What a great way to win subscribers – I just registered to be able to comment on this. 😄
Ok, more seriously, I’d firstly like to thank the authors for bringing these cases forward. Transparency and pharmacovigilance are exactly what this field needs, and these stories deserve to be reported on and discussed too.
That said, the article documents harm without a denominator or comparison. Four reported serious incidents across roughly 2’500 authorisations only becomes meaningful when compared to baseline rates of suicide attempts and serious adverse events in the same patient population under more “conventional” care, which carries its own well-documented risks. Those comparisons are missing.
It's also worth naming the harm caused by the current framework itself: even though we may benefit from a more permissive framework here in CH, patients who could benefit are forced to wait years or continue with less effective treatments, and that prolonged suffering is also invisible in the statistics.
I'm not a health professional, but I like numbers and hard data. My gut feeling is that more transparent reporting, done well, is likely to strengthen rather than weaken the case for these therapies. Showing their safety and efficacy while also making clear, as the research already shows, that psychedelics are not a universal solution and that careful screening and integration matter enormously.
Also, a note on the headline. "The hidden harms of the Swiss psychedelic program" is what most people will see when this is shared, and it frames a piece that, read in full, is actually a careful argument for better reporting infrastructure.
Many readers will take away "psychedelic therapy is hiding deaths" rather than "Switzerland needs standardised pharmacovigilance for a high-risk patient population."
Given the stakes, including the risk that sensationalised framing delays access for patients suffering now, a headline reflecting the article's actual substance would serve the cause of transparency better.
On the denominator point: you are right. The reason it is absent is not oversight but a sourcing problem: there is no reliable denominator. The FOPH's own data is acknowledged to be incomplete, the reporting is unstandardised, and the number of SAEs in Switzerland has no statistical value and permits no interpretation, as swissethics told us. Comparing an unreliable numerator to a baseline rate would have created a false precision that the data does not support.
Your second point that access delays cause invisible harm did not make it into this piece but it belongs in a follow-up investigation.
On the headline: Your reading is fair. The piece is an argument for better reporting infrastructure, not an indictment of the therapy itself.
Headlines tailored towards maximising engagement can be a double-edged sword; on the one hand they catch people’s attention (as was the case for me), but they can also leave or reinforce incorrect impressions that are then hard to dislodge in the minds of those who don’t engage with the content and just see the article preview on LinkedIn for instance. I can only imagine how counterproductive a title like this would be in the Blick.
Personally I would’ve been more cautious with the semantics of the “hidden” qualifier which can convey the idea that these numbers were intentionally hidden, kept from the public eye, whereas, as you correctly point out, they are being discussed openly at events like the one from the SÄPT and that there are ongoing initiatives for better reporting as opposed to intentional efforts to suppress that information.
But once again, sobering articles like this one that are based on data (…or pointing out the lack of it) matter since they push for more scientific rigour. So in that sense I’m happy to support your journalism work and discover your past and future investigations.
I picked the headline. You need something in a few words. I see the point about hidden being readable as 'intentionally hidden', but hidden doesnt mean intentionally hidden. suggested alternative?
I agree with @Raphael on the discordance between the title and content--'gaps in SAPT reporting in adverse events' would have been more accurate. I also agree the content is important. The Swiss SAPT compassionate use program (like the Canadian Special Access program) were not designed for careful capture of adverse events (as you correctly point out re lack of incentives for physician reporting for example), and they are not resourced to do that. These programs are not the answer to expanding access or measuring adverse events. I am not apologizing for them. The kind of quantitative data collection paired with sound (eg not attached to a 'movement') and consistent clinical judgment about how to attribute adverse events that I think you are calling for is expensive. I am not sure that suggesting that the Swiss infrastructure is 'hiding' problems is constructive, honestly. But the gaps are real.
