Operationalizing Excellence in Psychedelic Care Through Advancing Competencies in Nurses: State-of-the Science Review.

Abstract

As interest in psychedelic-assisted therapies grows ahead of regulatory standardization, mental health nursing stands at a critical clinical and professional inflection point. This state-of-the-science review examines psychedelic-assisted therapies through a mental health nursing lens and advocates for the formal recognition of psychedelic nursing as a specialty with defined competencies, training pathways, and professional standards. Emerging evidence from neurobiology, empirical data, policy, and patient experience literature was synthesized alongside nursing scope of practice, ethics, and models of care. The evidence demonstrates that psychedelic-assisted therapies occur within structured phases in which therapeutic outcomes are influenced not only by pharmacologic effects but also by relational presence, the therapeutic environment, and meaning-making. These interventions appear to enhance neuroplasticity, emotional processing, and memory reconsolidation, particularly among individuals with treatment-resistant mental health conditions, while qualitative evidence highlights the importance of patients' subjective and lived experiences. Mental health nurses are uniquely positioned to promote safety, optimize therapeutic outcomes, and reduce harm throughout the continuum of care. However, substantial gaps remain in standardized education, role delineation, and nursing leadership in research and implementation. Safe, equitable, and scalable integration of psychedelic-assisted therapies will require specialty recognition, competency-based education, certification pathways, and greater nursing leadership in protocol development, research, and policy. A nursing-informed, evidence-based framework has the potential to strengthen interdisciplinary care while ensuring ethical, patient-centred, and trauma-informed practice.