People with depression who use psilocybin are not abandoning conventional mental health treatment, according to a new analysis published in the journal Psychological Medicine by researchers at UC San Diego School of Medicine, UCLA and New York University. The finding pushes back on a common worry among clinicians: that interest in psychedelics, fueled by splashy headlines about clinical-trial results, might lead people to self-treat instead of seeking professional help.
The team, led by UC San Diego medical student Avery Eun, analyzed the 2024 National Survey on Drug Use and Health — the first version of the federal survey to ask specifically how recently respondents had used psilocybin, rather than just whether they ever had. Among 6,793 survey respondents who reported a past-year major depressive episode, 7.3% said they had also used psilocybin in the past year. Comparing that group with non-users, the researchers found psilocybin use was not associated with lower rates of outpatient therapy, inpatient care, telehealth visits or use of antidepressant medications.
A gap in unmet need
One difference did stand out: people with depression who used psilocybin reported a perceived unmet need for mental health treatment at a much higher rate — 52.0%, compared with 33.9% among those who hadn't used it. Psilocybin users in the sample were also more likely to be younger, male, never married and employed full-time.
Those using psilocybin aren't abandoning conventional mental health care, which is good news.
Avery Eun, lead author, via UC San Diego Today
Eun said the unmet-need gap could be useful clinically rather than alarming: "providers can use this as a way to start a conversation about the motivations for use," she said, suggesting it may signal people who feel underserved by existing treatment options rather than people rejecting treatment altogether.
The study's authors are careful to note its limits. The data are cross-sectional and self-reported, so the analysis cannot establish whether unmet need drives people toward psilocybin, or the reverse, or some other factor explains both. It's also a different picture from the controlled, FDA-regulated trials of psilocybin-assisted therapy for depression now underway at UC San Diego and elsewhere, which pair the compound with trained clinicians, screening and structured psychological support — safeguards absent from the naturalistic, self-directed use the survey captured. The study was funded by two National Institute on Drug Abuse grants; one co-author disclosed past consulting work for a federal drug-enforcement program.
About 2.8% of the U.S. population age 12 and older — roughly 8 million people — reported past-year psilocybin use in the same 2024 survey, researchers have separately estimated, even as the mushroom-derived compound remains a federally controlled substance outside a small number of state decriminalization measures and clinical-trial settings. The authors argue their findings support continued research into both the therapeutic potential of psilocybin and policies, such as decriminalization, that could reduce stigma and encourage people to disclose use to their doctors.