I think the industry would like to focus on whether the headline is sensationalist or not (Ive changed it to 'the unreported harms of the swiss psychedelic industry'), when there is a much, much bigger issue for the industry to face - can people experience severe extended difficulties even in clinical settings? this has been denied by leading figures in the field. David Nutt, when arguing for the legalisation of MDMA and psilocybin therapy in Australia, said that no one has ever come out of a clinical treatment feeling worse. Gasser's paper, mentioned in our piece, says there have been ZERO serious adverse events in over a decade of treatment. When Mary was offered this treatment, she wasn't given any warning that serious extended difficulties could occur. THAT is the key issue the industry needs to face, not my headline. Can severe side effects occur even under optimum clinical conditions? Yes - Mary and others were brave enough to come forward and speak about their experience (and I notice not a single person from the industry has commended her or expressed concern about her situation in the response to this article). their stories show that YES people can experience severe side effects even under optimum clinical circumstances. Given that such side effects can occur, should patients be given information about them in advance, should the general public be warned about the risk of destabilization. YES they should.
Mary's experiences weren't solely the effects of MDMA, the practitioner, the therapy, or her mental illness—they were the complex interaction of all four. And she wasn't experiencing beneficial effects and side effects as separate phenomena. MDMA therapy causes shifts in the complex system landscape of trauma reactions and avoidance; the beneficial and difficult parts are the same process. What looks like a "side effect" is often newly-exposed material that needs to be worked through, not a separable harm running in parallel to the therapy.
That's also why I think the framing of her year-long aftermath as primarily a reporting or pharmacovigilance failure misses something. The deeper problem is that the treatment model around her session didn't understand what it had set in motion. A single session activated a lot of trauma reactions—childhood abandonment, the "no skin" somatic stuff, the depersonalization—without the container to process any of it. She was then handed back to emergency rooms, which are stabilization-and-contain environments, the opposite of what activated material needs.
As Mary herself eventually realized, the persistence of her symptoms was facilitated by avoidance. In her own words: she stopped fighting the symptoms, let herself go through the panic attacks, stopped ruminating. That's the core therapeutic process: feeling the distress enough to process/unlearn it. She figured out on her own what the treatment should have been providing. If she or her practitioner had understood how the process works, the newly-exposed material could have been processed much faster—through talk therapy that facilitates memory reconsolidation, through further MDMA sessions with the window open again, or through daily practices of non-avoidance.
None of this is an argument that MDMA therapy is safe to enter casually for people with severe issues. It can be overwhelming, and it should be entered into at a time in your life when you have the space to work through what comes up. But "overwhelming and destabilizing" isn't the same as "harmful side effect." It's the middle of a process that needs to be completed, not abandoned.
You are right that the distinction between side effect and newly-activated material matters, but the argument that "overwhelming and destabilising is the middle of a process that needs to be completed" depends entirely on the quality of the container that follows. Mary did not have that container. She had emergency rooms. Her practitioner had no awareness that extended post-MDMA difficulties were possible. The peer-reviewed safety literature he would have consulted claimed no serious adverse events had occurred. The FOPH has no follow-up mechanism beyond 12 months.
Your argument actually strengthens the investigation's conclusion: if MDMA therapy activates complex material that requires skilled ongoing support to process, then a system with no mandatory long-term follow-up, no standardised adverse effect reporting, and a regulatory blind spot confirmed by two federal authorities is not equipped to deliver that therapy safely at scale.
I generally agree with you. My primary fear here is that a reporting system would not properly contextualize destabilization.
What are you basing the assessment of "not equipped to deliver that therapy safely at scale" on? While the regulator certainly has issues that could be improved on, I imagine that making an overall judgement of the system would require a nuanced weighing of both the benefits and downsides of the system as it currently operates.
Thank you for your thoughtful response, much of it resonated with me.
I agree that this work is complex, and that these therapies can open deep material requiring careful integration. I also had that full container: preparation, follow-up, and strong professional support.
And still, I almost died from this therapy.
