Patient and facilitator safety will be top of mind for Colorado mental health professionals when the state begins to distribute psilocybin next year. Stakeholders considered ways to address that last week.
Mental Health Colorado and the Healing Advocacy Fund hosted the final session of a webinar series detailing the impact of psilocybin legalization in the state. Nearly 1.3 million residents voted affirmatively for Proposition 122 in 2022. Colorado is the second state in the nation to approve a state-regulated program for legal access to psilocybin therapies.
“Coloradans deserve more tools to address mental health issues, including approaches such as natural medicines that are grounded in treatment, recovery, health, and wellness rather than criminalization, suffering, and punishment,” Mental Health Colorado CEO Vincent Atchity said.
Colorado is in the process of developing rules for the rollout of its psilocybin program, which is slated to launch in 2025. Those involved are benefitting from being able to learn from Oregon’s implementation process in rolling out its psilocybin program. Oregon passed Measure 109 in 2020, which created a state-regulated therapeutic model for access to psilocybin.
Dr. Seth Mehr is a licensed psilocybin facilitator in Oregon, and serves as the director of health and safety at InnerTrek’s psilocybin service center. He said clients are required to fill out intake forms for screening and safety assessments. Intake form questions ask about a client’s medical history and any medications they take.
“I’ll engage directly with the clients, as well as their providers or specialists, and ultimately (provide) the service center with a safety risk assessment,” Mehr said. “And then ultimately it’s the service center’s decision to either offer or decline services to a client.”
Mehr said it is quite common to see clients list two or three psychiatric medications on their intake forms, but that does not necessarily disqualify them for services.
“Their intake form says, ‘Don’t worry, I’m going to stop all of them before the session,’” Mehr said. “And that may not be necessary. There may be more risk by (them) running into withdrawal symptoms, or destabilizing a condition that (medications) are being used to treat.”
InnerTrek denies services to some clients for reasons that include suicide risk, family history, mental health disorders, heart issues, or consumption of certain medications, Mehr said.
“I think right now our denial rate is (at) about five percent of applicants who we don’t feel (are) safe enough to offer services to. We’re trying to find this balance of providing access to this service we feel has potential to help many people who are suffering, but to minimize the risk to the clients, the service center, and our collective movement as a whole to set this up for sustainability.”
— Mehr
Clients also have the option to call a helpline if they don’t feel safe in their experience, or just need someone to talk to. Vanessa Cruz is a supervisor for Fireside Project, a psychedelic support line (62-FIRESIDE) that provides emotional support during and after psychedelic experiences.
“Fireside is a national peer support line available to any individual that is actively within a psychedelic experience or looking to recreate a previous psychedelic experience,” Cruz said. “We have a group of volunteers that will support individuals that call in. This line works to support people in educating them on how to navigate these experiences, offering comfort measures or suggestions on ways they can navigate some challenging experiences. And also just (be) with people as they move through their journey.”
Sometimes people aren’t prepared for certain elements of a psychedelic experience, Cruz said.
“Sometimes it’s very introspective, and can produce some anxiety at times,” she said. “So just knowing that there’s somebody on the other side of the line they can speak to and hold space with will be reasons why people call.”
Healing Advocacy Fund Executive Director Tasia Poinsatte noted that those looking to become licensed psilocybin facilitators in Colorado will want to keep Fireside in mind as they work with clients.
“It’s important to know that Fireside exists, especially for those of you who are thinking of becoming licensed facilitators or somehow working in this realm. We see it as an additional support. Sometimes somebody’s just struggling and they just need someone to talk to. And the folks on the Fireside line have training to show up compassionately to be there for that person in their moment of need. And it’s free.”
— Poinsatte
U.S. Army veteran Jesse Gould noted the importance of psilocybin treatment for veterans. After being deployed as an Army Ranger in Afghanistan three times, he founded the Heroic Hearts Project in 2017 to spearhead the acceptance and use of ayahuasca therapy to address the current mental health crisis among veterans.
Gould said he visited a psychedelic retreat in Peru to help with his mental health, and it saved his life. The Heroic Hearts Project provides access to psychedelic therapies for veterans, connecting them to services in countries where it is legal.
“More recently, we’ve been able to start work in Oregon and, hopefully soon, Colorado,” Gould said. “Which is super exciting for us because that is the future. What does the American psychedelic culture look like? How do we integrate this into our health systems, (and) make it accessible? That’s what we’re experimenting with, and we’ve already seen some amazing results around that community piece.”