Should the NHS use magic mushrooms to treat mental health?

The debate about whether the NHS should embrace psychedelic substances, specifically magic mushrooms, to treat debilitating mental health conditions like depression is reaching a critical juncture. As groundbreaking research continues to unveil the potential therapeutic benefits of compounds such as psilocybin, the active ingredient in magic mushrooms, the medical community, regulators, and politicians are grappling with the complex ethical, scientific, and practical implications of integrating these once-demonized substances into mainstream healthcare.

By Pallab Ghosh, Science Correspondent

Larissa Hope, a former actress, firmly believes that psilocybin offered a lifeline during a profoundly challenging period in her mental health journey. At just 17, her burgeoning career, marked by a role in the popular TV drama Skins, inadvertently triggered deeply buried trauma. Despite trying conventional antidepressants, she found little relief. It was a single, carefully controlled dose of psilocybin, administered under strict clinical supervision, that she identifies as a pivotal moment in her recovery. She vividly recalls the profound emotional release: "When I experienced it, I burst out crying. It was the first time in my life I had ever felt a sense of belonging and safety in my body. I kept saying, ‘I’m home, I’m home’." Nearly two decades later, Larissa credits this experience, coupled with ongoing therapy, with helping her confront and ultimately overcome suicidal ideation. Her testimony stands as a powerful example of the transformative potential proponents attribute to psychedelic-assisted therapy.

However, not everyone shares such a positive narrative. Jules Evans, a university researcher, experienced a starkly different outcome from his first encounter with LSD at 18, albeit for recreational purposes. His trip quickly devolved into what he describes as a "deluded" and terrifying state. "I believed that everyone was talking about me, criticising me, judging me. I thought, I’ve permanently damaged myself; I’ve permanently lost my mind. It was the most terrifying experience of my life," he recounts. This harrowing experience left him with lingering social anxiety and panic attacks for years, eventually leading to a diagnosis of post-traumatic stress disorder (PTSD). Today, Evans channels his experience into positive action as the director of the Challenging Psychedelic Experiences Project, an initiative dedicated to supporting individuals who encounter difficulties after taking psychedelics. His work underscores the critical need to acknowledge and understand the potential adverse effects, which can range from transient distress to prolonged psychological suffering requiring medical intervention.

These two contrasting accounts – one of profound healing, the other of enduring trauma – encapsulate the core dilemma confronting doctors, regulators, and policymakers. The central question is whether, and under what conditions, medical professionals should be permitted to prescribe treatments involving magic mushrooms and other potentially therapeutic psychedelic drugs within a national health service like the NHS.

Magic Mushrooms and the Battle Against Depression

The renewed interest in psychedelics as a treatment for mental health has been fueled by a surge of new scientific studies. These investigations suggest that psychedelic drugs hold promise in treating a wide array of conditions, including various forms of depression, obsessive-compulsive disorder (OCD), PTSD, general trauma, and even severe addictions to substances like alcohol and gambling. Currently, the use of psychedelic medicine is strictly illegal outside of authorized research and clinical trials in the UK. Yet, since 2022 alone, over 20 such trials have been initiated, testing different psychedelic compounds for conditions ranging from major depressive disorder to various forms of addiction. While many of these studies have yielded promising results, suggesting genuine therapeutic efficacy, others have produced mixed or inconclusive findings. Crucially, only a handful have definitively shown no benefit on their primary outcome measures, maintaining a general sense of optimism within the research community.

A highly anticipated moment for the field is the imminent release of results from one of the largest clinical trials investigating psilocybin, conducted by the UK biotech firm Compass Pathways. These Phase 3 trial results are crucial, as the UK’s medicines regulator is keenly awaiting this data. Their decision will be pivotal in determining whether the current stringent restrictions on psychedelic medicine can be relaxed, potentially allowing its use beyond strictly controlled research environments and into broader clinical practice.

Professor Oliver Howes, chair of the Royal College of Psychiatrists’ Psychopharmacology Committee, expresses cautious optimism about the future of psychedelics. He views them as a "promising potential new treatment for psychiatric disorders," envisioning their eventual integration into NHS patient care. Professor Howes highlights the urgent need for innovative mental health treatments: "One of the key messages is that this is something we desperately need – more treatments and better treatments for mental health disorders… These treatments are really interesting because they’ve shown promise in these small-scale studies… and have the potential to work quicker." However, he tempers his enthusiasm with a crucial caveat, emphasizing the absolute necessity of robust trial data: "It’s really important that we get evidence and not overhype the potential benefits." This sentiment is echoed in a report published by the Royal College of Psychiatrists in September 2025, which explicitly warned of the potential dangers associated with psychedelics, reinforcing the medical consensus that taking these drugs outside of a supervised medical context is not only illegal but can also be harmful.

