I don’t write about PTSD treatment as a journalist parachuting into a topic. I write about it as a combat veteran who has sat in enough VA waiting rooms and enough sleepless 3 a.m. stretches to have earned an opinion. So when the Department of Health and Human Services and the Department of Veterans Affairs announced a new Memorandum of Understanding this month to accelerate research into rapid-acting psychedelic treatments for veterans, I read the announcement twice before I let myself feel anything about it.
Here’s what’s actually happening, stripped of the hype. HHS and VA signed an agreement in mid-July to strengthen collaboration on the research, clinical development, and — critically — the responsible deployment of psychedelic drug products, contingent on FDA approval. The plan includes increasing clinical trial participation, training therapists, nurses, and doctors to administer these medications if and when they clear federal review, and building the evidence base regulators and physicians will need to make the call. Advocates are framing this as something that could eventually touch more than a million veterans. That’s not a small number, and it’s not a small shift for two federal bureaucracies that have historically moved at the speed of federal bureaucracies.
I want to hold two things as true at once, because that’s what honesty about this requires. The first is that I understand exactly why this excites people in my community. Traditional first-line PTSD treatments — SSRIs, prolonged exposure therapy, cognitive processing therapy — work for plenty of veterans and fail plenty of others. I’ve watched brothers cycle through years of talk therapy and medication with marginal improvement, then watch the VA’s own pilot data on MDMA-assisted and psilocybin-assisted therapy show response rates that make grown men who don’t cry, cry. If a treatment exists that can meaningfully shorten the distance between a veteran and his own peace of mind, I want it studied, funded, and — if it’s safe — made available. Full stop.
The second thing I want to hold is skepticism about the rollout, not the science. This same announcement is arriving alongside separate news that the VA is proposing to change how it rates mental health disability claims — moving to a more structured, symptom-based system and eliminating the 0% rating in favor of a 10% minimum for any service-connected diagnosis. On its face, that sounds like a win: more veterans compensated, fewer stuck at zero. But I’ve been around this system long enough to know that “more structured” can cut both ways. A more rigid symptom-based rubric can also mean less room for the messy, non-linear way trauma actually presents in real people. I want to see the actual language of that rule before I celebrate it, and I’d encourage every veteran reading this to do the same when it hits the Federal Register for comment.
There’s also the question of access, which is where my Milwaukee lens comes in. A million veterans potentially eligible for a groundbreaking treatment sounds great in a press release. It sounds different if you’re a veteran in central-city Milwaukee whose nearest VA facility already has a backlog for basic mental health appointments — and to be fair, the VA reports over 200,000 new healthcare enrollees and more than 60,000 mental health appointments completed or scheduled so far this year, which is real movement in the right direction. But scaling up a novel, intensive therapy that requires trained clinicians, extended session times, and careful post-session integration support is a different logistical animal than scaling up a prescription refill. Rural and urban VA facilities are not equally resourced. Black veterans, who already report lower satisfaction with VA mental health care in survey after survey, deserve a straight answer about whether this rollout will actually reach them or whether it becomes another treatment available mainly to veterans with the means to seek it out privately once FDA approval lands.
My faith plays a role in how I think about this, too — not as a wall against science, but as a lens. I don’t believe healing is purely chemical, and I don’t believe it’s purely spiritual either. The veterans I know who’ve made the most progress combined clinical treatment with community, purpose, and something bigger than themselves to hold onto. Whatever this psychedelic research produces, it should be built to work alongside that, not instead of it.
So here’s where I land, and it’s the same place I try to land on most stories: cautious hope, paired with a demand for follow-through. This partnership deserves support. It also deserves oversight — from veteran service organizations, from journalists, from veterans themselves — to make sure “responsible deployment” isn’t just a phrase in a press release. If this treatment works the way early data suggests, it could be the most significant advance in combat trauma care of my generation. If it’s rolled out unevenly, it becomes one more example of promising VA innovation that never quite reaches the veterans who need it most. I’ll be tracking which one it becomes.
Marcus Hart is a combat veteran and founder of The Urban News Journal.