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A systematic review of income and education reporting in psychedelic clinical trials

Nature Mental Health volume 3, pages 567–574 (2025)Cite this article

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Abstract

Socioeconomic status (SES) substantially influences mental health outcomes and treatment access, yet its reporting in psychedelic-assisted therapy trials remains underexplored. Here we systematically reviewed 98 articles (49 primary trials and 49 secondary analyses) published between 2006 and 2024 examining classic psychedelics and MDMA for mental health conditions. Only 12% of primary trials reported participant income data, and 31% reported educational attainment. In US-based trials, participants showed markedly higher SES than the general population: 93% had some college education (versus 62% nationally), and median incomes in major trials substantially exceeded the national median for all workers. Non-US trials showed variable patterns. This widespread underreporting of SES data and evidence of socioeconomic disparities, particularly in US trials, highlights an urgent need for standardized SES reporting and targeted strategies to improve socioeconomic diversity in psychedelic-assisted therapy research, ensuring broader generalizability and access to these emerging treatments.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request. This study conducted a systematic review of published literature, and all primary data sources are cited within the manuscript. No new data were generated in this study. The search strategy, inclusion and exclusion criteria and data extraction methods are detailed in the Methods.

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Acknowledgements

N.J.M. is funded by the National Center for Advancing Translational Sciences (2KL2TR001870). The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA

    Daniel H. Grossman & Kevin R. Madden

  2. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Nicky J. Mehtani

  3. Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA

    Brian T. Anderson & Jennifer M. Mitchell

  4. Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Lori L. Davis

  5. Birmingham VA Health Care System, Birmingham, AL, USA

    Lori L. Davis

  6. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA

    Jennifer M. Mitchell

  7. Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA

    Peter S. Hendricks

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Contributions

D.H.G. and K.R.M. were involved in all stages of the project, including planning, conducting the systematic review, writing and editing. N.J.M. assisted with planning, systematic review and editing. B.T.A. and J.M.M. contributed to planning and provided editorial feedback. L.L.D. provided editorial feedback. P.S.H. oversaw the project, contributed to planning and editorial feedback, and served as the corresponding author.

Corresponding author

Correspondence to Peter S. Hendricks.

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Competing interests

D.H.G., K.R.M., B.T.A., L.L.D., N.J.M. and J.M.M. have no competing interests with for-profit entities to declare. P.S.H. was previously in paid advisory relationships with Eleusis Benefit Corporation, Journey Colab Corporation, Reset Pharmaceuticals Inc. and Silo Pharma and is currently in a paid advisory relationship with Bright Minds Bioscience Ltd and has stock options with Beckley Psytech. P.S.H. is also a co-founder of Equulus Therapeutics and Mycelial Health.

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Nature Mental Health thanks Paige Seath, Richard J. Zeifman and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Grossman, D.H., Madden, K.R., Mehtani, N.J. et al. A systematic review of income and education reporting in psychedelic clinical trials. Nat. Mental Health 3, 567–574 (2025). https://doi.org/10.1038/s44220-025-00417-3

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