Psychedelic- and Substance-Assisted Therapies in Global Mental Health: Bridging Cultures, Evidence, and Access.

Psychedelic- and substance-assisted therapies, including MDMA, psilocybin, and ketamine, are gaining attention for conditions such as PTSD and depression, yet their development and implementation remain largely concentrated in high-income settings. This graphical abstract summarizes the central argument of the commentary: while these interventions may hold relevance for global mental health, particularly in conflict-affected and humanitarian contexts, their equitable use is constrained by cultural, ethical, regulatory, and resource-related challenges. Responsible implementation requires culturally grounded, ethically robust, and context-sensitive pathways rather than uncritical expansion.