The results do the talking

Have you ever taken magic mushrooms? Many people have, for fun. But the Psychedelic Research Group at Imperial College takes psychedelic drugs seriously. The group studies the action of psychedelic drugs in the brain, and their clinical utility. And in particular, their relationship to depression.

This documentary by Monty Wates was filmed over two years and follows one such trial run by the research group. It starts with a brief run-through of why we are in the position we have today, with certain drugs being classified as illegal (Class A, B and C). Magic mushrooms are Class A, which means running even a small-scale feasibility trial requires an immense amount of time and effort to navigate the bureaucracy of the Home Office. This drudgery has already happened before the cameras roll. The trial is to test the feasibility of psilocybin (the 'magic' element), combined with psychological support, for treatment-resistant depression.  

The filmmaker obtained permission to follow three of the participants (see interview for details of how access to the trial was obtained). And whilst the film is interested in the clinical trial, and we hear from some of the researchers, it's the stories of these three men that is the focus. As people who have had depression for many years, they are all desperate to escape their virtual prisons.

We are allowed in to observe the sessions when psilocybin is administered – first a safety dose, then a week later a treatment dose. We gain some insight into some of the issues that can be brought up by the psychedelic 'journey', and why that might facilitate a process of psychological transformation. For two of the men at least, the difference is almost immediate, and startling. It's especially moving to hear John's teenage children talk about seeing their father in a new light: both are too young to have much memory of him before depression took hold. The film quietly makes the point that how the family around the person behave, and react, is a crucial part of the treatment process. Everyone must be willing, and able, to change.

The film does not make any grand claims about psilocybin, but lets the results do the talking. I was left with the feeling at the end that, for two men at least, it is an absolute tragedy that they cannot be prescribed another dose of psilocybin in the future. It is, obviously, still illegal. Perhaps this film will help to show that the drugs do work.

Why did you decide to make this documentary?
I had a friend, Lizzie Gillett [the film's executive producer], who had been looking to make a documentary about mental health for a while, but had just not found the right story. All the stories were just depressing and hard to watch, and so she couldn't work out how to tell them in an interesting way. Then she saw an article in the Evening Standard [about the trial] and rang me and said we need to make this film, and make it together.

Why did the study team agree to filming?
We went and met with Robin Carhart-Harris (Head of Psychedelic Research Group, Imperial College), and he said no initially. He was approached by lots of people actually. Then Robin contacted us again out of the blue and said do you want to come in and meet Professor David Nutt this time as well? After the first 12 participants had been through their process, Robin realised they were happy with the way it was going, and they thought there was an interesting story about that. He liked the idea of there being a film around the trial– it's a very different way of talking to an audience than an academic journal. I think that he believed in the possibility and thought it would make an interesting documentary.

I was amazed that Robin and David said yes. First medicinal psychedelic trial in the UK ever, and they let a cameraman come in and film it. But David Nutt believes in the power of these drugs, and the possibility of changing the perception of them. If this film gets on TV, which it hopefully will do, that's a million people plus seeing something about their trial.

Robin liked the way that we were approaching the subject, and we basically said to him, we're not going to make this film unless we have completely unfettered access to the trial and the people. We're not sugar-coating this, we're not doing a puff piece for your trial, we will film what happens, and that's the story that we're going to tell… if you can't agree to that then this one's not for us.

And he did agree to that, and it turned out that he completely stood by that. Whenever I wanted to speak to him, I was able to; whenever I wanted to speak to David Nutt, I was able to. I could ask any question I wanted, there was never an issue… because I was genuinely inquisitive about what was going wrong and what was going right.

Did the participants have concerns about your presence?
Yes they did. That was their call. In hindsight, I think that me being there may have helped, not hindered. I was trusted. I was there to be able to reflect back to participants a lot of stuff they had seen in their trips, and thought about, and also some things that they hadn't thought about.

By the point we started filming, there were only five patients left who hadn't taken the drugs. Three said yes to filming. During the trial [when taking psilocybin] I wasn't in the room, it was a fixed camera. I was in the room during the re-integration sessions. With people who are clearly struggling with mental health problems, to just be able to put anything out was just wrong. I said to them you can pull out at any time during filming, but no one did. They go to some deep places with me in the film. It seemed to me there was nothing off limits… 
I never heard 'I'm not going to answer that question', and they would go wherever I asked them to go.

