Implementing psilocybin-assisted therapy in palliative care settings: A survey of stakeholders

Background: While the adoption of psilocybin-assisted therapy for existential distress offers promising support for patients with life-threatening illnesses, implementing this intervention into palliative care settings presents significant real-world challenges. Aim: To examine palliative care stakeholders’ knowledge and attitudes regarding psilocybin-assisted therapy, and identify barriers and facilitators to its implementation. Design: We conducted a cross-sectional online survey between April 15 and December 18, 2024. The survey assessed perceived knowledge, attitudes, and perceived barriers and facilitators to the effective integration of psilocybin-assisted therapy into palliative care settings. Setting/participants: One hundred and twenty-one adults involved in palliative care (physicians, other healthcare professionals, caregivers, and managers) were recruited from Canada’s four most populous provinces: Québec, Ontario, Alberta, and British Columbia. Results: Forty-three percent of stakeholders reported having good knowledge of psilocybin’s potential benefits and risks. Attitudes towards psilocybin-assisted therapy were predominantly non-favourable (61%), yet varied across occupational groups ( p < 0.0001), with 95% of physicians reporting favourable attitudes. The lack of trained healthcare providers was viewed as the primary barrier to implementation. Key facilitators included further research and developing standardised intervention protocols. Sixty-eight percent of stakeholders endorsed the introduction of psilocybin-assisted therapy during the early stages of the illness trajectory. Conclusions: Translating the potential of psilocybin-assisted therapy for existential distress from clinical trials into palliative care settings requires careful consideration and collaboration with stakeholders. Given the significant divergence in perspectives between clinical and non-clinical groups, tailored interprofessional education could help build shared understanding and support effective implementation. Being conducted in Canada, transferability to different regulatory frameworks may be limited.