Policy Brief by Kris Metzger
School of Social Work, Boston University


The purpose of this policy brief is to first examine the alarming mental health statistics of Veterans in America and further scrutinize how this population is being underserved when it comes to mental health care. To address the unmet needs of the Veteran community, this policy brief recommends the passing of House Bill 3684, the Douglas Mike Day Psychedelic Therapy to Save Lives Act of 2023, as well as advocates for the use of psychedelic therapies within the Veteran community. This bill also draws attention to the limitations of House Bill 3684 and the concerns associated with these limitations. In turn, modifications for House Bill 3684 are proposed for best effectiveness.


America has long been a two-party system, but in the last several years the partisan polarization has become palpable. Democrats and Republicans views of one another have increasingly become more negative, with each party seeing not only the other party, but the people who identify with said party, as more immoral, dishonest, and close-minded than the other (Pew Research Center). Currently, 72% of Republicans view Democrats as immoral, and 63% of Democrats say the same about Republicans (Pew Research Center). In a survey conducted among 6,174 Americans in 2022, the American Trends Panel revealed holding the belief that an opposing party’s policies are harmful to the country remains a major factor in why Republicans and Democrats choose to affiliate with their party (Pew Research Center). And while Republicans and Democrats continue to express negative views of those in the other party, they simultaneously have become more positive about the people in their party (Pew Research Center). Overall, the antipathy expressed by both parties is higher than it has been in decades (Pew Research Center). Whether conversing while you wait in line for your pour over or doom scrolling, the divide can often feel like tidal wave with culture wars at the undercurrent.

Despite the infinite agony, culture wars continue to remain plentiful, even when rooted in the idea of extinction. They underwrite our politics and the ways in which our politics become reflections of deeper cultural dispositions—not just attitudes and values—and it is these cultural dispositions which create the basis for policy (Politico). Veterans themselves seem to serve as some kind of détente within these culture wars, and perhaps this is why they can rapidly move the needle forward when it comes to policy and research around psychedelic therapies.

The Problem

The state of mental health and mental health policy within the United States (U.S) remains abysmal. Mental Health America stated in its 2023 key findings that the vast majority of individuals with a substance use disorder in the U.S. are not receiving treatment, millions of adults in the U.S. experience thoughts of suicide, almost one third of all adults with a mental illness reported they were not able to receive the treatment they needed, and in the U.S. there are an estimated 350 individuals for every one mental health provider (Mental Health America). When examining the Veteran community specifically, mental health issues become even more dire.

Veterans are 1.5 times more likely to commit suicide than nonveterans, with an average of 22 Veterans dying by suicide every day, with the recent discovery that it could be as high as 44 Veterans per day (Jordan, 2023 & Leonard, 2019). The National Center for PTSD found that 11% to 20% of Operation Iraqi Freedom (OIF) and Enduring Freedom (OEF) Veterans are diagnosed annually with PTSD (VETS). And with PTSD leaving out no generation, 12% of Gulf War Veterans and 30% percent of Vietnam War Veterans are affected by PTSD (VETS). Additionally, Special Operations Forces (SOF) have been diagnosed with PTSD at a rate almost double NON-SOF units (VETS). One out of every five female Veterans report having experienced military sexual trauma while serving in the military (MST) (Leonard). Furthermore, men and women who have experienced MST have the highest lifetime rates of PTSD with 65% of male Veterans and 49.5% of female Veterans experiencing such (VETS). Other prominent issues within the Veteran community include: traumatic brain injuries (TBIs) (with nearly 414,000 U.S. service members having experienced a TBI between 2000 and late 2019), substance abuse (with two out of every 10 Veterans experiencing a substance use disorder), anxiety and depression (with one in three Veterans having depressive symptoms), chronic pain (with one in five Veterans experiencing chronic pain, social anxiety), obsessive compulsive disorder (OCD), suicidal ideation (SI), and moral injury (VETS & VA).

Current treatments for such disorders are approved and used by the Veterans Administration (VA): trauma-focused therapies such as Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure (PE), Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), and medication to name a few (VETS & VA). Other PTSD treatments beginning to be explored by the VA include mindfulness and present-centered therapy, as well as Stellate Ganglion Block (SGB) which requires an injection of anesthesia into the sympathetic nerves of the neck possibly reducing the bodies flight or fight system (VETS & VA). However, half of Veterans do not complete the full course of therapy or medication due to unwanted side effects and/or increased symptoms, long VA wait times, and the stigma around mental health treatment (VETS). And with the VA receiving the third lowest rating among 10 agencies and departments in a recent Pew Research Center survey, this comes as no surprise (Stanton, 2021). Veterans continue to be dismissed and underserved as they are passed through the VA like hot potatoes (their description), with no real resolution for the complex mental health issues that continue to inhibit Veterans from leading a life which is whole (Bedford, 2016). While it seems clear organizations like the VA want to provide care for Veterans, statistics show a clear discrepancy between the care which exists for this population and the desired outcome. What remains unclear however, is why tending to the gap in Veteran care is not a priority, especially when viable alternative solutions exist. 

