Therapeutic Potential and Policy Barriers: Lived Experience Perspectives on Psilocybin from Licensed Mental Health Professionals

Background and Purpose: Research indicates that psilocybin can significantly reduce symptoms of treatment-resistant depression, PTSD, anxiety, and substance use disorders (Carhart-Harris et al., 2017). Despite its therapeutic potential, psilocybin remains classified as a Schedule I substance federally, which severely restricts access, clinical use, and public awareness. This disconnect among research, policy, and practice perpetuates stigma and creates systemic barriers, particularly affecting marginalized communities (Thrul & Garcia-Romeu, A., 2021). Positioned at the crossroads of clinical practice and policy advocacy, social workers play a crucial role in addressing these disparities. This study explored how licensed mental health professionals (MHPs) with lived experience of psilocybin use understand its clinical value and the need for integrative, justice-informed policy change. It also examines how current drug scheduling contradicts emerging science and community needs, and considers how incorporating psilocybin-assisted therapy into mental health policy could drive transformative change and help dismantle long-standing injustices.

Methods: This qualitative study used Interpretative Phenomenological Analysis (IPA) to explore the insights of eight U.S.-licensed MHPs regarding their personal psilocybin experiences. Participants were selected through purposive sampling and included five LCSWs, two LPCs, and one PMHNP. The sample consisted of seven females and one male, with five identifying as white and three as Latino/a practicing in California, Colorado, Florida, and Illinois. Data were collected from March to September 2024 through 60–90-minute semi-structured Zoom interviews. A reflexive thematic analysis allowed codes and themes to emerge organically without reliance on pre-existing frameworks. This inductive process facilitated a deep exploration of participants’ clinical, ethical, and cultural reflections. Analysis was informed by Shankar’s (2010) Integrative Medical Framework, which emphasizes whole-person care by blending conventional and alternative healing approaches.

Results: Three overarching themes emerged. (1) Therapeutic Impact: Participants described an increased sense of resilience, self-confidence, psychological well-being, and stronger connections with themselves and others. Many also reported reductions in fear and anxiety, and improvements in personal relationships, viewing psilocybin not only as a therapeutic tool but as a catalyst for long-term emotional growth. (2) Systemic Barriers: Participants identified stigma, Schedule I classification, and lack of access for marginalized populations as key obstacles. They emphasized that criminalization continues to block safe and legal therapeutic use. (3) Policy and Practice Misalignment: There was a strong consensus that current drug policy is out of step with clinical realities. Participants called for policy reform to reflect emerging evidence and to include protections for Indigenous healing practices and community-led models of care.

Conclusions/Implications: This study reveals a growing disconnect between outdated mental health policy and the evolving realities of therapeutic practice (Kargbo,2023). Psilocybin’s healing potential calls for thoughtful integration into clinical care, grounded in ethics and cultural humility. The current policy momentum, or “window,” opens up a critical opportunity for social workers to lead by advocating for evidence-informed policy, expanding equitable access to integrative care, and dismantling stigma. Our findings contribute to a transformative vision for mental health—one that aligns with SSWR’s 2026 theme by bridging research, policy, and practice to reimagine what healing can look like across communities.