Evaluating the attitudes of mental health professionals towards trials of MDMA: a randomised vignette trial

Mental health professionals' attitudes toward a trial of MDMA-assisted psychotherapy did not differ overall from their attitudes toward a neutrally labeled pharmacotherapy trial. Psychiatrists were less willing to recommend participation in the MDMA-AP trial than in the control trial. Psychologists and researchers showed no differences. More experienced professionals had greater concern and stronger objections to the MDMA-AP trial than less experienced ones. The findings suggest that certain mental health professionals, particularly experienced psychiatrists, may be hesitant about MDMA-AP, which could pose barriers to its research and implementation.

Study at a glance

Abstract

Objectives To compare attitudes of mental health (MH) professionals towards trials of methylenedioxymethamphetamine-assisted psychotherapy (MDMA-AP), with a neutrally labelled pharmacotherapy trial.Design A randomised controlled vignette study design, with experimenters blinded to group condition.Setting Participants were recruited online via professional societies.Participants Psychiatrists, psychologists and MH researchers from across Australia.Interventions Participants were randomly allocated to read a vignette about a trial of either MDMA-AP or a neutrally labelled pharmacotherapy.Outcomes Comparison of the difference in four attitudes towards MDMA-AP and control: How likely they were to (1) recommend participating, or (2) object to participating in the trial; (3) their predicted efficacy; and (4) concerns about the safety of the trial.Results There were no overall differences between professional’s attitudes towards MDMA-AP (n=51) and the control pharmacotherapy (n=43) trial vignettes. Psychiatrists were less likely to recommend participation in the MDMA-AP than the control trial (d=0.72, p=0.02), but did not differ in other attitudes. Psychologists and researchers did not differ in any attitudes. The correlation between professional experience and both: (1) concern about, and (2) strength of objection to, the trial, was higher for MDMA-AP, than control (d=0.60, p=0.01 and d=0.40, p=0.03, respectively).Conclusions Psychiatrists, but not psychologists or researchers showed more hesitancy in recommending trials of MDMA-AP versus an unknown pharmacotherapy. Experienced MH professionals were more likely to have negative views about MDMA-AP trials than less experienced MH professionals. This may reflect the experience of prior unfulfilled pharmacotherapy innovation or exuberance associated with fewer years of practice. Research into, and implementation of, MDMA-AP may face barriers with certain MH professionals, which will need be addressed if MDMA-AP continues to show promise as an efficacious treatment.Trial registration number The study design was registered with the ANZCTR (ACTRN12620001068954).