How hospital leaders view psychedelics

No, you’re not tripping. Psychedelics news has been everywhere lately.

Psilocybin (magic mushrooms) is being tested for treatment-resistant depression (TRD), LSD is being studied for generalized anxiety disorder, and MDMA is in clinical trials as a PTSD treatment.

Major academic medical centers, like Mass General Brigham (MGB) and Chicago-based Rush University System for Health, are among those leading research to find new treatments for hard-to-treat mental health conditions. According to the National Institute for Health’s clinical trials database, between 2005 and 2025, there were 430 unique trials registered for psychedelics research, but nearly 88% started in or after 2019, when interest sharply increased in the field.

TRD patients are associated with more healthcare resource use and higher care costs. A 2021 retrospective study found that commercially insured patients with certain chronic pain conditions and a TRD diagnosis had higher healthcare use: an annual average of $6,300 more per patient a year compared to those with the same conditions who responded to treatments.

Beyond the economic aspect, though, physicians also recognize how “frustrating and a bit demoralizing” it can be for patients when typical treatments don’t work, Joshua Eloge, associate director of the Women’s Board Depression Treatment Research Center at Rush University Medical Center and assistant professor of psychiatry, told Healthcare Brew. Mental health is a public health issue and psychedelics could help alleviate some conditions, he added, while also helping hospitals stand out as innovative research centers with cutting-edge treatments.

“There’s something really important about leading into a new phase of treatment and having that available to patients,” Eloge said.

How do hospitals approach psychedelic research?

Taking psychedelics as treatment requires medical supervision throughout the entire process since patients may experience physical health effects, like increases in blood pressure or heart rate. Patients need to be screened to make sure they meet certain benchmarks before participation, too, Eloge said.

Psychedelics can give patients intense experiences that can be “distressing,” he added.

A study published in the Canadian Medical Association Journal last year found an association between bad trips outside of trials and early mortality. So during trials, the patients work with psychotherapists to discuss their mental health and goals leading up to and during treatment to address issues that may come up during dosing, such as physical and emotional effects, Eloge said.

How do hospital leaders receive support from their institution for psychedelic research?

Rush has researched how a drug based on psilocin (which is the psychoactive compound in psilocybin that causes hallucinations) and other psychedelic treatments can treat depression, including in patients who are treatment resistant. The system’s researchers didn’t face “significant institutional resistance” to conduct their late-stage trials testing psychedelics with TRD patients, Eloge said. The bigger challenge was navigating the federal regulations, like which DEA forms to submit.

Hospitals and universities receive financial investment from the federal government and private sources. Johns Hopkins Medicine, for example, has $55 million in public and private funds to research psychedelics, and in 2021, received the first NIH grant in over 50 years to investigate the therapeutic effects of a classic psychedelic.

Otherwise, researching novel treatments is an academic medical center’s bread and butter.

“On the medical side, there’s a strong argument to be made” for testing psychedelics in patients with TRD to improve access to care and advance public health, Eloge said. There’s also an argument from an institutional perspective, he added, as a hospital can stand out as one that can provide “cutting-edge treatment and research to patients” and therefore become a more desirable medical provider.

How are hospital leaders innovating in psychedelics?

Jerrold Rosenbaum, director of the Center for the Neuroscience of Psychedelics at MGB, is overseeing translational research in psychedelics, which examines how the therapies work in the brain and if non-psychedelic molecules can lead to similar results.

The health system has a “medicinal plant lab” and rooftop greenhouse space where researchers study plants with an ethnobotanical history “that suggests some potential for altered consciousness or psychedelic-adjacent or psychedelic-like properties,” Rosenbaum said. Ethnobotany looks at how communities of different cultures and areas use indigenous plants for medicines, food, and rituals.

“We’re not looking to try to find the same molecules that others are focused on. We’re hoping to find new compounds that might either give us novel mechanisms of action or novel structures to build upon for potential new treatments,” Rosenbaum, who is also professor of psychiatry at Harvard Medical School, said.

Dell Medical School at the University of Texas at Austin and Arizona State University’s Barrow Neurological Institute are also researching novel therapies like ibogaine, a plant-based drug that, when combined with magnesium, has been shown to safely help veterans with brain injuries and PTSD.

This idea of studying potentially new treatments, compared to existing psychedelics, is that even if some existing psychedelics-based therapies make their way through FDA approval, they won’t be perfect and can always be improved, Rosenbaum said. For example, the treatments that require monitoring for hours and working with hospital psychotherapists, like what Rush researchers are working on, limit where and how they can be used.

“You really only can treat so many people if you have to tie up a whole clinical room or office for a day with one or two people monitoring a patient,” Rosenbaum said. He added that in the future, acute efficacy could improve and that the treatments could become less disruptive. At some point, he hopes they can be taken as “regular medicine” at home rather than a supervised procedure.

Where do we go from here?

While hospital leaders are optimistic about the potential of psychedelics, in mental health especially, antidepressants remain the gold standard for depression. Plus, there’s still a lot to learn about long-term effects and which patients benefit the most from them, Rosenbaum said.

“No psychedelic has been directly compared to other antidepressants,” he said. “We still have to be cautious about not getting too far out over our skis and saying these are miraculous.”