By Anshul Rao.
Psychedelics have recently been gaining traction as alternative, potent therapies in a variety of mental health conditions. The enthusiasm regarding the effectiveness of these treatments is unmistakable. Researchers at Johns Hopkins found that participants had stable rates of response to the treatment and remission of symptoms throughout the follow-up period, with 75% response and 58% remission at 12 months with two doses of psilocybin. The FDA has already designated MDMA and psilocybin as breakthrough therapies, with possible approval of these treatments coming as soon as 2024. As regulatory agencies approach approval of clinical use of psychedelics, questions about the privileges assumed with their implementation become increasingly important in the pursuit of healthcare justice. Certain populations may be distrusting of new trials with the previously evaluated “recreational” psychedelics, so measures need to be taken to remove anti-drug sentiments within professional spheres.
The cultural stigma surrounding psychedelic substances is deeply rooted in societal perceptions, often stemming from historical narratives associated with counterculture movements, especially in the US. The Vietnam War and racial discrimination fueled counterculture movements to change the beliefs of mainstream culture and fight for freedom of expression. Psychedelics were thought to transform individuals and society, changing their metaphysical beliefs. Consequently, psychedelic therapies retain a dimension of going against social norms and promoting anti-work culture.
This stigma infiltrates professional spheres and creates a barrier to acceptance and integration of psychedelic therapies into mainstream mental health care. Mental health professionals, who are essential stakeholders in the successful implementation of these therapies, may be uncertain or resistant in the integration of these innovative approaches into established treatment paradigms. A pilot study was done to examine the attitudes and knowledge of NHS psychiatrists towards psychedelic-assisted psychotherapy, surveying 83 psychiatrists in one NHS mental health trust with questions examining awareness and perceptions around psychedelic therapies. A common theme found in the paper was the inherent biases towards psychedelics with a psychiatrist reporting “Recreational drugs obviously have a very bad name in psychiatry because it causes so many problems”. Psychiatrists were also skeptical themselves that the structures that supported their work environment (i.e. legislative, private funding) would subsidize implementation of psychedelic assisted psychotherapies. “The government is genuinely very reluctant to make any concessions on the use of any kind of psychedelics in any area of psychiatry medicine, they’re just so blinkered” and “I think it’s more the organisational barrier” represents psychiatrist’s suspicions from the study, exemplifying the effects of stigma in professional spheres. The literature shows a clear bias against psychedelics in mental health care professionals, which can prevent an effective, possibly life-changing treatment from getting into patients hands.
Psychedelic drugs need the support of trained and trusted mental health care professionals to advance to the clinic. The anti-psychedelic sentiment sewn throughout government structures and other institutions of society severely affects mental health care professionals. The severity of anti-psychedelic sentiment may vary from healthcare provider as well. A provider’s lack of knowledge of current research and outcomes concerning psychedelic research can lead to lower rates of referrals of patients for psychedelic therapies. Since providers play a more immediate role in a patient’s life than general research studies, it can be extrapolated that a higher level of trust would be inherent with a provider-patient relationship. With a trusting relationship, providers could more easily impose their biases toward psychedelic therapies, and influence their patients to be closed off to these potentially life changing treatments.
To address these challenges, researchers and institutions must adopt a proactive approach. Outreach programs that aim to destigmatize psychedelic therapies and provide accurate information to the public can help shift societal attitudes. Additionally, engaging in dialogue within professional circles to dispel myths and misinformation about psychedelic therapies can contribute to overcoming workplace and institutional resistance. Clarifying outcomes of research trials to patients and specifically increasing efforts to educate all levels of mental health care professionals will be instrumental in progressing the use of psychedelic treatments.
Author: Anshul Rao.
Affiliations: UC Santa Barbara
Competing interests: None declared