation with HHS, initiate and complete review of any product containing a Schedule I substance that has successfully completed Phase 3 clinical trials for a serious mental health disorder, so that rescheduling, if appropriate under 21 U.S.C. 811, may proceed as quickly as practicable for such specific products that are ultimately approved under section 505 of the Federal Food, Drug, and Cosmetic Act.
This covers moving a drug to a lower schedule. Justice must review such products. The health department is consulted. Only drugs that passed late stage trials qualify. The illness treated must be serious. A drug law sets the process. The review must be quick. It applies to drugs the agency finally approves.
Sec. 6. General Provisions
Every order carries this. It is not what the order does.
(a) Nothing in this order shall be construed to impair or otherwise affect: (i) the authority granted by law to an executive department or agency, or the head thereof; or (ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals. (b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations. (c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. [[Page 21711]] (d) The costs for publication of this order shall be borne by the Department of Health and Human Services. <GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT> (Presidential Sig.) THE WHITE
(a) Nothing in this order shall be construed to impair or otherwise affect: (i) the authority granted by law to an executive department or agency, or the head thereof; or (ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals. (b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations. (c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. [[Page 21711]] (d) The costs for publication of this order shall be borne by the Department of Health and Human Services. <GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT> (Presidential Sig.) THE WHITE
This is the closing clause that nearly every order carries. It says the order does not change what the law already allows. It also says no one can sue to enforce it.
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