Royal College of Psychiatrists Calls for Improved Trauma Care: Could Psychedelic-Assisted Therapy Help?
Written by Prof Michael Lynskey, Drug Science - Chief Research Officer
The Royal College of Psychiatrists issued a position statement at the end of August highlighting the need for improved care and systems to address the impact of non-recent child sexual abuse (CSA) on the mental health of adults.
Like other forms of trauma, the report noted how CSA is alarmingly prevalent and has enduring consequences for health and wellbeing but lacks adequate, effective treatment.
The immediate past President of the Royal College of Psychiatrists Dr Lade Smith CBE, acknowledged that “many survivors and victims have suffered avoidable harm as adults because they haven't received the care they need”, before reiterating the report’s emphasis on “compassionate, holistic, person-centred and trauma-informed support” for survivors.
While appropriately emphasising the importance of trauma-informed care and patient-centred approaches, the report also briefly acknowledged the emerging evidence for the use of psychedelic-assisted therapy for treating PTSD. We believe, given emerging evidence, that the potential benefits of these treatments deserve fuller consideration.
The Case For MDMA For Trauma Care
While some studies have explored the use of psilocybin for treating Post Traumatic Stress Disorder (PTSD), clinical interest has largely focused on the potential of MDMA. Multiple randomised controlled trials have tested the use of MDMA to treat PTSD, and meta-analyses of results from these studies have uniformly highlighted both its efficacy and safety. While much of this research has not distinguished between PTSD and complex PTSD, the latter of which is the focus of the Royal College report, many of these studies have included a mix of people with either PTSD or complex PTSD, and thus the results are likely to hold for survivors of CSA.
MDMA may be uniquely suited for the treatment of CSA and other traumas for several reasons. Firstly, unlike treatments with serotonergic psychedelics like psilocybin, patients and therapists can have active conversations during the MDMA experience. MDMA also releases several neurotransmitters, particularly serotonin, as well as dopamine and noradrenaline. This combination is thought to reduce fear and defensiveness and allow patients to revisit trauma memories without becoming overwhelmed and engage more fully with the therapeutic process.
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A 2025 attempt by MAPS (by then renamed as Lykos and now renamed as Resilient Pharmaceuticals) to received FDA marketing authorisation of MDMA in 2025 was declined on a number of grounds including concerns about insufficient blinding of treatment, potential risk of addiction and unclear information on the role and type of therapy. Despite this setback there are initiatives underway to re-apply to the FDA, including conducting an additional Phase 3 clinical trial.
In 2023, the Australian medicines regulatory authority (“TGA”) decided that the evidential base was sufficient to re-schedule MDMA as a medicine for treatment-resistant PTSD (as well as psilocybin to treat treatment-resistant major depression). Under the rescheduling, prescribing rights are limited to psychiatrists who are authorised prescribers under the TGA's Authorised Prescriber Scheme. The charity Mind Medicine Australia also provides access to the drug. According to the TGA, by December 2025, 123 patients had been treated with MDMA and 65 with psilocybin.
Conclusion
The combination of high population prevalence and inaccessible, generally ineffective treatments options highlights the need for new, innovative approaches to care and treatment among survivors of CSA. Available evidence supports the utility of MDMA, psychedelics and cannabis as a potentially effective treatment for survivors of CSA and other traumas. Growing evidence from observational and real world studies, including Drug Science’s project T21, also suggests that medicinal cannabis may be effective in reducing symptoms of PTSD and improving other aspects of well-being, including mood, sleep, and quality of life among people with PTSD who have not responded to traditional forms of treatment. There is a need to further research and develop these treatments and determine how best to integrate them into the care pathway.
The Royal College of Psychiatry’s position statement has highlighted the urgent need for innovation in this area while acknowledging the potential of psychedelic-assisted therapy to contribute to reducing symptomatology and improving wellbeing among survivors of trauma. However, such research remains severely limited by the illegal status of these medicines, with psychedelics and MDMA being in Schedule 1 and cannabis in Schedule 2 of the UK 1971 Misuse of Drugs Act.
We hope that the Royal College of Psychiatry’s call for action will encourage the government to follow the ACMD’s 2025 call to reduce barriers to researching these drugs to accelerate desperately needed research for the victims of trauma.