Earlier this year, COMPASS provided an unrestricted educational grant to the Emory University/Grady Trauma Project in Atlanta, Georgia to explore the mental health care needs and attitudes towards psychedelic therapy in marginalized and underprivileged communities, with the goal of developing culturally-informed psilocybin therapy for depression and other mental health conditions. We spoke to two leading researchers of the project: Dr Sierra Carter, Assistant Professor in the Department of Psychology at Georgia State University, and Dr Jessica Maples-Keller, Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine.
What is the Grady Trauma Project?
The Grady Trauma Project (GTP) is a large research study looking at the impact of stress and trauma-related risk factors for post traumatic stress disorder (PTSD) and related mental and physical health conditions in Black Americans in Atlanta, Georgia. Our research suggests that this community experiences high rates of trauma, with over 90% reporting at least one traumatic experience, almost half suffering from PTSD, and 36% having lifetime major depressive disorder. The project is run by an interdisciplinary team of investigators and uses a variety of techniques (neuroimaging, psychophysiology, focus groups, intervention research) to understand poor health outcomes related to trauma and PTSD. Over the last 15 years, we have conducted trauma interviews with over 12,000 people through the Grady Memorial Hospital in Atlanta, GA.
A study looking at the impact of stress and trauma-related risk factors for PTSD and related mental and physical health conditions in Black Americans in Atlanta, Georgia
Tell us about the research you’re doing around perceptions of psychedelic therapy, and what you’re hoping to achieve?
Black Americans experience systemic racism and oppression, resulting in increased rates of trauma and poor mental and physical health outcomes. Distrust of the medical community due to historical injustices and racial inequalities in mental health care may be a barrier to engaging in innovative new treatments.
We have seen strong evidence emerging for the efficacy of psychedelic therapy in addressing mental health challenges, but most people who take part in psychedelic studies to date are non-Hispanic white. We believe that language and context is an important part of psychedelic therapy, and that cultural factors should be considered, particularly for marginalized groups.
COMPASS Pathways is supporting us in our research to investigate perceptions of psychedelics in underserved groups, particularly racial and ethnic minorities, to help inform best practices. We are conducting focus groups with members of the Black community and mental health providers who support them, to understand perceptions of psychedelic therapy, potential barriers to engaging in these investigational treatments, and views of language and cultural context of these therapies. Our goal is to improve access to communities of color by addressing unique barriers, conducting outreach, developing culturally-informed modifications for psychedelic therapy, and informing best practice for cultural competency within psychedelic interventions.
COMPASS is supporting us in our research to investigate perceptions of psychedelics in underserved groups, particularly racial and ethnic minorities
What is your background and how did you become interested in this field?
Dr Carter – My background is in understanding and addressing racial health inequities, particularly among Black American populations. I’m really interested in identifying evidence-based practices that may need to be culturally-tailored or more readily culturally-informed to provide the most optimal treatment to marginalized populations. A common theme throughout much of my work involves understanding the pernicious effects of multi-level forms of racism on the mind and body. As a clinical psychologist I use this research background to inform how I conceptualize potential reasons that marginalized populations might not engage or fully benefit from certain treatments. I became interested in this field because I believe that, in order to break down barriers and mental health stigma for interventions like psilocybin therapy, we must wrestle with historical and contemporary contexts within our US society to inform best practices. I’m interested in listening to marginalized groups about their needs and desires in order to provide the most efficacious treatments in underserved communities.
Dr Maples-Keller – I wanted to be a clinical psychologist since I was a child. In college I worked as a research assistant on a study of Hurricane Katrina evacuees which led to my passion for clinical research, as I was inspired by the potential for clinical science to improve our ability to help people with mental health difficulties. My research focuses on understanding and improving psychotherapy, including behavioral and pharmacological augmentation strategies, and individual differences and other factors that increase risk of mental health difficulties or impact treatment response. During graduate school I became very interested in the therapeutic potential of psychedelics, so I was excited to accept a postdoctoral fellowship with Dr Barbara Rothbaum which involved a study investigating MDMA and fear extinction learning, and have since become a therapist on the COMPASS psilocybin therapy phase 2b trial. I am passionate about psychedelic therapy and clinical research to investigate and understand its effectiveness, and to increase access and cultural competence within these interventions.
I’m really interested in identifying evidence-based practices that may need to be culturally-tailored or more readily culturally-informed to provide the most optimal treatment to marginalized populations.
In an ideal world, what does mental health care look like for you in 10 years’ time?
Dr Carter – For me, in 10 years it would be wonderful if mental health care was accessible to all who need it. I also would like for mental health care to be broadened into more integrated health care models that allows for both mental and physical health aid in the same space. With that in mind, a dream would be for communities, particularly marginalized communities, to have the space and resources to heal themselves with all of the knowledge and strengths that they bring to the table about best practices to reduce ailments and distress.
Dr Maples-Keller – In an ideal world, in 10 years every single person would have access to high quality evidence-based mental health care, including preventative treatment and routine screening integrated with other medical care, through treatment formats that address barriers to make treatment accessible. Ideally, clinical research will have advanced such that we can provide personalized medicine approaches to an individual’s mental health care, and be able to recommend and provide novel interventions such as psychedelic therapy. I would also love to see a decrease in stigma surrounding mental health awareness and intervention, where people felt comfortable seeking help and support when needed.
In an ideal world, in 10 years every single person would have access to high quality evidence-based mental health care
Our vision is a world of mental wellbeing, what does this mean to you?
Dr Carter – A world of mental wellbeing would be a space where all people in our world see the value of mental health and wellness. As a Black woman, I particularly think a world of mental wellbeing must involve embracing the diversity of mental health presentations as well as the diverse ways in which we define mental wellbeing outside of primarily Eurocentric values. Our world is multicultural and multifaceted, and a world of mental wellbeing has to encompass all of the lenses from which to view health and wellness.
Dr Maples-Keller – Mental wellbeing to me speaks beyond just treating the specific clinical disorders and symptoms that are often the focus of psychiatric treatment, and to a holistic sense of physical and mental wellness, ability to function in areas important to the individual, and to live a life with meaning and consistent with an individual’s values.
Our world is multicultural and multifaceted, and a world of mental wellbeing has to encompass all of the lenses from which to view health and wellness