---
type: source
title: "Psilocybin Services and Mental Health Outcomes Within Oregon's State-Regulated Model (medRxiv Preprint)"
author: "Bendable Therapy Research Team (medRxiv preprint)"
url: https://www.medrxiv.org/content/10.64898/2026.02.18.26346580v1.full
date: 2026-02-18
domain: health
secondary_domains: []
format: preprint
status: processed
processed_by: vida
processed_date: 2026-05-11
priority: high
tags: [psilocybin, Oregon, mental-health, access, demographic-data, outcomes, naturalistic-study]
intake_tier: research-task
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

**Study design:** Prospective naturalistic study at Bendable Therapy in Oregon. March 2024 – April 2025. 311 screening applications → 126 eligible → 91 enrolled → 88 completed all components.

**Client demographics:**
- Age: Median 43 years (range 22-79)
- Sex: 52% male
- Race/ethnicity: **87.5% White** — significant disparity vs. Oregon's general population
- Education: **84.1% completed higher education** — extreme over-representation of college-educated
- Employment: 67.1% employed
- Income: 22.7% earned below $50,000 annually (thus 77.3% earned above $50K)
- Geography: 53.4% resided in Oregon; 46.6% traveled from out of state
- Military veterans: 15.9%

**Mental health baseline:**
- Depression diagnosis: 51.1%
- Anxiety diagnosis: 42.0%
- PTSD: 19.3%
- Concurrent psychiatric medications: 46.6%
- Prior psilocybin experience: **64.8%** — program is NOT primarily reaching naive first-time users
- Pre-session symptoms: 69.2% mild-to-severe depression, 67.0% mild-to-severe anxiety, 93.2% low/very-low wellbeing

**Mental health outcomes (30-day follow-up):**
- Depression (PHQ-8): -4.63 points (p<0.001), large effect size d=0.90
- Anxiety (GAD-7): -4.85 points (p<0.001), large effect size d=1.04
- Well-being (WHO-5): +10.67 points (p<0.001), very large effect size d=2.14
- Post-session: 61.4% reporting minimal depression, 70.5% minimal anxiety, 64.8% normal wellbeing

**Session parameters:**
- Average dose: 27.8 mg TPE (Total Psilocybin Equivalents)
- Individual sessions: 56.8%; Group sessions: 43.2%
- Integration session attendance: 80.0%

**Adverse events:**
- HPPD symptoms at 1-day: 39.7% (mostly transient)
- Clinically significant HPPD at 30-day: 0%
- Lingering negative effects: 3.4%

**Notable:** The study site enhanced Oregon's minimum regulatory requirements with additional screening, multiple preparation sessions, and structured integration support — outcomes may exceed what minimal-compliance centers produce.

**Limitations:** No control group; 30-day follow-up only; small sample (n=88); self-selection bias; expectancy effects possible; severe racial and educational over-representation limits generalizability.

## Agent Notes
**Why this matters:** This is the first published outcomes study from Oregon's Measure 109 program. The effect sizes are large — but the demographic data confirms what SB 303 aggregate data also shows: the program is capturing a white, highly-educated, likely high-income population. 87.5% white, 84.1% with higher education, 46.6% traveling from out of state. This is not population-level mental health access.

**What surprised me:** The out-of-state visitor proportion (46.6%) — nearly half of clients are traveling specifically for psilocybin services. Oregon is functioning partly as a "psilocybin tourism" destination. This fundamentally changes the equity analysis: the program isn't just failing local underserved populations, it's also drawing wealthier out-of-state visitors who can afford both the sessions and the travel.

**What I expected but didn't find:** Evidence that Oregon's program is serving the populations most affected by the mental health supply gap (low-income, rural, uninsured). Instead, the demographics mirror those of high-end wellness tourism.

**KB connections:**
- [[the mental health supply gap is widening not closing because demand outpaces workforce growth and technology primarily serves the already-served rather than expanding access]] — this source CONFIRMS and extends this claim to psilocybin services; state-regulated psilocybin is replicating the same access pattern
- [[prescription digital therapeutics failed as a business model because FDA clearance creates regulatory cost without the pricing power that justifies it for near-zero marginal cost software]] — psilocybin faces the opposite problem: high fixed costs (facilitator time, regulatory compliance) that justify high prices but limit access

**Extraction hints:**
- New claim candidate: "Oregon's Measure 109 psilocybin services reproduce the 'already-served' access pattern, with clients averaging 43 years, 87.5% white, 84.1% higher-educated, and 46.6% out-of-state — confirming that regulated therapeutic access does not automatically expand structural reach"
- The 30-day outcomes are strong but follow-up is too short to assess durability (the Compass Phase 3 key selling point is 26-week durability with 1-2 doses)
- The integration session attendance (80%) supports the "meaning-making as mechanism" claim — most clients who saw strong outcomes attended integration

**Context:** First published outcomes study from any real-world state psilocybin program globally. Published as preprint February 2026, not yet peer-reviewed. Single-site study (Bendable Therapy, Portland). One of the higher-quality service centers; minimum-compliance centers likely produce different outcomes.

## Curator Notes (structured handoff for extractor)
PRIMARY CONNECTION: [[the mental health supply gap is widening not closing because demand outpaces workforce growth and technology primarily serves the already-served rather than expanding access]]
WHY ARCHIVED: Provides the first empirical data on who Oregon's psilocybin program is actually serving and what outcomes look like. The demographic data (87.5% white, 84.1% higher education, 46.6% out-of-state) is the critical finding — this confirms that regulated psilocybin access is not closing the structural mental health gap.
EXTRACTION HINT: Two separate claims: (1) access equity finding — who is using Oregon's program; (2) outcome data — what happens when they do. Keep separate. Don't conflate the strong outcome data (which is real) with the access equity failure (also real). A treatment can work and still fail to reach those who need it most.
