A psychiatrist in Australia can prescribe psilocybin, for exactly one condition.

A psychiatrist prescribing psilocybin in Australia is doing it on a personal approval, and it has to be a specialist psychiatrist. The authority sits in subsection 19(5) of the Therapeutic Goods Act 1989, with Appendix D clause 9 as the narrow limit that admits the supply. A clinic cannot hold it. Neither can a profession. Beyond that authority, supply is lawful to a clinical trial approved by or notified to the Secretary.

There is one condition, and that is the whole list. In the Poisons Standard the substance is spelled psilocybine, and Schedule 8 admits it for treatment-resistant depression alone, with everything else left in Schedule 9. If you are asking whether another diagnosis qualifies, the Standard does not provide for one.

Which raises the question of what there is to prescribe, because the regulator that licenses the prescribing does not control the supply. As for making it here, the Office of Drug Control says it has no power, under Commonwealth law, to permit psilocybin synthesis or mushroom cultivation in Australia. So a prescriber’s supply depends on an import licence, with a permit for each consignment.

No psilocybine product is on the Australian Register of Therapeutic Goods, as of the August 2026 review of Australia’s entry in the register.

The regulator holds the number and has not published it. Every authorised prescriber reports patient numbers to the Therapeutic Goods Administration every six months. Every prescriber or patient number in the public record arrived through the TGA’s freedom-of-information disclosure log.

Seven releases went out between August 2024 and February 2026, each covering MDMA and psilocybin together. Two of them carry the prescribing figures. This is what they say.

Across every six-monthly report filed for psilocybin through 30 June 2025, prescribers reported 47 new patients. The scheme’s first six months produced none: three reports, no patients. Of the 41 psilocybin report rows in the release, 21 report a total of zero.

Thirty-six prescribers hold an approval to prescribe psilocybin, from 40 applications. Between them they reported those 47 new patients over two years, which is barely more than one each. Every approved application named the same indication, treatment-resistant depression.

A later TGA summary, released in February 2026, counts 40 prescribers and 65 patients. That is a different measure over a different window, and the release does not say how it was aggregated, so the two figures cannot be subtracted from each other.

None of them is a count of people. The TGA’s own caveat on the cannabis version of this return says why: a patient seen under more than one approval, or who changes prescriber, is counted again, and the true patient count is unknown.

Across the whole life of the scheme, from July 2023 to the end of December 2025, the TGA recorded no adverse events reported to it for either drug. That is a fact about the reporting channel. Nothing reached the TGA in two and a half years, and whether anything happened is a question these files do not answer.

Medicinal cannabis sits on the same Authorised Prescriber pathway, with the same six-monthly return. For cannabis the TGA runs an interactive public dashboard. A warning rides on it: that cannabis return cannot be de-duplicated, so by the TGA’s own account the true patient count is unknown. That caveat describes the instrument, and it travels with every psilocybin number above.

Small numbers are a fair reason for silence. Per-approval publication could identify individual prescribers, and small-cell suppression is ordinary statistical practice. But the TGA has not made that argument. Nor has it said anything else about why one substance gets a dashboard and the other a filing cabinet, and a request.

Our trials corpus held 324 records as of 25 August 2026. Five have an Australian site. All five are industry-sponsored, across three sponsors. One is a patient trial of psilocybin itself, in cancer-related adjustment disorder; two study psilocybin in healthy volunteers; two more test a deuterated psilocin analog for one sponsor’s linked program in major depressive disorder. None of the five is in treatment-resistant depression, which is the one condition the prescribing pathway covers.

One trial is missing from that list, and it happens to be the one the TGA delegate leaned on hardest in the 2026 decision. We probed three times for a phase 2b randomised controlled trial at St Vincent’s Hospital Melbourne and came up empty each time. No site row in the corpus, no linked publication, no occurrence of the name. So these counts are floors, and for a second reason too. Seventeen corpus trials carry no location data.

Someone has. So far the answer is no. On 29 May 2026 a TGA delegate issued an interim decision that the current scheduling of psilocybine remains appropriate.

As of 28 August 2026, this is where that application stands.

In 2025 an applicant the TGA records only as private asked for a second Schedule 8 indication: existential distress towards the end of life, prescribed by palliative-care specialists. That class was not clearly defined, the committee found, and it recommended no change. Eleven months passed between the committee taking it up and the interim decision.

Existential distress is not a recognised diagnostic category in DSM-5-TR. The delegate agreed the evidence base was not sufficient, and the committee found the supporting trials small and short of the methodological rigour it expected. On implementation there was no clear pathway, with prescriber credentialling and dispensing controls undefined. Also named was the regulatory impact on state and territory poisons regulators.

Of 595 submissions received, 590 were in support, though only 321 of the 595 included any written component. Both opposing submissions and all three partial ones were written. In opposition, Palliative Care Australia told the consultation the research remains experimental and currently insufficient to support routine use.

The delegate did not close the question, though. Scheduling may be revisited as evidence and diagnostic criteria mature, the delegate recorded, and peak professional bodies not yet heard would be asked before any final decision. Submissions on the interim decision closed on 31 July 2026.