Comment on FR Doc # 2026-14146

Training and Care Delivery Models for Safe Administration of Potential FDA-Approved Psychedelic Therapies in Ambulatory Clinical Settings Public Comment in Response to HRSA Request for Information Federal Register Document 2026-14146: Thank you for the opportunity to provide comment on this important initiative. These statements reflect the position of leaders at Lane County Health & Human Services who serve many of our most acute and vulnerable individuals in this Oregon county. We certainly agree that standard treatments for individuals with significant mental health challenges are often inadequate and there is an urgent need to find more effective interventions. We further agree that the preliminary data is promising for psychedelic drugs and should be investigated further. In our view, mental health care is best delivered by a team of well-trained professionals who are skilled in assessment and can offer comprehensive care across multiple modalities, including non-pharmacological interventions such as health promotion activities. We have some concern over the fragmenting of mental health care into small stand-alone clinics that do only one thing. Further, we are concerned about the lowering of training standards when caring for people with refractory mental health conditions that, if poorly managed, can lead to disastrous outcomes. The United States already has a robust system of testing and approving mediations through the FDA. There also already exists training standards for who is permitted to prescribe medications. In our view, we should not reinvent the wheel here and instead should use these same systems and standards for psychedelic drugs. Specifically, this would mean the following. •Having psychedelic drugs go through the same FDA process as any other new medication •Having the administration of these medications be done by people who are trained medical professionals with a license to diagnose mental disorders and to prescribe medications •Discouraging stand-alone psychedelic clinics who don’t know their clients, can’t offer comprehensive care, and won’t stand by them if treatment is ineffective or leads to adverse outcomes Our population struggling with mental health concerns deserve high-quality comprehensive care delivered by well-trained experts. Let’s trust the system we have already built rather than creating carve outs for back-alley clinics that offer only psychedelic drug treatment at the exclusion of all the other things that we know can improve well-being. David Rettew, MD, DFAACAP Medical Director, Lane County Behavioral Health Lane County Health & Human Services