“Access to a substance without access to a therapeutic container is not comprehensive mental health care.”
By Melissa Scannell, Indiana Psychedelic Society
For years, veterans living with post-traumatic stress disorder (PTSD) have been asked to keep trying within a mental health system that too often offers symptom management without lasting relief. Many benefit from existing treatments, and those treatments remain essential. But others cycle through medications and therapies while still carrying nightmares, hypervigilance, depression, isolation and a nervous system that cannot recognize that the danger has ended.
The Trump administration’s decision to accelerate psychedelic research and expand pathways toward treatment represents a meaningful shift. In April, President Donald Trump signed an executive order directing federal agencies to reduce barriers to research and speed the evaluation of psychedelic therapies for serious mental illness. The order included a $50 million federal commitment to ibogaine research and called for greater coordination among the Department of Veterans Affairs (VA), Department of Health and Human Services (HHS) and Food and Drug Administration (FDA).
That direction is already becoming action.
VA launched an MDMA-assisted therapy trial for veterans with PTSD and alcohol use disorder in May. It has also launched the PIVOT trial, which will study psilocybin for treatment-resistant depression in veterans, including those who also have PTSD. In July, VA and HHS announced a five-year partnership to coordinate research, train clinicians and prepare the VA health system to implement psychedelic treatments that may ultimately receive FDA approval. VA reports involvement in 19 additional psychedelic clinical trials supported by more than $23 million in external funding.
This momentum deserves recognition. It is also important to be precise about what it means.
Psychedelics are not currently FDA-approved treatments for PTSD, and clinical access through the VA remains limited to research. The evidence is promising, not complete. Studies of MDMA-assisted therapy have shown significant reductions in PTSD symptoms, yet veteran representation in major trials has been limited. Psilocybin research for PTSD is even earlier. Ibogaine may hold potential for addiction and trauma-related conditions, while its cardiac risks make rigorous medical screening and monitoring especially important.
As a trauma therapist and psychedelic-assisted therapist, I have seen why hope around these treatments is growing. Psychedelics may temporarily reduce fear, loosen rigid patterns and help a person approach painful memories with greater openness or self-compassion. For someone whose survival system has been locked in place for years, that opening can be profound.
The medicine, however, is not the entire treatment. A psychedelic experience can surface grief, moral injury, traumatic memories, shame and parts of the self that a veteran has spent years trying to contain. Without careful preparation, skilled support and meaningful integration afterward, an intense experience may leave someone overwhelmed, confused or vulnerable. Access to a substance without access to a therapeutic container is not comprehensive mental health care.
Preparation helps veterans understand what may arise, establish trust with their care team and develop tools for navigating fear and dysregulation. The medicine session requires psychological safety and clinicians trained in both trauma and altered states of consciousness. Integration helps a person make sense of the experience and translate insight into daily life: repairing relationships, changing destructive patterns, reconnecting with purpose and learning how to live differently in the nervous system and in the world.
These elements also raise practical questions that policymakers must address now.
Who will train and supervise the workforce? Will treatment models be culturally responsive to the experiences of women, veterans of color, survivors of military sexual trauma and those living in rural communities? Will veterans taking psychiatric medications receive careful, individualized guidance rather than being pressured to discontinue them? Will VA reimburse the full course of care, including preparation and integration, or only the day a medicine is administered? And will veterans have ongoing support if difficult material emerges weeks later?
We must also resist turning understandable urgency into inflated promises. Calling psychedelics a cure or a miracle may encourage self-medication and expose vulnerable people to unregulated providers. Screening matters. Informed consent matters. Ethics, data collection and long-term follow-up matter. Veterans should not be forced to choose between the stagnation of the old system and the risks of a poorly built new one.
This issue should not belong to one political party. VA’s return to federally funded psychedelic research began before the current administration, and today’s expansion reflects years of work by veterans, researchers, clinicians and bipartisan lawmakers. That continuity is a strength. It creates an opportunity to build policy around evidence and human need rather than ideology.
America has asked veterans to carry experiences most civilians will never fully understand. We owe them more than gratitude, and more than another prescription. We owe them rigorous research, honest education and access to treatment that honors the complexity of trauma. The administration’s actions have opened an important door. Now federal leaders must ensure that what waits on the other side is not simply a drug, but a safe, ethical and fully supported pathway toward healing.
Melissa Scannell, MA, LMHC, LPC, LPCC, RMT, is a 20 plus year-licensed mental health counselor, trauma specialist and psychedelic-assisted therapist. She founded the Indiana Psychedelic Society and facilitates a free weekly psychedelic integration group.
Photo courtesy of Mark Groeneveld.
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