Welcome and Introduction of Melissa Lavasani
Lia Mix: Hello, everyone, and welcome. I am Lia Mix, the CEO of Delphi, and we are excited to have you for our monthly insight session. Today, we welcome Melissa Lavasani, the founder and CEO of the Psychedelic Medicine Coalition (PMC).
PMC is the only Washington, D.C.-based nonprofit dedicated to advancing psychedelic-assisted therapies at the federal level. A nationally recognized policy leader, Melissa authored and led the passage of Washington, D.C.’s Initiative 81, the Entheogenic Plant and Fungus Policy Act of 2020. This passed with 76 percent voter approval, motivated by her personal experience using psychedelic medicines to recover from severe postpartum depression.
Under her leadership, PMC has built bipartisan support in Congress and advanced key federal legislation through the Congressional Psychedelics Advancing Therapies (PATH) Caucus. This includes the Innovative Therapies Centers for Excellence Act and the Expanding Veterans Access to Emerging Treatments Act. Melissa, it is great to have you with us to discuss your background, what you are seeing on the ground, and your forecast for the future.
Melissa Lavasani: I am grateful to be here, Lia. My trajectory was unexpected; I never anticipated working on the issue of psychedelics. I had no real experience with these medicines, recreational or otherwise. My exposure came through an act of desperation.
I was working for the D.C. government in budget and finance policy, a role I had held for nearly a decade. However, my experience with postpartum depression was mind-altering in its own way. Navigating the U.S. healthcare system left me with more questions than solutions. I did not qualify for clinical trials—specifically for treatment-resistant depression—because I had not failed on two different medications yet. I had a new baby, a toddler, a career, and a marriage; I did not have time to fail treatments.
I discovered that institutions like Johns Hopkins, Harvard, and Stanford were studying psychedelics. That gave me the green light regarding credibility; this was not a “hippie cure.” My husband, who had experience with psychedelics in his past, guided me through the process. I grew psilocybin mushrooms in my closet and used them with the intention of getting my life back.
While it worked for me, I acknowledge the privilege I had: a supportive partner, homeownership security, and a boss who covered for me during my depression. If I had been in any other position, I likely would have been fired. That experience shaped my sense of responsibility. I cannot guarantee it works for everyone, and I believe the safest path is through a healthcare system backed by clinical data. My experience over the last six years has made me deeply cautious about offering narratives of transformation without the proper safety nets.
Shifting the Narrative from Counterculture to Compliance
Lia: You have a front-row seat to how legislators respond to different messages. It seems the healthcare policy and evidence-based conversation is what actually moves policy.
Melissa: It was surprising. I initially thought the heavy lift would be convincing people that psychedelics were acceptable. In early 2021, few staffers even knew FDA trials were underway. However, once the veteran narrative entered Washington—and we have the veteran community to thank for that—the conversation shifted from “is this promising?” to “what are the institutional constraints?”
Congressional staff think about jurisdiction, budgets, liability, agency authority, procurement rules, and workforce capacity. My job is to translate emerging science into something that fits existing regulatory and reimbursement structures. We are not convincing them that something is interesting; we are showing them how to implement it without breaking the machinery of federal healthcare.
We are not going to completely overhaul the healthcare system with psychedelics. We must figure out how to fit this into the current system incrementally. That is where the work has matured: shifting from storytelling to system design.
The Strategic Role of the VA and New Legislation
Lia: You distinguish between raising awareness and having the tactical conversations necessary for decision-makers. Recently, we have seen meaningful movement around veterans-focused legislation, including the Expanding Veterans Access to Emerging Treatments Act. Why is this moment different?
Melissa: The moment is different because we are on the cusp of FDA approvals and facing an immense unmet clinical need inside one of the most conservative healthcare institutions: the Department of Veterans Affairs (VA).
The VA is the perfect place to start because it is a fully integrated healthcare system. It delivers care, trains clinicians, conducts research, tracks outcomes, and operates at a national scale. If something can be rigorously evaluated and implemented responsibly at the VA, it becomes credible across the rest of the healthcare ecosystem.