What I struggle with in your framing is the idea that extreme reactions are part of a process that would resolve if worked through correctly. That was not my experience, and it’s a narrative I heard repeatedly while I was suffering. It was incredibly difficult to hear, because it carries the implicit assumption that either I or my practitioners were doing something wrong. In reality, I had extensive support, at times the equivalent of a mental health ICU just to keep me alive, and still I was in hell.
What I went through was not just “overwhelming.” It was prolonged, extreme, and at times life-threatening. I surrendered to the process again and again. There was no avoidance, only months of enduring and feeling what was happening, with no way out. Only much later was I able, in a very basic way, to begin stabilizing and using simple tools to cope with the aftermath.
I’m not denying that the therapy also helped me, I hold deep gratitude for that. It’s complex. But we need to make space for the reality that it can also lead to severe, prolonged suffering that would lead the most resilient human being to want to jump under a train, daily, for many months.
When people hear that framing, they may not grasp what it can truly involve: losing your ability to function, your work, your relationships, your sense of self, and suffering in ways that are hard to even put into words, without knowing if or when it will end.
Part of the difficulty in many conversations, for me, is that there can be a reluctance, especially among strong advocates, to fully acknowledge that this remains experimental, and that there is still a great deal we do not understand.
That’s why informed consent matters so much to me. Not to dismiss these therapies, I’ve seen how much they can help others, but to be honest about the full range of possible outcomes, including the most severe, and the limits of our knowledge, so that patients can decide if they are willing to take the risk, and so that the research, and doctors on the field, can hopefully find ways of better helping those that are in great danger after the therapy.
I’m glad this conversation is happening. I just want experiences like mine to be heard as they are, without being softened into something more manageable.
Thanks for the comment. I believe you when you say that the experience was extremely bad in the ways you mention. I also agree that informing people up front of the potential for severe destabilization is important, and I wish we better understood who was at risk so they can be better supported and make more informed choices.
That's a great quote, "I thought a medical professional would understand and be able to help me. And then I realized, none of them know what is going on, and I have to take care of myself". Points to a problem of overconfidence in a pseudo-medical framework around psychedelics, perpetuated by many [but not all] patients and clinicians.
Highlighting ‘We expect suicidal ideation. It is not relevant to report it.’ by itself seems misleading. The previous sentence in the quote is necessary to contextualize it; without it, the quote conveys a very different meaning.
I thought the following quote ‘If serious incidents occur, it puts the entire movement at risk.’ was actually more notable and concerning.
Posting on behalf of the Board of the Swiss Medical Society for Psycholytic Therapy (SÄPT). The following comment has been published today on saept.ch.
An article by Sarah Zeines and Jules Evans, published on 17 April 2026 on ecstaticintegration.org, raises questions about how serious adverse events are recorded under the Swiss exceptional authorisations for psychedelic-assisted therapy (PAT). We share the view that the recording of adverse events under the limited medical use framework should be improved. The assumption running through the article — that treating physicians withhold unfavourable outcomes in order to protect the field — does not, however, reflect our own understanding of this work, nor what we know from working with colleagues. An open engagement with difficult treatment courses is in the interest of patients and therapists alike.
Beyond the regulatory steps mentioned in the article, further measures are already in place that the piece does not address. SÄPT operates an ombuds office to which patients can turn with complaints. The physicians carrying out these treatments are also asked to complete an evaluation after the end of treatment, which records adverse events as well. Difficult cases are furthermore discussed in intervision and supervision groups and at professional meetings.
The limited medical use of psychedelics in Switzerland is intended for patients whose usual treatment options have been exhausted. These are people living with severe, chronic conditions, in whom crises are unfortunately part of clinical reality, regardless of the therapy chosen. This entails a difficulty the article touches on but does not pursue further: how often serious events occur, and whether they can in fact be attributed to the treatment, can only be determined to a limited extent from data gathered in clinical care. There is no comparison group, and events can therefore often not be clearly linked to the therapy. Cases such as that of the patient described in the article should of course be carefully documented. Reliable statements about adverse effects, however, require above all clinical studies.
