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INTRODUCTION: Despite the rapid advance of psychedelic science and possible translation of psychedelic therapy into the psychiatric clinic, very little is known about mental health service user attitudes. OBJECTIVES: To explore mental health service user attitudes to psychedelics and psilocybin therapy. METHODS: A questionnaire capturing demographics, diagnoses, previous psychedelic and other drug use, and attitudes to psychedelics and psilocybin therapy was distributed to mental health service users. RESULTS: Ninety-nine participants completed the survey (52% female, mean age 42 years). The majority (72%) supported further research, with 59% supporting psilocybin as a medical treatment. A total of 27% previously used recreational psilocybin, with a male preponderance (p = 0.01). Younger age groups, those with previous psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin. A total of 55% of the total sample would accept as a treatment if doctor recommended, whereas 20% would not. Fewer people with depression/anxiety had used recreational psychedelics (p = 0.03) but were more likely to support government funded studies (p = 0.02). A minority (5%) of people with conditions (psychosis and bipolar disorder) that could be exacerbated by psilocybin thought it would be useful for them. One fifth of the total sample viewed psychedelics as addictive and unsafe even under medical supervision. Concerns included fear of adverse effects, lack of knowledge, insufficient research, illegality, and relapse if medications were discontinued. CONCLUSIONS: The majority supported further research into psilocybin therapy. Younger people, those with previous recreational psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11845-021-02668-2.

non-peer-reviewed ; In Ireland, psychological morbidity has been reported in 21-27% of young adults, while the rate of youth suicide is the fourth highest of 26 European Union countries. The challenge of youth mental health for primary care is especially evident in socio-economically disadvantaged areas where risk factors for mental health problems are especially common. Mental health care in primary care has been defined as "the provision of basic preventive and curative mental health care at the first point of contact of entry into the health care system" (WHO, 2001). However despite frequent interaction with general practice, young people may be reluctant to contact general practitioners (GPs), or even recognise them as a source of help when distressed. Health professionals also face many challenges when trying to identify the mental and substance use disorders, including fear of 'over-medicalising' young lives and misinterpreting depression as a normal response to the wider psychosocial context of a young person's life.