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by Ivan Madan
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Call for action: If you have voting rights in California, you can support by your signature the TREAT California initiative that asks the state to provide funding for research, clinical trials, and FDA approval of psychedelic-assisted therapy (PAT) in various settings. 

If you cannot vote, you can consider donation. The very rough estimate below shows QALY gained in the order of tens of millions per year.

Disclaimer: my epistemic on this topic is low - I don't have a medical background and have read only a handful of papers on the issue.  Below I insert GPT$ estimates as they seems to be as good (bad) as mine.

Why to act?

If the PAT lives up to its promise, PTSD, depression, and addictive behavior treatment can be treated much more efficiently than through conventional therapy which is not only of low efficiency but is very costly. 

Below is a very rough estimate of QALY-gained-per-year produced by GPT4 (assuming the therapy is affordable to everyone):

Target Conditions: Let's consider major depression and PTSD, given some of the current research on psychedelic-assisted therapy. As of my last update in 2022:

  • Global prevalence of depression: About 5% of the world population.
  • Global prevalence of PTSD: Varies significantly by region but let's estimate an average of 2%.

World Population: Approximately 7.9 billion in 2022.

Potential Beneficiaries:

  • Depression: 5% of 7.9 billion = 395 million.
  • PTSD: 2% of 7.9 billion = 158 million.
  • Total: 553 million (some individuals might have both conditions).

QALY Improvement: Let's assume psychedelic-assisted therapy provides an average improvement of 0.5 QALYs per person over a year. This is a speculative figure.

Adoption Rate: Given cultural, personal, and other barriers, let's assume 10% of those who could benefit actually take up the therapy: 10% of 553 million = 55.3 million.

Total QALYs Gained in One Year:

  • 55.3 million x 0.5 = 27.65 million QALYs

Other disclaimers:

Personal concerns:

I believe PAT will treat symptoms, but not the cause of mental health epidemics. That is, I think the best solution to mental health issues is a revaluation of the societal values and systematic change that will create social integration for each member of the society. I don't see that happening in the near future, nor do I see any forces pushing for such systemic changes in a coherent, non-controversial fashion. This is why I support PAT with this huge "asterisk".

That being said, I hope responsible PAT will create more favorable conditions for social changes that would address the root cause of mental health epidemics. 

Critique is more than welcome.

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