Thank you for your engagement with our investigation.
However, the article did not assume that there was deliberate withholding of information by physicians. We reported on a structural gap, not a moral failing. The article states explicitly that reporting failures reflect the absence of a standardised framework, not bad faith on the part of individual physicians.
SÄPT's statement also notes the existence of an ombuds office and internal evaluation forms. Our article's main finding, though, concerns what reaches the FOPH, the authority responsible for authorising and monitoring the programme. SÄPT's ombuds office handles patient complaints within the association. There is no formal mechanism by which those complaints are reported systematically to the FOPH. SÄPT's ombuds office is not a substitute for a national framework.
Finally, SÄPT argues that serious events in this patient population cannot reliably be attributed to treatment, a point our article raises and does not dismiss. However, it was also raised during our correspondence with Professor Liechti and Dr. Müller prior to publication, and is reflected in the article.
What we documented is narrower: the FOPH's own response to our transparency request used the term "événements indésirables graves" to describe four cases across a decade. One of those cases, a suicide three days after a final psilocybin session, documented in a peer-reviewed paper co-authored by SÄPT's co-president, was described in that paper as potentially linked to treatment. Dr. Müller confirmed to us that at the time of the death, there was no requirement to report serious adverse events directly to the FOPH, and that the case was reported only in the treating physician's final report. We reported these facts accurately and on the basis of named sources and official documents.
"It is important to emphasise that there is a significant delay between the last recorded intake of the substance and the occurrence of the serious adverse events.... Those hospitalisations took place five weeks to three months after the last substance session."
This is a reasonable caution. But it should be applied consistently: if a temporal gap weakens causal claims about adverse events, then the same gap should also temper causal claims about BENEFITS that emerge weeks or months after a session.
What a great way to win subscribers – I just registered to be able to comment on this. 😄
Ok, more seriously, I’d firstly like to thank the authors for bringing these cases forward. Transparency and pharmacovigilance are exactly what this field needs, and these stories deserve to be reported on and discussed too.
That said, the article documents harm without a denominator or comparison. Four reported serious incidents across roughly 2’500 authorisations only becomes meaningful when compared to baseline rates of suicide attempts and serious adverse events in the same patient population under more “conventional” care, which carries its own well-documented risks. Those comparisons are missing.
It's also worth naming the harm caused by the current framework itself: even though we may benefit from a more permissive framework here in CH, patients who could benefit are forced to wait years or continue with less effective treatments, and that prolonged suffering is also invisible in the statistics.
I'm not a health professional, but I like numbers and hard data. My gut feeling is that more transparent reporting, done well, is likely to strengthen rather than weaken the case for these therapies. Showing their safety and efficacy while also making clear, as the research already shows, that psychedelics are not a universal solution and that careful screening and integration matter enormously.
Also, a note on the headline. "The hidden harms of the Swiss psychedelic program" is what most people will see when this is shared, and it frames a piece that, read in full, is actually a careful argument for better reporting infrastructure.
Many readers will take away "psychedelic therapy is hiding deaths" rather than "Switzerland needs standardised pharmacovigilance for a high-risk patient population."
Given the stakes, including the risk that sensationalised framing delays access for patients suffering now, a headline reflecting the article's actual substance would serve the cause of transparency better.
Thank you for registering Raphaël!
On the denominator point: you are right. The reason it is absent is not oversight but a sourcing problem: there is no reliable denominator. The FOPH's own data is acknowledged to be incomplete, the reporting is unstandardised, and the number of SAEs in Switzerland has no statistical value and permits no interpretation, as swissethics told us. Comparing an unreliable numerator to a baseline rate would have created a false precision that the data does not support.
Your second point that access delays cause invisible harm did not make it into this piece but it belongs in a follow-up investigation.