Faster Acting, Fewer Side Effects? A Historical Perspective

The use of psychoactive substances is deeply ingrained in human history, dating back to ancient civilizations that utilized magic mushrooms, opium, and cannabis for both recreational enjoyment and sacred rituals. The 1960s and 1970s saw a dramatic resurgence in the prominence of substances like LSD, or "acid," which became synonymous with the counterculture movement. Figures like Harvard psychologist and counterculture icon Timothy Leary famously exhorted young people to "turn on, tune in, drop out." This phrase encouraged individuals to "turn on" and awaken their inner potential through psychedelic experiences, "tune in" to the prevailing societal issues and consciousness around them, and "drop out" of conventional social norms and expectations.

However, this period of open experimentation was short-lived. Psychedelic drugs soon became inextricably linked with social unrest, perceived moral decline, and widespread public concern. By the late 1960s and early 1970s, these substances were systematically banned, and stringent restrictions were simultaneously imposed on scientific research into their therapeutic potential, effectively halting legitimate inquiry for decades.

A turning point arrived in the 2010s with the groundbreaking work of Professor David Nutt and his team at Imperial College London. Their pioneering scientific developments reignited the conversation, initiating a process that could ultimately lead to a paradigm shift in how these compounds are viewed and utilized. Subsequent clinical trials conducted on depressed patients offered compelling evidence that psilocybin could be at least as effective as conventional antidepressants, and potentially with fewer adverse side effects. Professor Nutt also highlighted another significant advantage: the remarkable speed of its action. "We thought rather than wait for eight weeks for antidepressants to switch off the part of the brain associated with depression, maybe psilocybin could switch it off in the space of a few minutes," he posited, referring to its ability to rapidly modulate brain networks, such as the default mode network, often implicated in rumination and depressive states.

While scientifically intriguing, this view has not been universally accepted without controversy. Professor Nutt, despite being a highly respected scientist, previously faced public scrutiny and was dismissed in 2009 from his role as chair of the government’s drugs advisory body, the Advisory Committee on the Misuse of Drugs. This dismissal, under the then Labour Home Secretary Alan Johnson, followed public comments – such as his assertion that there was "not much difference" in harm between horse-riding and ecstasy – which were deemed incompatible with his advisory position. This incident underscores the deeply sensitive and often politically charged nature of discussions surrounding drug policy and research. Nevertheless, Professor Nutt’s seminal studies served as a catalyst, sparking numerous additional investigations worldwide into the potential therapeutic benefits of other psychedelic compounds.

Should Psychedelic Therapies Really Be Available on the NHS?

At University College London, neuroscientist Dr. Ravi Das is at the forefront of research aiming to unravel the mechanisms behind addiction and how habits solidify. He believes psychedelics could offer crucial insights and potential solutions. His current study is recruiting heavy drinkers to investigate whether dimethyltryptamine (DMT), a potent, short-acting psychedelic also known for its recreational use, can effectively target the brain’s memory and learning systems. This research builds upon existing evidence suggesting that psilocybin has the capacity to disrupt entrenched habitual behaviors linked to addiction. Dr. Das explains the neurobiological basis: "Every time someone drinks, a bit like Pavlov’s dog, you’re learning to associate things in the environment with the rewarding effect of alcohol. We’ve been focusing on whether certain drugs, such as psychedelics, can break down those associations."

While this remains a very early-stage study, its ultimate objective, assuming successful future trials and regulatory approval, is to pave the way for such treatments to be offered within the NHS. Dr. Das passionately advocates for equitable access: "If psychedelic therapies prove to be both safe and more effective than current treatments, I would hope to see them made accessible via the NHS – rather than to just the privileged few who can afford them privately."

The legal landscape for psychedelics in the UK is complex. Ketamine, which Dr. Das previously studied, occupies a different legal category and is already permitted for certain medical treatments. However, other potent psychedelics such as DMT, LSD, psilocybin, and MDMA are currently classified as having no legitimate medical use, placing them under the strictest controls (Schedule 1). This classification means they can only be used for research purposes, and even then, under extremely strict and notoriously difficult-to-obtain medical licenses. Dr. Das remains hopeful that a growing body of positive scientific evidence will compel the government to reconsider these classifications. "I hope if there’s sufficient evidence, the government will be open to revising the scheduling of these drugs," he states.

