3 Strategies for Increasing Diversity in Psychedelic Research

Psychological distress is more common in people of color than in non-Hispanic Whites, increasing their risk of negative mental health outcomes.¹ Medication is the most common treatment plan for mental health conditions like substance use disorder, clinical depression, post-traumatic stress disorder (PTSD), and anxiety but unfortunately, up to 60% of patients are affected by treatment resistance, and those who aren’t often face severe side effects from medications.² Psychedelic therapy is an exciting solution. Research has demonstrated that psychedelics can reduce and even remove mental health disorder symptoms when paired with proper administration and support.³  

However, psychedelic research has so far not been representative of the minority groups that could greatly benefit from such treatments. A review of psychedelic studies from 1993 to 2007 revealed that, of the total participants included in the analysis, only 4.6% were Indigenous, 2.5% African American, 2.1% Latino, and 1.8% Asian.¹ The average of patients of color across all reviewed studies was 18.4%, less than half of the average 38.2% country-level representation.¹ Furthermore, the diverse participation rates for the reviewed psychedelic studies were low even when compared to the low rates of diverse participation in other American clinical trials (10%). ⁴ 

To ensure people of color have safe, consistent access to effective psychedelic therapies, we must make a conscious effort to increase racial and ethnic diversity in psychedelic research. It’s important to note that psychedelic research must be inclusive of all minority groups, not just people of color. However, in this blog, we offer three possible strategies for increasing racial and ethnic diversity, specifically.  

1) Creating More Culturally Inclusive Diagnostic Criteria

The Diagnostic and Statistical Manual 5^th Edition (DSM-5) has lists of symptom presentations and treatments that generally do not account for the cultural variations that play a large role in people of color’s psychopathology presentation.¹ A good example of this oversight is that PTSD’s diagnostic criteria does not include race-based trauma even though it has been shown to produce PTSD symptoms like those of other traumas listed.⁵ Research has also shown that Asian Americans are more likely to report somatic symptoms, while Hispanic and Latino patients’ symptoms are so distinct that healthcare providers often miss them.^6,7 Culturally inclusive diagnostic criteria are important for psychedelic research diversity because they ensure racial and ethnic minority groups qualify for treatments even though their symptoms might present differently than those of their non-Hispanic White counterparts.  

2) Increasing Diversity in Psychedelic Researchers

When minority patients receive treatment from a clinician who shares their ethnic or racial background, studies have shown that the treatment results improve.⁸ Unfortunately, psychedelic providers and researchers have, historically, been mostly White men, meaning the therapeutic area not only has a representation problem but that it also struggles with including people of color in clinical trial design and implementation.⁹ By including more researchers of different ethnic and racial identities, psychedelic research will see an improvement in minority treatment results and an increase in minority participation. 

3) Purposefully Engaging With Diverse Patients Through Elligo’s PatientSelect^® Model  

Traditional patient recruitment methods are not enough to enroll racial and ethnic minorities in psychedelic research. There are many possible reasons, such as that these groups often don’t have the means for psychological care or that they frequently look to alternative providers for mental health assistance, excluding them from psychological referrals to clinical trials.¹ No matter the cause, we clearly need to use different methods to identify and engage minorities in psychedelic trials — such as Elligo Health Research’s PatientSelect model.  

PatientSelect uses AI-powered analysis of HIPAA-compliant identified healthcare data to accurately identify and engage with specific patient groups. We first conduct an EHR search to find previously untapped, qualified patients and then we connect with the hospitals, doctor’s offices, pharmacies, and other healthcare facilities where these patients routinely seek psychological care. Because we form relationships with these facilities and give them the support they need to become healthcare-first research sites, patients are able to participate in trials with their trusted physicians and in their local communities—a method proven effective for recruiting minority research patients.¹⁰ Our EHR network also includes more than 115 hospitals and major health systems, 200 healthcare-based sites, and 100 research-based sites. This wide variety allows us to target physician and psychological referrals as well as outpatient providers who accept Medicaid and other forms of affordable care, further supporting the inclusion of racial and ethnic minorities.  

Advance Diverse Psychedelic Research With Elligo  

Psychedelic research is a prime example of mental healthcare inequalities, but it is also a critical opportunity to rectify them. With the largest network of hand-selected psychedelic research sites and a team of psychedelic therapy specialists, Elligo stands ready to navigate and mitigate psychedelic research challenges while working towards equitable participation of racial and ethnic minorities.  

Please email angela.hargrove@elligodirect.com today to learn how we can help advance your psychedelic research with conscious efforts to increase diversity. 

References

1. Michaels, T.I., et al. Inclusion of people of color in psychedelic-assisted psychotherapy: a review of the literature. BMC Psychiatry. Published 2018 July 31.  
2. Howes, O., et al. Treatment resistance in psychiatry: state of the art and new directions. Mol Psychiatry. Published 2021 July 13. 
3. REPS. CORREA, BERGMAN RE-LAUNCH BIPARTISAN CAUCUS TO EXPLORE PSYCHEDELIC RESEARCH FOR MENTAL HEALTH. Representative Lou Correa for California’s 46th District. Published 2023 March 2. 
4. Flores LE., et al. Assessment of the Inclusion of Racial/Ethnic Minority, Female, and Older Individuals in Vaccine Clinical Trials. JAMA Netw Open. Published 2021 Feb. 19. 
5. Butts, HF. The black mask of humanity: racial/ethnic discrimination and post-traumatic stress disorder. Journal of the American Academy of Psychiatry and the Law. Published 2002.  
6. Keh-Ming, L. et al. Mental Health Issues for Asian Americans. Psychiatric Services. Published 1999 June 1.  
7. Mendoza, D.B., et al. Minority inclusion in randomized clinical trials of panic disorder. J Anxiety Disord. Published 2012 Feb. 13.  
8. Sue, S., et al. Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting Clinical Psychology. Published 2016.  
9. George, J.R., et al. The psychedelic renaissance and the limitations of a White-dominant medical framework: A call for indigenous and minority inclusion. Journal of Psychedelic Studies. Published 2019 July 1.  
10. Williams, M. et al. The role of ethnic identity in symptoms of anxiety and depression in African Americans. Psychiatry Research. Published 2012 Aug. 30.