Three mental health megatrends to watch in 2023

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"A state of consciousness is characteristically very transitory," Sigmund Freud wrote in The Ego and the Id exactly 100 years ago. "An idea that is conscious now is no longer so a moment later, although it can become so again under certain conditions that are easily brought about."

Predicting the longevity of an idea has always been a fool's errand. But never has it been more hazardous than now, when mysterious algorithms control how ideas surface and sink in the public consciousness. Yesterday's viral meme is today's yawn – until Instagram declares it 'retro' and makes it cool all over again. No idea lasts forever. But nothing dies either.

With that caveat, here are three big ideas that I believe will shape the world of mental health in 2023. (PS: Includes bonus tips generated by artificial intelligence, because how can you talk about the future and not ask a bot?)

1. The science of psychedelics turns a corner

One of the most contentious stories in mental health is poised for a heady plot twist in 2023.

Just over half a century ago, psychedelics – 'powerful psychoactive substances that alter perception and mood and affect numerous cognitive processes' – were being talked up as a miracle treatment for alcohol abuse, anxiety, and depression. But their public image unravelled during the tumultuous countercultural era of the 1960s. Over the following decades, mounting social stigma against mind-altering drugs would give them the stench of a fringe science at best and a taboo at worst.

A small group of scientists and therapists started a guerrilla project to restore legitimacy to these drugs in the 1990s, journalist Michael Pollan writes in How to Change Your Mind: the New Science of Psyschedelics. But widespread criminalisation and persistent fears and myths about these chemicals continued to choke mainstream scientific conversations around their potential benefits.

Intrepid researchers kept plugging away, running experiments where participants often reported profound improvements in their emotional health from clinically supervised use of substances such as psilocybin – a chemical found in 'magic' mushrooms.

"Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance," concluded one paper. Psilocybin combined with therapy could be four times more effective than antidepressants in relieving depressive symptoms, claimed another. The science of psychedelics was turning a corner.

Now, all this work could finally be culminating in a cultural tipping point. In the US, where the most influential research on psychedelics has been concentrated, there are signs of a dramatic turnaround in public attitude towards these drugs. Exhibit A: Just days into this new year, Oregon became the first US state to allow adult use of psilocybin under the supervision of licensed guides.

Exhibit B: MDMA* – the active ingredient in the infamous party drug Ecstasy – is gearing up for approval from the US Food and Drug Administration (FDA), following evidence of its efficacy in treating PTSD when coupled with talk therapy. Approval for PTSD treatment could expand research on the drug's potential use in other indications, such as eating and anxiety disorders.

Talk about an image makeover.