Comment on FR Doc # 2026-14146

Thank you for the opportunity to provide comments regarding training and care delivery models for the safe administration of potential FDA-approved psychedelic therapies in ambulatory clinical settings. As an organization serving veterans in rural Montana and as Community Care providers participating in the Department of Veterans Affairs Whole Health initiative, we have witnessed firsthand both the strengths and the challenges of caring for veterans living with PTSD, depression, chronic pain, traumatic brain injury, and moral injury. One veteran’s experience illustrates why psychedelic therapies should not be viewed as standalone treatments, but rather as one component of a comprehensive Whole Health model. This veteran spent years navigating conventional mental health care while living with severe PTSD and chronic pain. Like many veterans, treatment often focused on managing symptoms through medications and brief appointments rather than addressing the underlying causes of suffering or rebuilding purpose and connection. When introduced to the VA’s Whole Health approach, the experience changed dramatically. Instead of asking, “What’s the matter with you?” the care team began asking, “What matters to you?” The veteran was connected with complementary services including meditation, Tai Chi, massage therapy, peer support, nutrition, movement, mindfulness practices, and opportunities to reconnect with nature and community. These interventions improved physical health, reduced isolation, and restored hope. Within that broader framework, psychedelic-assisted therapy represents another evidence-based tool—not a replacement for Whole Health, but an extension of it. The veteran described psychedelic therapy not as a cure, but as an accelerator of healing. Insights gained during treatment were only meaningful because they were supported before and after administration through trusted relationships, behavioral health counseling, peer support, and continued engagement in healthy daily practices. This experience highlights several recommendations: * Psychedelic therapies should be embedded within comprehensive Whole Health programs rather than delivered as isolated medical procedures. * Preparation and integration are equally as important as medication administration and should be reimbursed accordingly. * Veterans benefit from interdisciplinary teams including physicians, nurse practitioners, psychologists, licensed counselors, social workers, peer specialists, Whole Health coaches, and complementary and integrative health providers. * Rural veterans should have access through hybrid models combining telehealth preparation and integration with regional centers for medication administration. * Training should emphasize trauma-informed care, cultural competency, suicide prevention, medical emergency preparedness, ethical practice, and long-term integration rather than focusing solely on pharmacology. * Community Care providers already participating in VA Whole Health programs should be considered valuable partners in expanding access while maintaining continuity of care. Many veterans have spent decades searching for healing after exhausting conventional treatments. Psychedelic therapies offer significant promise, but their greatest potential will only be realized when delivered within systems that recognize healing as more than symptom reduction. The VA’s Whole Health model already provides that foundation. Rather than creating a separate psychedelic treatment system, policymakers should build upon the Whole Health framework that is already transforming veterans’ lives by integrating evidence-based psychedelic therapies alongside behavioral health, complementary medicine, physical wellness, nutrition, social connection, purpose, and ongoing peer support. Done safely and thoughtfully, this approach has the potential to improve outcomes while honoring the VA’s commitment to treating the whole person—not simply the diagnosis. Thank you for your consideration and for your continued efforts to expand safe, evidence-based treatment options for America’s veterans.