Black Americans are significantly underrepresented in psychedelic trials despite significant mental health disparities. Growing research suggests that psychedelic-assisted therapy (PAT) is an effective treatment for post-traumatic stress disorder and depression. It is important to understand perceptions of PAT among populations with unmet mental health needs.
Methods:
We conducted four focus groups to understand perceptions of psychedelic therapy within a low-income, Black, urban population.
Methods:
Three main themes were identified using an inductive thematic analysis approach: (1) informed hesitation mixed with increasing openness; (2) trust, autonomy, and choice; and (3) practical solutions to increase accessibility.
Conclusions:
Participants described many concerns related to legacies of racism in healthcare, research, drug prescription, and criminalization. Healthcare systems must invest in trust building with Black Americans to adequately meet healthcare needs. Participants emphasized ways of building trust through supporting autonomy and choice, investing in community building and agency, and suggestions to address barriers (e.g., providing childcare, providing transportation). These findings support calls to center the needs of Black American people given the lack of culturally salient therapeutic paradigms specifically for Black Americans utilized within PAT, improve access and address barriers to healthcare for Black Americans, and increase the quality of care available.
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References
1.
WilliamsDR, CollinsC. Racial residential segregation: A fundamental cause of racial disparities in health. Public Health Rep, 2001; 116(5):404–416; doi: 10.1093/phr/116.5.404
2.
GoldsteinRB, SmithSM, ChouSP, et al.The epidemiology of DSM-5 posttraumatic stress disorder in the United States: Results from the national epidemiologic survey on alcohol and related conditions-III. Soc Psychiatry Psychiatr Epidemiol, 2016; 51(8):1137–1148; doi: 10.1007/s00127-016-1208-5
3.
GluckRL, HartzellGE, DixonHD, et al.Trauma exposure and stress-related disorders in a large, urban, predominantly African-American, female sample. Arch Womens Ment Health, 2021; 24(6):893–901; doi: 10.1007/s00737-021-01141-4
4.
WilliamsDR. Stress and the mental health of populations of color: Advancing our understanding of race-related Stressors. J Health Soc Behav, 2018; 59(4):466–485; doi: 10.1177/0022146518814251
5.
TupperKW, WoodE, YensenR, et al.Psychedelic medicine: A re-emerging therapeutic paradigm. CMAJ, 2015; 187(14):1054–1059; doi: 10.1503/cmaj.141124
6.
MithoeferMC, FeducciaAA, JeromeL, et al.MDMA-assisted psychotherapy for treatment of PTSD: Study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology (Berl), 2019; 236(9):2735–2745; doi: 10.1007/s00213-019-05249-5.
7.
MitchellJM, BogenschutzM, LiliensteinA, et al.MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study. Nat Med, 2021; 27(6):1025–1033; doi: 10.1038/s41591-021-01336-3
8.
Carhart-HarrisRL, BolstridgeM, RuckerJ, et al.Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study. Lancet Psychiatry, 2016; 3(7):619–627; doi: 10.1016/S2215-0366(16)30065-7
9.
Carhart-HarrisR, GiribaldiB, WattsR, et al.Trial of psilocybin versus escitalopram for depression. N Engl J Med, 2021; 384(15):1402–1411; doi: 10.1056/NEJMoa2032994
10.
GoodwinGM, AaronsonST, AlvarezO, et al.Single-dose psilocybin for a treatment-resistant episode of major depression. N Engl J Med, 2022; 387(18):1637–1648; doi: 10.1056/NEJMoa2206443
11.
MichaelsTI, PurdonJ, CollinsA, et al.Inclusion of people of color in psychedelic-assisted psychotherapy: A review of the literature. BMC Psychiatry, 2018; 18(1):245; doi: 10.1186/s12888-018-1824-6
12.
GeorgeJR, MichaelsTI, SeveliusJ, et al.The psychedelic renaissance and the limitations of a white-dominant medical framework: A call for indigenous and ethnic minority inclusion. Jrn of Psychedelic Stds, 2019; 4(1):4–15; doi: 10.1556/2054.2019.015
13.
ChingT. “MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder: Examining Ethnoracial Differences in Efficacy and Safety, and a Mixed-Methods Case Study of a Participant of Color” (2020). Doctoral Dissertations. 2560. https://digitalcommons.lib.uconn.edu/dissertations/2560
WilliamsMT, ReedS, AggarwalR. Culturally informed research design issues in a study for MDMA-assisted psychotherapy for posttraumatic stress disorder. J of Psychedelic Stds, 2019:1–11; doi: 10.1556/2054.2019.016
16.
BrooksJR, HongJH, CherefS, et al.Capability for suicide: Discrimination as a painful and provocative event. Suicide Life Threat Behav, 2020; 50(6):1173–1180; doi: 10.1111/sltb.12671
17.
MekawiY, CarterS, PackardG, et al.When (passive) acceptance hurts: Race-based coping moderates the association between racial discrimination and mental health outcomes among Black Americans. Psychol Trauma, 2022; 14(1):38–46; doi: 10.1037/tra0001077
18.
SibravaNJ, BjornssonAS, Pérez BenítezACI, et al.Posttraumatic stress disorder in African American and Latinx adults: Clinical course and the role of racial and ethnic discrimination. Am Psychol, 2019; 74(1):101–116; doi: 10.1037/amp0000339
19.
TonryM, MelewskiM. Malign effects of drug and crime control policies on black Americans. In: Crime and Justice: A Review of Research. University of Chicago Press, 2008; 37(1):1–44.
20.
StraussD, de la SalleS, SloshowerJ, et al.Research abuses against people of colour and other vulnerable groups in early psychedelic research. J Med Ethics, 2021; doi: 10.1136/medethics-2021-107262
21.
KruegerRA, CaseyMA. Focus Groups: A Practical Guide for Applied Research. Sage Publications, Inc; 2015.
22.
BaschCE. Focus group interview: An underutilized research technique for improving theory and practice in health education. Health Educ Q, 1987; 14(4):411–448; doi: 10.1177/109019818701400404
23.
WilsonV. Focus Groups: A useful qualitative method for educational research? British Educational Res J, 1997; 23(2):209–224; doi: 10.1080/0141192970230207
KevernJ, WebbC. Focus groups as a tool for critical social research in nurse education. Nurse Educ Today, 2001; 21(4):323–333; doi: 10.1054/nedt.2001.0563
26.
WilkinsonS. Focus groups in feminist research. Women’s Studies International Forum, 1998; 21(1):111–125; doi: 10.1016/s0277-5395(97)00080-0
27.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.
28.
WilliamsMT, ReedS, GeorgeJ. Culture and psychedelic psychotherapy: Ethnic and racial themes from three black women therapists. JPS, 2021; 4(3):125–138; doi: 10.1556/2054.2020.00137
29.
WilliamsMT, CabralV, FaberS. Psychedelics and racial justice. Int J Ment Health Ad, 2023:1–17.
30.
ViñaSM, StephensAL. Psychedelics and workplace harm. Front in Psy, 2023; 14; doi: 10.3389/fpsyt.2023.1186541
31.
StewartKA, RistvedtS, BrownKM, et al.Giving voice to black men: Guidance for increasing the likelihood of having a usual source of care. Am Journal of Men’s Heal, 2019; 13(3):1557988319856738.
32.
StanleySJ, ChathamAP, TrivediN, et al.Communication and control: Hearing the voices of low-income African American adults to improve relationships with healthcare providers. Health Commun, 2020; 35(13):1633–1642.
33.
BuchananNT, RiosD, CaseKA. Intersectional cultural humility: Critical inquiry and praxis in psychology. Women Ther, 2020; 43(3–4):235–243; doi: 10.1080/02703149.2020.1729469
34.
WilliamsMT, ReedS, AggarwalR. Culturally-informed research design issues in a study for MDMA-assisted psychotherapy for posttraumatic stress disorder. J of Psychedelic Stud, 2019; 4(1):40–50; doi: 10.1556/2054.2019.016
35.
KrebsTS, JohansenP. Psychedelics and mental health: A population study. PLoS One, 2013; 8(8):e63972–e9; doi: 10.1371/journal.pone.0063972
