Advancing Standardized Care Metrics Across the Field
One of the greatest challenges to accelerating our ability to bring mental health and psychedelic assisted-care to marginalized communities through coverage by Medicaid and other insurers is the lack of sufficient data. Large studies are expensive, and the data often lives in a vacuum, not usable for other analyses.
That is why PMHA is focused on the development of a standardized set of variables to evaluate delivery of care—work that has been led by the team at Berkeley Center for the Economics of Psychedelics and shaped by input from a diverse group of stakeholders.
Drawing from a review of existing literature and expert consultation, we have developed an initial core set of variables intended to capture key elements of care delivery.
This draft set has been socialized with 13 stakeholders from academia, clinical practice, and policy advocacy, forming the basis of our ongoing Delphi process, which is being led by Dr. Kyle Greenway at McGill University.
Below we share an interview we conducted with Dr. Greenway where he shared more about the importance of this work.
Delphi Integration and Stakeholder Engagement
We are now entering a deeper phase of stakeholder engagement to ensure the variables are both practical and meaningful for real-world implementation. Our aim is to balance research rigor with feasibility—exploring who would fill out the data, how long it takes, and whether the data collection process can be streamlined or integrated into existing workflows.
The ultimate goal is to produce a shared framework that supports consistent data collection across the field. This will make it easier to compare outcomes, identify effective care models, and support initiatives such as a practice-based research network.
Importantly, we are designing this in close collaboration with practitioners and the medical community, prioritizing alignment with tools already in use. Adoption will only happen if these measures are compatible with the way people work today.
Why This Matters for Philanthropic Impact
The Delphi process has two critical components: identifying the right variables and securing strong stakeholder buy-in. Even the most rigorous metrics will fall flat without the support of the field.
For philanthropy, this work offers a valuable tool: a national standard of variables that can be used to guide and evaluate funded projects. By adopting these shared metrics, funders can enhance the impact of their investments and help generate comparable, actionable data. Eventually, this could also shape what state agencies choose to collect, moving the entire field toward greater alignment.
Next Steps: Implementation and Use
Once finalized, the standardized variables will be implemented in our PMHA work and shared with the Office of the System Catalyst, a new initiative spearheaded by many leading philanthropists in the field to help unify work across organizations.
We are exploring the potential to create shared databases, enabling organizations to contribute and access collective insights. With broad adoption, this data infrastructure can play a pivotal role in advancing policy discussions, improving care models, and informing insurance decisions.
Four Questions for Dr. Kyle Greenway
Kyle Greenway, MD MSc FRCPC, is an Assistant Professor in Psychiatry at McGill University, attending psychiatrist at the Jewish General Hospital, and investigator at the Lady Davis Institute.
He conducts clinical, naturalistic, and fundamental research on novel psychiatric interventions, particularly psychedelic-assisted psychotherapies for refractory depressive disorders. He leads the Ketamine-Assisted Therapy service at the Jewish General Hospital, one of only a handful of clinics in the world to offer a psychedelic therapy for severe depression in a public payer system. His work explores the impacts of extra-pharmacological factors on psychedelic and conventional psychiatric treatments, including how treatment protocols can be tailored to individuals based on their unique life experiences and cultures.
He co-led the Delphi Process conducted for a study on Set and Setting, exploring the most important non-pharmacological factors that impact psychedelic experiences in clinical trials. He will be directing our Delphi Process to establish a core set of variables intended to capture key elements of care delivery that will have the highest likelihood of adoption across the field.
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Dr. Greenway: I would say that there are two forces that drove me into psychedelic research and have sustained me over the years. On one hand, it’s hard to imagine an aspect of psychiatry that is such a wide-open frontier for research and full of so much potential for meaningful benefits to the countless people around the world who are suffering. There are so many joyous challenges and intriguing knowledge gaps, I can’t imagine ever being bored doing this work.
On the other hand, I and many other clinicians are frequently frustrated with the ways in which conventional psychiatry practice and research can become reductionistic and dehumanizing. For me, psychedelic science represents an unparalleled opportunity to steer psychiatry towards a more human and person-centered future. text goes here
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Dr. Greenway: In my mind, the first wave of psychedelic research demonstrated the potential of these interventions, and the second wave re-demonstrated this potential after it had been largely forgotten. Studies conducted during both waves were hugely impactful, but suffered to various degrees from methodological flaws and ideological excesses. I believe that there is now a third wave afoot, which aims to marry some of the excitement of the previous waves with a much higher standard for research methodologies and ethical practices.
Although this wave may seem less exciting in that expectations are less ‘game-changing’, I am extremely optimistic that greater rigor and nuance will help transition psychedelic treatments from intriguing but fringe treatments to becoming reliable and safe new tools in Psychiatry and beyond.
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Dr. Greenway: In the world of research, things don’t really exist until they are measured. For instance, ‘set and setting’ has been a hugely influential concept for psychedelic research since many decades now, yet the lack of pragmatic and shared approaches to measure set & setting variables has undermined efforts to take drug-context interactions seriously. Even more so, the subjective nature of psychiatric research means that measurement tools inevitably shape experiences and therefore outcomes – sort of like a psychiatric ‘observer effect’.
There is thus an urgent need to develop universal standards for care delivery variables, and the specific choices of these variables is extremely important to ‘get right’, insofar as is possible.
PMHA’s mission aligns perfectly with these goals, and its coordinated projects and networks are ideally placed to ensure that the science of this endeavour is done right, and the results will have widespread impacts.
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Dr. Greenway: The ideal product of this Delphi process will be a simple yet powerful tool that can provide clinicians and researchers with ‘best practices’ recommendations for measurement tools that are tailored to their particular contexts. Not only will this ensure that valuable resources are spent wisely – including the limited time of patients and clinicians – it will also greatly facilitate advancements in psychedelic research and policy.
This would mean much less time spent collectively researching and selecting instruments, reduced paperwork burdens, a shared ‘language’ for process and outcome data, and ultimately a much clearer global view of the safety, efficacy, and accessibility of emerging psychedelic therapies.
Help Shape the Future of Psychedelic Care
We’re launching a Delphi process to gather expert and community-informed perspectives on key variables that define safe, effective, and equitable psychedelic-assisted therapy.
If you're interested in contributing to this process—or want to stay informed as it unfolds—please fill out our short interest form.
Your voice matters in building models of care that reflect real-world needs and wisdom. Please share!