My relationship continued with them way after the trial finished with them. Just having that person there that they could talk to, and I'd ring them every few weeks or months, and just see how there were, and to have that was helpful.

At the point (of the final cut) we had agreed together they were going to be in the film. We agreed that they couldn't at that point pull out as I had invested so much time and energy in the film, over the last two years. But if there was something in the film that was factually incorrect, or they felt it completely misrepresented their story, then we would have talked about that, and if they wanted it out, then it would have come out. But actually at the end of the viewing John was crying, and I cried with him. He said, 'I'll never forget you for that, Monty, I haven't trusted people for a very long time, I've only trusted a few people. It's reignited my faith in human beings.'

He did ask me if it was me being a clever director and being friendly to get what I wanted from him, and I assured him that's not who I am!

How much of the science did you feel you had to understand or explain?
I don't really understand the details of the science… part of me thinks the scientists don't really understand some of the science either! For me it was a human story all the way, but we would drop in bits of science when it was relevant. This is a film for a general audience. I didn't set out to do this, but now that it's done I realise it's a film which is there to educate people as to the possibilities of this drug, not just being a hedonistic and dangerous drug, but one that in the right circumstances can be used to treat.

What did the trial show?
At three weeks half of the group were off antidepressants, completely depression-free, living a completely functional life. At six months there were six people. The trial stopped collecting data after that. If that doesn't show promise, I don't know how you define promise.

For a number of people it had a completely transformative effect. With John for a month, maybe two months after, it was quite meaningful. He felt fixed, he felt like he'd been cured. But then the problem he was facing was, how do I now integrate my cure into my family life?

We could have finished the edit at six months, John would have been OK, Andy would have been OK. This would have been amazing, wonderful. But that's not a good way to present this information. The message is, there is a promise here, there are still two people, maybe three who are still depression-free three years later. And these are people who have had depression for an average of 18 years, between the whole group.

The film's not saying give everyone psychedelic medicine because it's a winner, it's saying make it easier to research so they can try and work out if it is or not. What if these people were complete flukes? We just don't know that.

Did the study team learn anything from you?
Maybe! The main thing that they may have learnt was that partners, and families, need to be looked after too, and that they should connect people in the trial with each other. They may have got there on their own, but the fact was that I was talking to the families so much, and then talking to them, it raised issues, e.g. Maggie feels she hasn't got a clue what's going on, she feels like she's a bit stupid; John can't talk to Maggie about it as she hasn't been through it; Yvonne feels the same with her partner. I think in the next trial they're setting up WhatsApp groups for the people who have been through the trial, and producing information for the families.

What advice would you give to others who are running trials and want to involve a filmmaker?
Choose very, very carefully the person you get to do it. Make sure that you know their history and that you get lots of references as to the type of person that they are, and the type of films that they make. I would watch the films that they'd made before, insist on that. That will tell you the type of filmmaker that they are.

I really believe in the power of stories. I think films have a way into people that almost nothing else does. I really do believe that a story well told is fascinating and interesting and really worth doing. The danger is that you get someone who is wanting to make a name for themselves, and they make a film that doesn't represent reality. So the other thing is to get a contract which says you have the right to review.

If you want to do it, do your research with the filmmaker and then jump in with everything. Don't try and sugar-coat the reality of what's happening, because that will just reflect really badly both in the film and on you. So if you believe in your trial, and you believe in your filmmaker and have done your due diligence on that, then go in completely and just say what you want to say, try not to stop yourself. The more honest you are, the better you come across, and the better the film will be. Do all the due diligence up front and once you're completely satisfied you're in a safe place, then treat the filmmaker like a friend and there will be a much more interesting product at the end.

- The premiere of Magic Medicine is at the Curzon Soho, London on 8 November, and includes a Q&A with Monty Wates; and a screening at the Regent Street Cinema, London on 19 December features a Q&A with Professor David Nutt. Details of these and more screenings can be found at magicmedicine.net.

Magic Medicine is available for organisations and individuals to license, or to organise public or private screenings. Email [email protected] for further information or call the distributors directly on 020 7845 5857.

See also our September 2014 issue on hallucinogens.