Frontline Clinician Psilocybin Study

Inclusion criteria

• ✓. Participants must be physicians or nurses with at least 1 month of frontline clinical experience during the COVID pandemic who rate at least 2 of 4 items from the COVID Exposure index as 'more than half the days' during their peak 2 week period of exposure: i. Caring for someone critically ill with COVID-19, or who became critically ill while you were involved; ii. Working longer hours than usual in order to provide assistance or care to individuals with COVID-19; iii. Witnessing or responding to a death related to COVID-19, or losing a patient you had been caring for to COVID-19; iv. Caring for patients who have died without family physically present due to COVID-19 precautions
• ✓. Have a Montgomery-Asberg Depression Rating Scale (MADRS) clinician-administered depression score \>21, indicating moderately severe symptoms.
• ✓. Have had persistent symptoms despite at least one medication and/or therapy trial of standard care treatment for depression.
• ✓. English speaking - able to understand the process of consent and the risk and benefits associated with the study, and able to give written informed consent.
• ✓. Must be willing to sign a medical release for the investigators to communicate directly with their therapist and doctors to confirm a medication and/or medical history. This is decided on a case-by-case basis upon the discretion of the PI.
• ✓. Must be driven home after the medication dosing session by a driver (which could be a friend, family, rideshare or taxi).
• ✓. Must provide at least one adult to have continuous contact with the participant, provide participant transportation, monitor changes in the participant's behavior, and notify research staff of behavior changes.
• ✓. Has been off selective serotonin inhibitors (SSRIs) for at least five half-lives of the drug plus 2 weeks.

Exclusion criteria