‘We’re experiencing a growing mental health crisis. We need more innovative solutions.’

Campaigners believe using psychedelic medicines – including magic mushrooms and MDMA – to treat mental illnesses could be life changing.

The statistics on mental health are shocking.

One in five Australian adults has a chronic mental illness, and nearly half of us will experience mental illness in our lifetimes.

On top of this, COVID-19 is having a further devastating impact. Statistics from Lifeline show it answered almost 90,000 calls for help in March, a 25 per cent increase over the same time last year – the equivalent of one call every 30 seconds.

Yet there are growing concerns that psychiatrists and psychologists lack the tools to help.

Despite record-breaking increases in prescription rates of psychiatric medications, rates of mental illness indicate that we’re losing the battle.

Tania de Jong AM, co-founder of charity Mind Medicine Australia, says current treatment options are unable to adequately address the “mental health tsunami” being created by the COVID crisis.

“It is a dire situation,” de Jong says. 

“We’re experiencing a growing mental health crisis, and the majority of people are not going to get better. 

“We owe it to those who are suffering to explore more innovative solutions.”

The promise of psychedelic medicines

Mind Medicine Australia believes one solution lies in psychedelic medicines.

The charity, founded in 2019 by de Jong and her husband Peter Hunt AM, is seeking to establish, safe, accessible and effective medicine-assisted psychotherapy in Australia for major mental illnesses.

The primary focus has been on the use of medicinal psilocybin (magic mushrooms) for depression and possibly OCD and addiction, and medicinal MDMA for post-traumatic stress disorder (PTSD).

de Jong, who is also the founder of charity Creativity Australia and social inclusion program With One Voice, says it is a “major paradigm-shifting opportunity in the treatment of mental illness”.

“The case for these medicines in a medically-controlled, therapeutic environment is extremely strong,” she says.

“We’re experiencing a growing mental health crisis, and the majority of people are not going to get better.”

Under current treatments, only around 35 per cent of people who suffer with depression experience remission from antidepressants or psychotherapy. The remission rates for PTSD are even lower.

With psychedelic-assisted therapy, de Jong says patients can experience a reduction in symptoms within a few sessions.

“These medicines are getting 60 to 80 per cent remissions after just two to three treatments in combination with therapy,” de Jong says.

“With the results we’re seeing, why wouldn’t we make these medicines available?”

It is important to be clear. Mind Medicine Australia does not advocate for recreational use. The focus is wholly clinical.

It has four key strategic pillars: education and awareness; ethical and legal frameworks to ensure access to medically approved therapy; therapist professional development program (it just launched the Southern Hemisphere’s first Certificate in Psychedelic Therapies); and the establishment of an Asia-Pacific Centre of Emerging Mental Health Therapies.

It’s part of a global resurgence of interest in psychedelic science.

There are over 120 current or recently completed clinical trials around the world, including Australia’s first clinical trial at St. Vincent’s Hospital in Melbourne.

In the US, the Food and Drug Administration granted psilocybin a “breakthrough therapy designation” in 2018 putting it on the fast track to getting approved and prompting hopes that it could be legal for therapy by 2021.

Earlier this month, Canada’s Health Minister Patty Hajdu granted permission for four terminally-ill Canadians to consume psychedelic drugs. 

But while there is growing support, psychedelics remain out of reach for patients in Australia.

‘An interesting quandary’

Psychiatrist Dr Al Griskaitis, who works with depression, anxiety disorders and occupational PTSD and is the co-founder of the PSYCH collective, blames bureaucratic inertia.

He has been working with one patient with severe PTSD for around three years, who has tried “every conceivable treatment under the sun”, but remains extremely unwell.

Having seemingly reached the end of the road, Griskaitis approached the Therapeutic Goods Administration (TGA) through a special access scheme, seeking approval to use MDMA assisted therapy.

“And they approved the use of it, which as far as I know is an unprecedented move. So that was very exciting. I was overjoyed. My patient was optimistic,” he explains.

But they soon hit another hurdle. MDMA is considered a schedule nine drug. This means it is a prohibited substance, that has no medical use and is potentially harmful, in comparison to a schedule eight substance which is a controlled drug, that has a medical use.

“New South Wales Health has told me there is no provision for anyone to use a schedule nine item in New South Wales, unless it is in a research context,” Griskaitis says.

If the patient was in Victoria they could proceed as Victoria does not have this legal impediment. Griskaitis says it presents an interesting quandary.

“The TGA has said yes you can use it for your patient but New South Wales Health has no provision for that. The law is tying their hands,” he says.

“So, even with approval, I’m not in a position where I can legally prescribe it for my patient, until there is a change which is going to require a thousand committees.”

Mind Medicine Australia is currently putting in rescheduling applications for MDMA and psilocybin – the first step in making these treatments available to patients.

Griskaitis said it remains extremely frustrating that there is a viable treatment – that the TGA has approved – but the legal framework prevents him prescribing.

A matter of urgency

He says while there can’t be a free-for-all on people using psychedelics and there should be adequate gatekeeping, he believes MDMA could have life changing consequences for people who are resistant to other treatments.

“I think we could really move the needle on the suicide rate,” Griskaitis says.

“I see so many veterans and patients with PTSD, it is a lot of my practice. They’re getting all the treatments, they’re just not working. The suffering is extreme.”

For some patients, moving through the stages of PTSD recovery can be incredibly difficult, if not impossible.

“When you get people to disclose their trauma narratives it is like reliving the trauma, it is devastating,” Griskaitis says.

“What happens with the MDMA is that that process happens without all the retraumatization.”

He worries that if MDMA is not made legally available, the risk is that people will go underground.

“There are patients out there who can’t wait that long. That’s the thing we all need to bear in mind.”

“People are desperate out there. If the choice is suicide, why wouldn’t you?” he says.

de Jong agrees. She says it is forcing people to take risks that don’t necessarily need to be taken.

“We get heartbreaking emails every day with people begging us to help them get access to these treatments,” she says. 

“At the end of the day, most people don’t want to break the law and there is no quality control of the underground. But the longer that it takes for these treatments to be available above ground, the more people will go underground and search them out.”

With the mental toll associated with COVID only making things worse, she says it is a matter of urgency.

“There are patients out there who can’t wait that long. That’s the thing we all need to bear in mind,” she says. 

“If there are treatments that can heal people that are available now, then we need to run and not walk to them, because the level of suffering in the community is profound.”