U.S. Health System Readiness to Adopt Classic Psychedelic-Assisted Therapy for People with Serious Illness: A Scoping Review

Abstract

This scoping review will examine U.S. health system readiness to adopt psilocybin- and LSD-assisted therapy for people with serious illness, with particular attention to existential distress and demoralization. Our primary research question addresses the facilitators, barriers, and gaps that may affect adoption in the event of Food and Drug Administration (FDA) approval and Drug Enforcement Administration (DEA) rescheduling. We will review published and grey literature and organize findings across six readiness dimensions: regulatory, workforce, infrastructure, financial, equity, and ethics. We will use the updated Consolidated Framework for Implementation Research (CFIR) to examine how these determinants relate to the therapy, the broader policy environment, healthcare organizations, individuals, and implementation processes. We will distinguish evidence specific to serious illness care from broader implementation evidence relevant to U.S. adoption. The review will describe where evidence is concentrated and where gaps remain, with the aim of informing preparation by palliative care programs, health systems, clinicians, and policymakers.

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