Therapeutic ketamine providers are seeing growth and positive patient outcomes, but companies caution that the business requires guardrails as it expands.
The drug ketamine was originally invented in the 1960’s as a surgical anesthetic for humans and animals. But ketamine’s dissociative and hallucinogenic properties meant people have also used it recreationally, and more recently, for treatment-resistant depression. Today, ketamine is part of a booming psychedelic wellness provider business that companies say benefits patients but requires thoughtful planning.
“It takes a lot of work to provide ketamine therapy that is safe and effective,” explained Dr. Leonardo Vando, a psychiatrist and the medical director of online ketamine-assisted treatment provider Mindbloom.
Mindbloom advertises itself as a “psychedelic therapy” provider. The company charges $100 a month for six doses of an oral form of ketamine mailed to members’ homes along with psychiatric clinical consults and sessions with a psychedelic guide over Mindbloom’s digital platform. Members also have access to group therapy sessions. The company does not currently accept any insurance plans.
Dr. Vando told Behavioral Health Business that the startup has found 80% of its members report “significant improvements” in their anxiety or depression after four ketamine treatment sessions and only about 5% of clients reported any side effects, most of which he said were “minor and short-lived.”
But the psychiatrist noted that offering safe and effective ketamine services requires:
- Care to establish a good physical setting and mindset for the patient before they take ketamine
- Hiring psychiatric clinicians who have training with ketamine
- Establishing clinical protocols to screen prospective members for safety risks and guide treatment plans
- And creating “rigorous clinical oversight” to review these protocols
Mindbloom declined to share patient numbers, but Dr. Vando noted that the company expanded services to 21 states in 2019 and anticipates adding service to 10 additional states in 2022.
Integration of Mental Health
Another mental health care startup, Heading Health, takes a different approach by seeking insurance coverage. Heading Health offers behavioral health therapy and nutritional therapy online, but it also offers ketamine services at two clinics in Austin and Dallas, Texas.
Heading Health CEO Simon Tankel told Behavioral Health Business hat the company has treated over 50 people with ketamine and has over 1,000 patients in total.
“As long as appropriate screening, monitoring and measurement is performed, it is clear ketamine is a very promising treatment for mood and anxiety cases for whom SSRI’s have not worked, so access can be beneficial,” said Tankel.
“However, given ketamine is an off label and as such unregulated treatment, standards often slip. For instance, many ketamine clinics are not staffed by mental health professionals,” he added.
Ketamine itself is not currently approved by the FDA for treating mental health conditions, so outpatient providers can currently only offer it to patients able to pay out of pocket. However, some health plans do cover the FDA-approved nasal spray derivative Spravato or esketamine.
Ketamine treatment providers who use Spravato have to follow stricter FDA and payor protocols than those who opt to use the non-FDA-approved oral or intravenous form of the drug. Tankel says Heading Health “welcomes” the higher bar Spravator requires and the accessibility for in-network patients and provides patients both the nasal spray and intravenous ketamine.
‘Turnkey’ Ketamine-Assisted Psychotherapy
As Mindbloom’s Dr. Vando noted, another problem with providing ketamine-assisted health services is finding trained professionals.
Health care startup Journey Clinical noted that although many therapists might want their patients to be able to access Ketamine-Assisted Psychotherapy (KAP), the clinicians may lack access to trained prescribers or the tools to implement it in their own practices. That’s the raison d’etre for the health care startup, which offers therapists a “turnkey” telehealth platform allowing them to add KAP to their practice.
Journey Co-founder and CEO Jonathan Sabbagh told Behavioral Health Business that the company provides 100 licensed psychotherapist members nationwide with KAP for their practice.
Sabbagh shared testimonies from several members, including one New York-based licensed clinical social worker, Rebecca, who added KAP to her practice by using Journey’s platform.
“During these unique sessions, my clients enter parts of their mind that are often difficult to access in traditional therapy sessions, and the work we’ve done can permeate in a more enduring way,” said Rebecca. “Afterwards, the boost that ketamine provides can be a catalyst for actions that deepen the integration process.”
It’s a catalyst that Journey CEO Sabbagh says he’s hoping will help shift the behavioral health industry to “more lasting, effective treatment.”
That’s a paradigm shift that Mindbloom’s Dr. Vando said is needed now more than ever.
“We’re in the middle of a mental health crisis, and one of the main reasons is that classic treatments like SSRIs simply aren’t very effective,” he said. “At the same time, many people lack access to mental health care—especially next-generation treatments like ketamine therapy. If we’re going to turn the tide on this crisis, we need more evidence-based tools at providers’ disposal.”
Tankel agreed with the focus on evidence-based practices, and noted that Heading Health is currently conducting a study on ketamine outcomes to help shed light on the sometimes murky data of the psychedelic industry.
“As ketamine delivery is unregulated, many ketamine clinics claim 90% success rates, in spite of academic studies usually showing 50% success rates,” he said.
By Sloane Airey
Companies featured in this article:
