Trials, trips, and tribulations: pathways for implementing psychedelic therapy in Ireland
Creating a framework for psychedelic-assisted therapies and their introduction through phased, evidence-based implementation strategy with pilot programmes, specialised therapist training, robust regulation, and long-term outcome monitoring to ensure safe and equitable integration into Ireland's public healthcare system.
This policy and implementation review examines how psychedelic-assisted therapies could be safely introduced into Ireland's public healthcare system. The authors synthesise the current evidence and propose a roadmap covering regulation, workforce development, service delivery, health economics, and governance.
The authors conclude that Ireland has an opportunity to become a leader in evidence-based psychedelic medicine by adopting a phased, research-led implementation strategy. Rather than advocating rapid rollout, they propose:
HSE pilot services,
a national research and training hub,
robust governance,
long-term patient registries,
ongoing evaluation of clinical and economic outcomes.
This paper marks a shift in psychedelic research from asking "Do these therapies work?" to "How can health systems implement them safely, effectively and equitably?" It provides one of the first detailed national implementation frameworks for integrating psychedelic-assisted therapy into a public healthcare system, making it a valuable reference for policymakers, clinicians and health service planners.
Abstract
Classical serotonergic psychedelics, such as psilocybin, show emerging evidence of therapeutic potential across a range of mental health disorders, including depression, anxiety, and substance use disorders, with indications of transdiagnostic efficacy. While early-phase studies yielded encouraging results, recent larger-scale phase 3 trials, such as those evaluating psilocybin for treatment-resistant depression, have shown more modest effects, and further findings from ongoing trials are awaited.
Despite the absence of regulatory approvals from the U.S. Food and Drug Administration and European Medicines Agency, a small but growing number of countries have permitted psychedelic therapies within regulated clinical settings. Across these divergent international approaches, the long-term trajectory and real-world impact of these therapies within public health systems remain uncertain.
In anticipation of potential future approval, Ireland has an opportunity to draw on international experience and proactively plan for the integration of psychedelic therapies. Building on emerging evidence, international frameworks, and Ireland-specific policy and health system features, this paper examines the challenges of integrating psychedelic therapies into the Irish public healthcare system.
These challenges span regulatory approval, Health Technology Assessment, service implementation, workforce capacity, and the evaluation of long-term patient outcomes. The aim is to inform policymakers, practitioners, and researchers about key system-level considerations.
John R Kelly, Christopher Sheridan, Patricia Iusan, Lisa Coakley, Lisa Burke, Christine Brennan, Annie MacDonald, Jo-Hanna Ivers, Dominic Trepel, Garrath Tormey, Martha Finnegan, Gareth W Young, Andrew Harkin, Trials, trips, and tribulations: pathways for implementing psychedelic therapy in Ireland, International Journal of Neuropsychopharmacology, Volume 29, Issue 6, June 2026, pyag028, Read Paper
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