Exploring Determinants of Psilocybin Acceptance as an Alternative Modality for Major Depressive Disorder: A Pilot Study

Abstract

Introduction: Major depressive disorder (MDD) affects over 21 million adults in the U.S (NIMH, 2023) and remains a significant public health challenge. Despite the effectiveness of traditional medications, 30% of patients remains resistant. Little is known about the beliefs individuals hold regarding novel treatments, such as psilocybin and the motivations behind medication acceptance. This study utilized the Health Belief Model (HBM) to explore factors influencing psilocybin-assisted therapy acceptance (PATA) among young adults with major depressive disorder. Methods: This pilot sample consisted of 33 young adults, primarily African American/Black women with self-reported diagnosis of MDD, who were recruited from four outpatient behavioral mental health clinics in Florida. A cross-sectional design was employed. Spearman's Rho Coefficient was performed for variables found to be associated with PATA. A hierarchical regression was also performed to analyze the utility of HBM constructs to explain variance. Results: The bivariate analysis indicated demographic variables were not significantly correlated with PATA (rs values ranging from –.285 to –.039, all P > .05), suggesting demographic factors did not play a significant role in predicting PATA. Model 1 included positively correlated predictors, showing a significant correlation between the two predictors and PATA (R=.506), accounting for 25.6% of variance in scores; R2 =.256, F (3,27) =3.10, P=.043. The HBM constructs in Model 2 strengthen the correlation with PATA (R=.916) and further increased in variance with an R2=.839. Adding the HBM constructs substantially improved the model (F (19,11) = 3.01, P = .033), suggesting the expanded set of variables significantly predicted PATA. Conclusion: Perceived benefits emerged as the strongest predictor of PATA (β = .584, P = .006), highlighting the need for communication strategies that emphasize evidence-based outcomes on psilocybin’s efficacy in reducing MDD symptoms. The inclusion of the HBM constructs suggest that psilocybin acceptance can be increased through targeted interventions.