Search for Evidence 

Strong evidence indicates that the therapeutic use of psychedelics could be the answer in solving this discrepancy. While psychedelics have been around for many years, research on plant medicine is just beginning to emerge. Thus far, the research is promising, and even more promising when applied to the Veteran population. Focus will be given to SOF Veterans due to their increased risk for a variety of mental health problems, as well as cognitive impairment, that is associated with their specific military service (Davis et al., 2020 & Frueh et al., 2020).

SOF Veterans include the most elite and well-trained military members across all branches (VETS). These elite service members are constantly at the ready, have significantly more deployments than non-SOF members, experience high rates of direct contact during missions, experience combat and training injuries, higher rates of death/injury (especially impact injuries leading to TBIs), and psychological distress and long-term disability (VETS & Frueh et al., 2020). Due to the specific and complex mental, physical, and emotional issues that SOF Veterans face, a new term “Operator Syndrome,” was given to the community (Davis et al., 2020). Operator syndrome may be understood and defined as the natural consequence of an extraordinarily high allostatic load, the accumulation of physiological, neural, and neuroendocrine responses resulting from the prolonged, chronic stress; and physical demands of a career with the military special forces (Davis et al., 2020). These SOF Veterans experience overlapping medical, physiological, and quality of life impairments which differ from other Veteran sectors and require more accurate treatment and care (VETS).

Current available treatments, such as EBIs and pharmacotherapies, demonstrate limited efficacy in addressing the unique and complex spectrum of psychiatric symptoms in SOF Veterans, making support for policies which advocate for potentially curative treatment approaches able to address the underlying etiology and complex spectrum of symptoms the SOF Veteran population experiences crucial (Davis et al., 2020). Specifically, psilocybin, lysergic acid diethylamide (LSD), and 3,4 methylenodloxymethamphetanine (MDMA) are the most widely researched psychedelic-assisted therapies which exhibit potential transdiagnostic treatment approaches for psychiatric conditions including depression, anxiety, treatment-resistant depression, substance use disorders, and PTSD (Davis et al., 2020). It is hypothesized that through pharmacological action on serotonergic functioning, as well as the stimulation of neurotrophic growth factors and neuroplastic changes, one can reprocess and reconsolidate traumatic content via these psychological mechanisms (Davis et al., 2020). This in turn creates and allows for emotional breakthroughs, mystical-type experiences, and adaptive changes in personality and one’s self concept (Davis et al., 2020). Promising results from preliminary studies reiterate these findings indicating that Ibogaine, 5-MeO-DMT, and MDMA may offer Veterans rapid, robust, and well-tolerated treatment options when it comes to psychological and cognitive impairment (Davis et al., 2020). 

Policy Option

Recently, House lawmakers have introduced a bill that would create a psychedelic research grant for active-duty troops, the Douglas Mike Day Psychedelic Therapy to Save Lives Act of 2023 (Congress.gov). The bill requires the Department of Defense to award grants to eligible entities to research the treatment of certain members of the armed forces using specific psychedelic substances (Congress.gov). This bill states that research must focus on those in the armed forces who are currently classified as active-duty members and have been diagnosed with PTSD, TBI, or chronic traumatic encephalopathy (Congress.gov). Eligible entities under the bill include federal/state government entities, academic institutions, and nonprofit entities (Congress.gov). While we should support this bill, we must not forget the Veterans who have already served and are in dire need of treatment.

Possible Outcomes

Veterans seem to be encouraging psychedelic bipartisanship due to their boots on the ground approach and moving personal accounts which continue to be accompanied by research (Jordan, 2023). A similar bill was introduced last year by Dan Crenshaw and while the bill passed in the House, it failed in the Senate. Research has since increased, more Veterans are coming forward, and the psychedelic movement has gained traction in the last year with various states beginning to implement bills regarding the decriminalization of psychedelic drugs for therapeutic use. Therefore, it seems that the chances of this bill passing are higher than last year.

Evaluative Criteria

Should this bill be passed Veterans which are actively serving and meet said criteria could benefit greatly. A good way to measure success of the bill would be to look at Veteran suicide rates. Should there be a five percent decrease in Veteran suicide in the first two years of Veterans being treated, the bill would seem to be successful. 