However, not all academics are convinced of a straightforward path to widespread adoption. An analysis published in the British Medical Journal in November 2024 by PhD student Cédric Lemarchand and his colleagues raised important questions about the challenges of precisely determining the effects of psychedelic drugs. They highlighted a significant methodological hurdle: "Because hallucinogens are often combined with a psychotherapy component, it is difficult to separate the effects of the drug from the therapeutic context, complicating comprehensive evaluations and product labelling." The analysis also warned that short-term trials might not adequately detect "the potential for harm and serious adverse events from long-term use of hallucinogens… The potential for abuse or misuse must also be considered." Lemarchand’s team called for greater scrutiny from medical journals, urging them to "appraise the evidence more critically, fully account for limitations, avoid spin and unsubstantiated claims, and correct the record when needed."

‘People Are Suffering… It’s a Moral Failing’

Despite the growing research suggesting therapeutic benefits, caution remains paramount among many medical professionals. Professor Howes firmly believes that, with the exception of ketamine (which has already undergone regulatory assessment), psychedelic treatments should not become routine medical practice in the UK outside of controlled research settings. This stance will hold until larger, more rigorous trials can provide more robust evidence of both their safety and effectiveness. He issues a stark warning about unsupervised use: "In a clinical trial setting, it’s very carefully evaluated. If people take these on their own or in a backstreet clinic, then there is no guarantee of that, and the safety issues start becoming a major issue."

His concerns are substantiated by data collected by the Challenging Psychedelic Experiences Project. Their findings indicate that 52% of respondents who regularly use psychedelic drugs reported experiencing an intensely challenging psychedelic trip. Alarmingly, 39% of these individuals considered it "one of the five most difficult experiences of their life." Furthermore, 6.7% reported contemplating self-harm or harming others following a challenging experience, and 8.9% stated they were "impaired" for more than a day after a difficult trip. Mr. Evans notes that some individuals required medical or psychiatric assistance and continued to feel worse for weeks, months, or even years after their adverse experience. "Ideally, I would love doctors and regulators to know more about these adverse effects, and how people can recover from them, before they say any of these therapies are safe," he argues, emphasizing the need for comprehensive understanding of both the benefits and risks.

However, proponents like Professor Nutt, Professor Howes, and Dr. Das argue that the slow pace of progress in bringing these therapies to the clinic is largely due to the formidable bureaucratic hurdles involved in obtaining permission for medically supervised clinical trials. Professor Nutt, a passionate advocate, states unequivocally: "There are so many people suffering unnecessarily. And some of them are dying, because of the unreasonable barriers to research and treatment that we face in this country. It is, in my view, a moral failing." He draws parallels with medical cannabis, which became largely available through the private sector, stressing: "When these medicines are proven to be safe and effective, I think it is vital they are made available through the NHS to all who need them, not limited to the private sector, as happened with medical cannabis." Professor Howes, while urging caution, echoes this sentiment, highlighting the significant barriers to research and calling on the government to review regulations, as they lead to "long delays" in developing desperately needed new treatments.

The Advisory Council on the Misuse of Drugs maintains a firm stance that Schedule 1 drugs "contain those of no medicinal value," warranting the tightest controls. Ministers, too, link the Home Office licensing regime directly to public protection. Yet, the government has shown some willingness to adapt, backing plans to ease licensing requirements for certain clinical trials that have been approved by the Medicines and Healthcare products Regulatory Agency (MHRA) and Health Research Authority. Work is currently underway to implement exemptions for specific universities and NHS sites, with a cross-government working group coordinating a cautious rollout, pending the results of pilot projects. Despite these steps, some doctors, including Professor Howes, feel the changes are moving "painfully slowly," indicating a persistent struggle against bureaucratic inertia.

Supporters of psychedelic medicines hold out hope that the upcoming Phase 3 trial results from Compass Pathways will be a game-changer, leading to further relaxations, at least in research regulations. Larissa Hope, whose life was profoundly impacted by psilocybin, firmly believes in the importance of these ongoing trials. Her experience, she says, offered crucial insights into her past suicidal ideation and trauma. "I had a solid plan to end my life. Then suddenly, death wasn’t the only way," she reflects. "Under psilocybin, my nervous system began, for the first time, to recognise what peace felt like." Her powerful testimony serves as a poignant reminder of the potential for relief that many hope these emerging therapies could offer within the NHS.

Top Image Credit: Getty Images

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