On the headline: Your reading is fair. The piece is an argument for better reporting infrastructure, not an indictment of the therapy itself.
Headlines tailored towards maximising engagement can be a double-edged sword; on the one hand they catch people’s attention (as was the case for me), but they can also leave or reinforce incorrect impressions that are then hard to dislodge in the minds of those who don’t engage with the content and just see the article preview on LinkedIn for instance. I can only imagine how counterproductive a title like this would be in the Blick.
Personally I would’ve been more cautious with the semantics of the “hidden” qualifier which can convey the idea that these numbers were intentionally hidden, kept from the public eye, whereas, as you correctly point out, they are being discussed openly at events like the one from the SÄPT and that there are ongoing initiatives for better reporting as opposed to intentional efforts to suppress that information.
But once again, sobering articles like this one that are based on data (…or pointing out the lack of it) matter since they push for more scientific rigour. So in that sense I’m happy to support your journalism work and discover your past and future investigations.
I picked the headline. You need something in a few words. I see the point about hidden being readable as 'intentionally hidden', but hidden doesnt mean intentionally hidden. suggested alternative?
I agree with @Raphael on the discordance between the title and content--'gaps in SAPT reporting in adverse events' would have been more accurate. I also agree the content is important. The Swiss SAPT compassionate use program (like the Canadian Special Access program) were not designed for careful capture of adverse events (as you correctly point out re lack of incentives for physician reporting for example), and they are not resourced to do that. These programs are not the answer to expanding access or measuring adverse events. I am not apologizing for them. The kind of quantitative data collection paired with sound (eg not attached to a 'movement') and consistent clinical judgment about how to attribute adverse events that I think you are calling for is expensive. I am not sure that suggesting that the Swiss infrastructure is 'hiding' problems is constructive, honestly. But the gaps are real.
I think the industry would like to focus on whether the headline is sensationalist or not (Ive changed it to 'the unreported harms of the swiss psychedelic industry'), when there is a much, much bigger issue for the industry to face - can people experience severe extended difficulties even in clinical settings? this has been denied by leading figures in the field. David Nutt, when arguing for the legalisation of MDMA and psilocybin therapy in Australia, said that no one has ever come out of a clinical treatment feeling worse. Gasser's paper, mentioned in our piece, says there have been ZERO serious adverse events in over a decade of treatment. When Mary was offered this treatment, she wasn't given any warning that serious extended difficulties could occur. THAT is the key issue the industry needs to face, not my headline. Can severe side effects occur even under optimum clinical conditions? Yes - Mary and others were brave enough to come forward and speak about their experience (and I notice not a single person from the industry has commended her or expressed concern about her situation in the response to this article). their stories show that YES people can experience severe side effects even under optimum clinical circumstances. Given that such side effects can occur, should patients be given information about them in advance, should the general public be warned about the risk of destabilization. YES they should.
Mary's experiences weren't solely the effects of MDMA, the practitioner, the therapy, or her mental illness—they were the complex interaction of all four. And she wasn't experiencing beneficial effects and side effects as separate phenomena. MDMA therapy causes shifts in the complex system landscape of trauma reactions and avoidance; the beneficial and difficult parts are the same process. What looks like a "side effect" is often newly-exposed material that needs to be worked through, not a separable harm running in parallel to the therapy.
That's also why I think the framing of her year-long aftermath as primarily a reporting or pharmacovigilance failure misses something. The deeper problem is that the treatment model around her session didn't understand what it had set in motion. A single session activated a lot of trauma reactions—childhood abandonment, the "no skin" somatic stuff, the depersonalization—without the container to process any of it. She was then handed back to emergency rooms, which are stabilization-and-contain environments, the opposite of what activated material needs.
