Mental Health Considerations

What we assess

• Stability

  Are current symptoms controlled? Is the applicant in a position of relative groundedness, not necessarily free of difficulty, but not in acute crisis?

• Safety

  What is the current suicidality risk? Self-harm history? We assess this directly and transparently, not to alarm, but because it matters.

• Insight

  Does the applicant understand their condition and how it may interact with an intense psychedelic experience? Can they communicate what they need?

• Support

  Is there a therapist engaged? A support network at home? Integration support is more effective when the applicant has existing relational infrastructure.

Conditions we can usually work with

• Depression (treated, stable)

  Usually supported

  The most common presentation we see. Psilocybin research at Imperial College and Johns Hopkins shows efficacy for treatment-resistant depression. Screening focuses on: suicidality risk (must be low), medication interaction review, and readiness for emotional intensity.

• Anxiety disorders (treated, stable)

  Usually supported

  Generalized anxiety, social anxiety, and stabilized PTSD can all participate with appropriate preparation. Screening focuses on: trauma processing readiness, medication interactions, and grounding skills. Panic disorder requires careful review of triggers.

• Grief and life transitions

  Usually supported

  These are not psychiatric conditions, they are human experiences. Psychedelics can support meaning-making during loss, transition, and existential questioning. Screening focuses on: realistic expectations, support system adequacy, and timing.

• PTSD (with trauma-informed facilitation)

  Usually supported

  Possible with trauma-informed screening and a facilitator trained in trauma response. Requires careful preparation and explicit discussion of what may arise in ceremony.

• Addiction recovery (stable, supervised)

  Usually supported

  Stable recovery, meaning no active uncontrolled use, with a support system and often a counselor, is distinct from active addiction. Individual assessment reviews: substance type, time in recovery, and retreat-type suitability.

Conditions requiring specialist assessment

• Controlled bipolar II disorder

  Specialist review required

  Individual assessment with psychiatrist involvement required. Long-term mood stability, medication review, and facilitator experience with bipolar presentations are all factors. Active cycling disqualifies.

• History of psychosis (in remission, 2+ years)

  Specialist review required

  Long-term stability on medication and formal psychiatric clearance required. We assess: time since last episode, current medications, current insight, and support system. Shorter remission periods or medication instability disqualify.

• Suicidality history (currently stable)

  Specialist review required

  Recent safety assessment from a therapist or psychiatrist required. The key question is current stability and support, not the history itself. Active suicidal ideation with plan is disqualifying.

• Personality disorders with emotional dysregulation

  Specialist review required

  Possible with a trauma-informed facilitator and pre-retreat skills-building. Borderline personality disorder in particular requires careful assessment of distress tolerance and support structures.

Absolute psychiatric contraindications

• Untreated or active psychosis

  Disqualifying

  Psychedelics can trigger or worsen psychotic episodes. This is a universal absolute contraindication across every FDA-phase psychedelic clinical trial. No exceptions.

• Uncontrolled bipolar I disorder (active mania or rapid cycling)

  Disqualifying

  Mania risk during a psychedelic experience is too high to manage in a retreat setting. This is disqualifying. Controlled bipolar I with a long period of stability may be reassessed individually.

• Acute suicidality with active plan

  Disqualifying

  This requires immediate crisis intervention, not a psychedelic retreat. Disqualifying without exception. We actively refer to crisis resources.

• Active uncontrolled substance abuse

  Disqualifying

  Uncontrolled use signals difficulty with impulse regulation and increases adverse reaction risk. Disqualifying. Stable addiction recovery is assessed differently, see above.

Trauma history and psychedelic work

Trauma history does not disqualify. Psychedelics can surface traumatic material, this is often where the most meaningful work happens. Our facilitation is trauma-informed, meaning we prepare participants for what may arise and hold what surfaces without rushing past it. The question is not whether you have trauma, it is whether you are stable enough to work with it in this format, and whether the timing is right.