Amid magic and menace: psychiatrists’ attitudes to psilocybin therapy

A survey of 151 psychiatrists in Ireland found that most hold positive attitudes toward psilocybin therapy: 81.5% agreed it shows promise for treating psychiatric disorders, 86.8% supported funding research, 86.8% would refer a patient if licensed, and 78.1% would consider it for themselves. However, only 40.0% felt knowledgeable and just 9.9% felt adequately prepared to participate. A minority expressed concerns: 6.6% thought it unsafe under medical supervision, 21.9% considered it potentially addictive, and 15.9% reported at least one concern about evidence, effectiveness, safety, cost, or impartiality. Consultant psychiatrists were less optimistic than trainees about its role in bipolar depression and emotionally unstable personality disorder.

Study at a glance

Abstract

Abstract Objectives: Understanding variations in knowledge and attitudes of psychiatrists to psilocybin therapy is important for the collective discourse about the potential impact on clinical practice and public health in Ireland. Methods: A 28-item questionnaire was designed based on previous studies and distributed to psychiatrists in Ireland via online mailing lists and at in-person academic events. Results: 151 psychiatrists completed the questionnaire (73.3% were under 40 years of age, 76.0% were trainees, and 49.0% were female). In the total sample, 81.5% agreed that psilocybin therapy shows promise in the treatment of psychiatric disorders and 86.8% supported funding research, 86.8% would be willing to refer a patient if it was licensed and indicated, and 78.1% would consider the treatment for themselves, if indicated. Conversely, 6.6% agreed that psilocybin therapy was unsafe even under medical supervision, and 21.9% thought it was potentially addictive. 15.9% of the total sample reported at least one concern including, lack of robust evidence, long-term effectiveness, superiority to current interventions, potential harmful effects, cost and accessibility, and impartiality. Less than half of respondents felt knowledgeable (40.0%) and 9.9% felt adequately prepared to participate in psilocybin therapy. Consultant psychiatrists trended towards less optimism for a potential role in bipolar depression and emotionally unstable personality disorder compared to trainee psychiatrists. Conclusion: Overall psychiatrists in Ireland held positive attitudes towards psilocybin therapy. However, there was a lack of knowledge evident. Addressing the knowledge gap and aligning with the best available evidence will be key if psychedelic therapy is to prevail in a clinical setting.