As Mary herself eventually realized, the persistence of her symptoms was facilitated by avoidance. In her own words: she stopped fighting the symptoms, let herself go through the panic attacks, stopped ruminating. That's the core therapeutic process: feeling the distress enough to process/unlearn it. She figured out on her own what the treatment should have been providing. If she or her practitioner had understood how the process works, the newly-exposed material could have been processed much faster—through talk therapy that facilitates memory reconsolidation, through further MDMA sessions with the window open again, or through daily practices of non-avoidance.
None of this is an argument that MDMA therapy is safe to enter casually for people with severe issues. It can be overwhelming, and it should be entered into at a time in your life when you have the space to work through what comes up. But "overwhelming and destabilizing" isn't the same as "harmful side effect." It's the middle of a process that needs to be completed, not abandoned.
Thank you for this Mark.
You are right that the distinction between side effect and newly-activated material matters, but the argument that "overwhelming and destabilising is the middle of a process that needs to be completed" depends entirely on the quality of the container that follows. Mary did not have that container. She had emergency rooms. Her practitioner had no awareness that extended post-MDMA difficulties were possible. The peer-reviewed safety literature he would have consulted claimed no serious adverse events had occurred. The FOPH has no follow-up mechanism beyond 12 months.
Your argument actually strengthens the investigation's conclusion: if MDMA therapy activates complex material that requires skilled ongoing support to process, then a system with no mandatory long-term follow-up, no standardised adverse effect reporting, and a regulatory blind spot confirmed by two federal authorities is not equipped to deliver that therapy safely at scale.
I generally agree with you. My primary fear here is that a reporting system would not properly contextualize destabilization.
What are you basing the assessment of "not equipped to deliver that therapy safely at scale" on? While the regulator certainly has issues that could be improved on, I imagine that making an overall judgement of the system would require a nuanced weighing of both the benefits and downsides of the system as it currently operates.
Hi Mark,
Thank you for your thoughtful response, much of it resonated with me.
I agree that this work is complex, and that these therapies can open deep material requiring careful integration. I also had that full container: preparation, follow-up, and strong professional support.
And still, I almost died from this therapy.
What I struggle with in your framing is the idea that extreme reactions are part of a process that would resolve if worked through correctly. That was not my experience, and it’s a narrative I heard repeatedly while I was suffering. It was incredibly difficult to hear, because it carries the implicit assumption that either I or my practitioners were doing something wrong. In reality, I had extensive support, at times the equivalent of a mental health ICU just to keep me alive, and still I was in hell.
What I went through was not just “overwhelming.” It was prolonged, extreme, and at times life-threatening. I surrendered to the process again and again. There was no avoidance, only months of enduring and feeling what was happening, with no way out. Only much later was I able, in a very basic way, to begin stabilizing and using simple tools to cope with the aftermath.
I’m not denying that the therapy also helped me, I hold deep gratitude for that. It’s complex. But we need to make space for the reality that it can also lead to severe, prolonged suffering that would lead the most resilient human being to want to jump under a train, daily, for many months.
When people hear that framing, they may not grasp what it can truly involve: losing your ability to function, your work, your relationships, your sense of self, and suffering in ways that are hard to even put into words, without knowing if or when it will end.
Part of the difficulty in many conversations, for me, is that there can be a reluctance, especially among strong advocates, to fully acknowledge that this remains experimental, and that there is still a great deal we do not understand.
That’s why informed consent matters so much to me. Not to dismiss these therapies, I’ve seen how much they can help others, but to be honest about the full range of possible outcomes, including the most severe, and the limits of our knowledge, so that patients can decide if they are willing to take the risk, and so that the research, and doctors on the field, can hopefully find ways of better helping those that are in great danger after the therapy.
I’m glad this conversation is happening. I just want experiences like mine to be heard as they are, without being softened into something more manageable.
Thanks for the comment. I believe you when you say that the experience was extremely bad in the ways you mention. I also agree that informing people up front of the potential for severe destabilization is important, and I wish we better understood who was at risk so they can be better supported and make more informed choices.