Outcomes Weighed

While the bill has many assets, as mentioned before, the seemingly biggest remaining debt is that the bill excludes those who are not active duty. A similar bill including those who are not active-duty members should be introduced and/or the current bill should be amended to include non-active-duty members. Additionally, there is some concern around the eligible entities the bill mentions and how these eligible entities will implement psychedelic research among those serving. 


While this policy would serve active members of the armed forces, besides the physical criteria listed (those active-duty members who have been diagnosed with PTSD, TBI, or chronic traumatic encephalopathy), it is unclear what other criteria, if any, these active-duty members would have to meet. This would and should certainly be specified as it is important to know how such criteria would or could affect the Veteran community. Therefore, while this bill should be supported, there are concerns which need to be addressed to effectively serve all sectors of the Veteran population. As it seems, fortunately and unfortunately, Veterans are often left to advocate for themselves. While there are policies and agencies in place to care for Veterans, the lack of efficiency and effectiveness within these organizations is abhorrent. And in turn, Veterans are left behind to fight another war. One which is deadly, internal, and invisible. They are left in the dark at war with themselves. Veterans have long carried us, now we must carry them. 


Bedford, S. (2016, August 8). Nine major veterans affairs failures. Washington Examiner. https://www.washingtonexaminer.com/nine-major-veterans-affairs-failures 

Congress.gov. https://www.congress.gov/bill/118th-congress/house- bill/3684/text?s=1&r=1&q=%7B%22search%22%3A%5B%22Douglas+Mike+Day+Psychedelic +Therapy+to+Save+Lives+Act+of+2023%22%5D%7D 

Davis, A., Averill, L., & Amoroso, T. (2020, July 8). Psychedelic treatment for trauma-related psychological and cognitive impairment among US special operations forces veterans. Sage Journals. https://doi.org/10.1177/2470547020939564 

Frueh, B., Madan, A., Fowler, J., Stomberg, S., Bradshaw, M., Kelly, K., Weinstein, B., Luttrell, M., Danner, S., & Beidel, D. (2020). “Operator syndrome”: a unique constellation of medical and behavioral health-care needs of military special operation forces. The International Journal of Psychiatry in Medicine, 0(0), 1-15. https://sealff.org/wp- content/uploads/2021/07/Operator-Syndrome-International-Journal-of-Psychiatry-in- Medicine.pdf 

Hooyer, K., Applbaum, K., & Kasza, D. (2020). Altered states of combat: veteran trauma and the quest for novel therapeutics in psychedelic substances. Journal of humanistic psychology. https://doi-org.ezproxy.bu.edu/10.1177/00221678209045 

Jacobs, A. (2021). Veterans have become unlikely lobbyists in push to legalize psychedelic drugs. NY Times. https://www.house.mn.gov/comm/docs/N-9u3nH44kKH4uLV0zKBCQ.pdf 

Jordan, K. (2023, April 3). Vets encourage psychedelic bipartisanship. Lucid News. https://www.lucid.news/vets-encourage-psychedelic-bipartisanship/ 

Leonard, N. (2019, November 8). The ongoing veteran healthcare crisis. National League of Cities. https://www.nlc.org/article/2019/11/08/the-ongoing-veteran-healthcare-crisis/ 

Mangini, P., & Averill, L., & Davis, A. (2021). Psychedelic treatment for co-ocurring alcohol misuse and post-traumatic stress symptoms among United States Special Operations Forces Veterans. Journal of psychedelic studies. 5(3), 149- 155.https://doi.org/10.1556/2054.2021.00176 

Mental Health America. (2023). The state of mental health in America. https://www.mhanational.org/issues/state-mental-health-america 

Pew Research Center. (2022, August 9). As partisan hostility grows, signs of frustration with the two-party system. Pew Research Center. https://www.pewresearch.org/politics/2022/08/09/as-partisan-hostility-grows-signs-of- frustration-with-the-two-party-system/ 

Schaeffer, K. (2021, April 5). The changing face of America’s veteran population. Pew Research Center. https://www.pewresearch.org/short-reads/2021/04/05/the-changing-face-of- americas-veteran-population/ 

Stanton, Z. (2021, June 20). How the ‘culture war’ could break democracy. Politico. https://www.politico.com/news/magazine/2021/05/20/culture-war-politics-2021- democracy-analysis-489900 

Veterans Administration. https://www.va.gov 

Veterans Seeking Treatment Solutions. https://vetsolutions.org

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