Psilocybin therapy has mostly reached the well-off. A small Oregon study tested a cheaper group model for low-income patients

Group psilocybin therapy appears feasible and well tolerated among low-income adults with depression, according to a small study conducted within Oregon’s state-regulated psilocybin program. Participants’ depression scores dropped substantially after two group dosing sessions, though the study had no comparison group, so the role of psilocybin itself remains uncertain. The findings were published in the Journal of Psychedelic Studies.

Psilocybin is the primary psychoactive compound found in certain species of fungi, often known as “magic mushrooms.” Under supervision, it is consumed to induce an altered state of consciousness that can help people process difficult emotions. Major depressive disorder is a common mental health condition characterized by persistent feelings of sadness, fatigue, and a loss of interest in daily activities.

Interest in psilocybin as a depression treatment has grown rapidly. For example, a 2020 randomized clinical trial found that psilocybin, paired with psychotherapy, produced rapid and substantial reductions in depression. But the people taking part in this research have tended to be better off than average: a 2025 systematic review found that only about 1 in 8 psychedelic trials reported participants’ income, and in U.S. trials, participants were far more educated and wealthier than the general population.

“Much of the research up to this point has unintentionally skewed toward higher income earners and I felt that something ought to be done about that,” lead author Matthew Hicks, an adjunct faculty member and affiliate research investigator at the National University of Natural Medicine and the Helfgott Research Institute, told PsyPost.

In 2020, Oregon voters passed Measure 109, creating a legal, state-regulated framework for adults to access supervised psilocybin services. The program has served over 15,000 people as of mid-2025. But a single session can cost around $2,000, making the program inaccessible to most low-income people.

Health economists and clinicians have been exploring ways to reduce these costs. A 2023 study calculated that treating patients in small groups rather than one-on-one cuts therapist costs by roughly a third. This economic rationale aligns with a study covered by PsyPost in 2022, which estimated that MDMA-assisted therapy for severe PTSD could save about $133 million in health care costs per 1,000 patients over 30 years compared with standard care.

“My motivation for doing the study is to start a longer series of studies aimed at demonstrating the potential cost-effectiveness of psychedelic therapies, especially in groups, so that they might one day be covered by insurance,” Hicks explained.

To test whether a more affordable group model could work in a real-world setting, Hicks and his colleagues designed a trial specifically for low-income patients. The authors noted that this represents the first clinical trial conducted within a state-regulated psychedelic program, as well as the first psychedelic study focused specifically on a low-income population.

The researchers designed a feasibility study, a small preliminary trial meant to test whether a treatment approach can be carried out in practice, focusing on recruitment, retention, safety, and acceptability. The study had no control group, and neither participants nor researchers were blinded; changes in depression were examined only as exploratory outcomes.

The team recruited adults living in Oregon whose income fell at or below 200 percent of the Federal Poverty Line. Participants had to have a formal diagnosis of major depressive disorder, maintain stable housing, and be actively engaged in regular psychotherapy outside of the study.

Out of 26 eligible volunteers, 20 began the treatment process, and 19 completed the full study. The participants were divided into small cohorts of up to six people. To minimize travel barriers, the researchers conducted two 90-minute preparation sessions online, followed by two in-person psilocybin administration sessions scheduled one week apart. Among those who enrolled, participants averaged 43 years old, 12 were women, and 17 identified as white.

During the dosing sessions, participants gathered in a single room on floor mats and drank a tea made from homogenized whole psilocybin mushrooms of the B+ strain. Within the allowed range, participants chose their own dose with guidance from the facilitators. Those taking SSRI or SNRI antidepressants, which can dull psilocybin’s effects, could take up to 50 milligrams of psilocybin, the maximum permitted under Oregon rules, while all others could take up to 35 milligrams. During the first session, a common approach was to start with about 18 to 20 milligrams and take an optional booster about an hour later.

Two facilitators oversaw the room, playing ambient music and offering individual support in a separate space if needed. Two days after each administration session, the cohort met online for a 90-minute integration session to share and process their experiences.

The study met its feasibility goals: 19 of 20 participants completed it, and attendance at study sessions was 98 percent. Several participants said the online preparation and integration sessions made it possible for them to take part, including some from rural areas, and volunteers received $200 for completing the follow-up interview. No severe adverse events were reported, and participants rated their satisfaction at an average of 4.8 out of 5, with no one rating it below 4.

The most common side effects were temporary nausea, headaches, and passing unease. One participant had nausea and vomiting for about two days after eating the blended mushroom rather than straining it from the tea, and another reported worsening depression that they later attributed to difficult life circumstances.

Depression scores, which the researchers treated as an exploratory outcome, dropped substantially. On the Hamilton Depression Rating Scale, where higher numbers indicate worse depression, participants’ average score fell from 22.21 at baseline to 8.79 two days after the second dosing session. At the three-month follow-up, the average had risen somewhat to 11.89 but remained roughly half of its starting level.

Participants also reported broad improvements across various quality-of-life measures. The largest improvements were in depression, fatigue, and the ability to take part in social roles and activities, and most of these gains held at three months, though they were somewhat smaller.

“One of the takeaways here is that low-income earners can benefit from these therapies if they are able to access them,” Hicks said. “Given the huge financial burden of depression and other mental health issues on our healthcare system and economy generally, my hope is that we can reduce all that suffering while also saving money in the long run.”

The findings are in line with research covered by PsyPost in 2023, which found that group-format psilocybin therapy produced sustained reductions in depression severity. However, that earlier trial examined depression in people with cancer using a different depression scale, whereas the new study focused on low-income adults assessed via the Hamilton Depression scale.

As with all research, there are some caveats to consider. The study involved only 20 participants and did not include a control group, so there is no way to compare these outcomes with those of people who received a placebo or standard care. Because everyone also continued their regular psychotherapy and took part in group preparation and integration sessions, and because neither participants nor researchers were blinded, it is not possible to say how much of the improvement stemmed from psilocybin itself.

Participants’ expectations were high, averaging 7 to 8 on 9-point scales, and those who said they would more confidently recommend the treatment to friends tended to show larger improvements. The two facilitators who guided the sessions were also two of the study’s authors, and the follow-up lasted only three months. The research team also noted that their sample lacked racial and ethnic diversity, with most participants identifying as white.

“The scope of my feasibility study was simply to demonstrate that it can be done with this population with these methods,” Hicks noted. “I hope it will provide sufficient justification to fund larger and more rigorous studies that can offer more definitive claims to persuade healthcare payers (like Medicaid and private insurance companies) to cover these services thus providing greater access.”

Future research with larger, more diverse groups and rigorous comparison conditions will be needed to confirm these early results. Such trials could help assess if group psilocybin therapy is a cost-effective alternative to standard mental healthcare.

The study, “Low-income group psilocybin assisted therapy for depression: An Oregon feasibility study,” was authored by Matthew Hicks, Olivia Hicks, Ryan Bradley, and Heather Zwickey.