That's a great quote, "I thought a medical professional would understand and be able to help me. And then I realized, none of them know what is going on, and I have to take care of myself". Points to a problem of overconfidence in a pseudo-medical framework around psychedelics, perpetuated by many [but not all] patients and clinicians.
Highlighting ‘We expect suicidal ideation. It is not relevant to report it.’ by itself seems misleading. The previous sentence in the quote is necessary to contextualize it; without it, the quote conveys a very different meaning.
I thought the following quote ‘If serious incidents occur, it puts the entire movement at risk.’ was actually more notable and concerning.
Posting on behalf of the Board of the Swiss Medical Society for Psycholytic Therapy (SÄPT). The following comment has been published today on saept.ch.
An article by Sarah Zeines and Jules Evans, published on 17 April 2026 on ecstaticintegration.org, raises questions about how serious adverse events are recorded under the Swiss exceptional authorisations for psychedelic-assisted therapy (PAT). We share the view that the recording of adverse events under the limited medical use framework should be improved. The assumption running through the article — that treating physicians withhold unfavourable outcomes in order to protect the field — does not, however, reflect our own understanding of this work, nor what we know from working with colleagues. An open engagement with difficult treatment courses is in the interest of patients and therapists alike.
Beyond the regulatory steps mentioned in the article, further measures are already in place that the piece does not address. SÄPT operates an ombuds office to which patients can turn with complaints. The physicians carrying out these treatments are also asked to complete an evaluation after the end of treatment, which records adverse events as well. Difficult cases are furthermore discussed in intervision and supervision groups and at professional meetings.
The limited medical use of psychedelics in Switzerland is intended for patients whose usual treatment options have been exhausted. These are people living with severe, chronic conditions, in whom crises are unfortunately part of clinical reality, regardless of the therapy chosen. This entails a difficulty the article touches on but does not pursue further: how often serious events occur, and whether they can in fact be attributed to the treatment, can only be determined to a limited extent from data gathered in clinical care. There is no comparison group, and events can therefore often not be clearly linked to the therapy. Cases such as that of the patient described in the article should of course be carefully documented. Reliable statements about adverse effects, however, require above all clinical studies.
Thank you for your engagement with our investigation.
However, the article did not assume that there was deliberate withholding of information by physicians. We reported on a structural gap, not a moral failing. The article states explicitly that reporting failures reflect the absence of a standardised framework, not bad faith on the part of individual physicians.
SÄPT's statement also notes the existence of an ombuds office and internal evaluation forms. Our article's main finding, though, concerns what reaches the FOPH, the authority responsible for authorising and monitoring the programme. SÄPT's ombuds office handles patient complaints within the association. There is no formal mechanism by which those complaints are reported systematically to the FOPH. SÄPT's ombuds office is not a substitute for a national framework.
Finally, SÄPT argues that serious events in this patient population cannot reliably be attributed to treatment, a point our article raises and does not dismiss. However, it was also raised during our correspondence with Professor Liechti and Dr. Müller prior to publication, and is reflected in the article.
What we documented is narrower: the FOPH's own response to our transparency request used the term "événements indésirables graves" to describe four cases across a decade. One of those cases, a suicide three days after a final psilocybin session, documented in a peer-reviewed paper co-authored by SÄPT's co-president, was described in that paper as potentially linked to treatment. Dr. Müller confirmed to us that at the time of the death, there was no requirement to report serious adverse events directly to the FOPH, and that the case was reported only in the treating physician's final report. We reported these facts accurately and on the basis of named sources and official documents.
"It is important to emphasise that there is a significant delay between the last recorded intake of the substance and the occurrence of the serious adverse events.... Those hospitalisations took place five weeks to three months after the last substance session."
This is a reasonable caution. But it should be applied consistently: if a temporal gap weakens causal claims about adverse events, then the same gap should also temper causal claims about BENEFITS that emerge weeks or months after a session.