Representative Jack Bergman’s legislation is the starting point. It mandates the VA to structure an evaluation of how psychedelics perform. It creates pathways for controlled pilots, institutional oversight, workforce development, and the generation of real-world evidence. Critically, it creates an on-ramp for veterans to access psychedelics under medical supervision outside of clinical trials, which often exclude patients with comorbidities. This helps capture veterans currently leaving the country for treatment and brings them back into a safe system.
Lia You have also been advancing the Innovative Therapies Centers for Excellence Act. How do these pieces fit together?
Melissa: I view the Centers of Excellence bill as the structure—the skeleton—and the Emerging Therapies bill as the muscle. They work in tandem. Our focus this year is on moving bipartisan legislation forward, public education, and developing institutional partnerships.
A Vision for Boring, Reliable Healthcare
Lia: Looking into your crystal ball, what does success look like for psychedelic policy in five years?
Melissa: People may not like my answer, but I want psychedelics to become boring. I want to stop seeing sensational headlines about transforming society. I want this grounded in reality so it can move through our healthcare system without a hype cycle.
In five years, I would like to see:
- FDA approvals completed.
- Therapies prescribed cautiously and delivered by trained clinicians.
- A wealth of basic scientific, longitudinal, and real-world data.
- Legislation that is adaptable as evidence evolves.
Success means psychedelics stop being treated as a cultural phenomenon and start being treated as regulated clinical tools.
Navigating Implementation, Bureaucracy, and Spirituality
Lia Mix: We have a question from Eric Bailly regarding healthcare systems. Aside from the VA, are there any other systems receptive to creating the infrastructure necessary for these medicines?
Melissa: Academic Medical Centers (AMCs) are the most promising early adopters. They are comfortable piloting new models of care and have existing Institutional Review Boards (IRBs), clinical trial infrastructure, and experience integrating investigational therapies. They are already thinking about credentialing, liability, and data capture.
Regarding reimbursement, systems taking this seriously are not assuming immediate payer coverage. They are planning for a hybrid period of research and specialty care, potentially using bundled payment models or grant-supported programs, until there is enough real-world evidence to justify broader coverage.
Lia: Alan Wiederhold asks about knowledge transfer. Since many veterans are also covered by employer-sponsored plans, can we expect a framework for sharing information between public and private sectors?
Melissa: Absolutely. The VA is uniquely positioned to generate high-quality data on clinical outcomes, workforce models, and safety. This cannot remain isolated. I see this not as “public versus private,” but as institutional learning transfer. We need standardized data reporting and clinical guidelines. Once these therapies demonstrate real-world value inside the VA, that evidence becomes the foundation for private payers to justify coverage. This evidence portability is essential to avoid a fragmented system.
Lia: Another listener notes that in this administration, the right hand often doesn’t know what the left is doing—for example, the disconnect between White House rhetoric and FDA actions. What is your strategy given these challenges?
Melissa: This fragmentation is not unique to this administration; it is how the federal system functions. There is no single decision-maker who can flip a switch. The FDA evaluates safety and efficacy, while the White House considers political risk. It is normal for different parts of the government to move at different speeds.
Our strategy is to focus on the institutions structurally responsible for implementation: the VA, NIH [National Institutes of Health], CMS [Centers for Medicare & Medicaid Services], and the FDA. These institutions operate on evidence, not rhetoric. We are not chasing perfect alignment; we are building coherence at the institutional level where healthcare happens.
Lia: Finally, a question from Marcina Hill: How do you believe psychedelics relate to spirituality, and how does that integrate into a medical system that generally does not work with that framework?
Melissa: I acknowledge that my own spiritual pathway was strengthened by my experiences. However, from a policy perspective, we must separate subjective experiences from healthcare structures.
Medical systems do not treat spiritual experiences as truth; they treat them as psychological phenomena that may have therapeutic value. Healthcare operates on symptom reduction and functional improvement. We do not need medicine to validate a spiritual interpretation to evaluate a therapeutic effect. We need strong professional standards that allow patients to interpret their experiences in their own way. As long as the system remains grounded in evidence and safety, it can hold space for patients to find their own meaning.
Lia: That reminds me of best practices in behavioral health, holding space for meaning-making without imposing it. Melissa, thank you for your work and this conversation.
Melissa: Thank you, Lia. Please reach out to us at the Psychedelic Medicine Coalition.
