• Clinics like Mindbloom and Field Trip Health want to make "psychedelic medicine" mainstream. 
• Mindbloom went virtual in 2020, offering at-home ketamine treatments. Field Trip's spas are open. 
• Research has shown that ketamine can help reduce depressive symptoms, but experts urge caution.

Last fall, Dan, a 43-year-old father of 2, confided in a friend that he was buckling under the stresses of daily life in the midst of a global pandemic. When a friend told him about Mindbloom, a telehealth start-up offering an at-home ketamine treatment, he was intrigued. 

A few days after that, a Mindbloom-branded journal, pen, and eye mask arrived in the mail. His medicine—oral ketamine tablets in a holographic package—arrived shortly after from Mindbloom's pharmacy partner.

"I wanted to be less reactive, to learn to trust myself," said Dan, who had struggled with a general anxiety disorder and ADHD for many years. (He asked that his full name not be used.) 

When it came time for his first session, he sat down in his favorite chair, tucked the ketamine tablets into his cheek so they could dissolve, pulled his eye mask down, and waited. Later he would read back what he had written in his journal: "Whoa what an experience, me now versus me before is totally different."

An hour later, he was videochatting with his Mindbloom "guide," trying to process the experience. 

Say hello to the next big thing in mental health.

For years, momentum has been building toward a brave new world in which psychedelic drugs, such as psilocybin, MDMA, and even LSD become accepted and approved mental health treatments. Although major strides have been made—MDMA is in final-stage clinical trials now—to bring these drugs out of the rave and into the pharmacy, none of them are likely to be available for at least another few years. 

Enter ketamine, which is best-known as the party drug, Special K, and has been available as an anesthetic since the 1970s. Ketamine has been used off-label as an antidepressant for the last decade in so-called "ketamine clinics," after researchers found that non-sedating doses of it led to relief from depression in the early 2000s. 

Clinics like Mindbloom (tagline: "Psychedelic Medicine is Here") are trying to make ketamine more accessible by lowering the costs of the treatments, which aren't covered by insurance. Four sessions at Mindbloom will run you $1,000, compared to infusions done at a ketamine clinic, which can cost anywhere between $400 and $2,000 per session. Mindbloom serves clients in 11 states: New York, California, Florida, New Jersey, Pennsylvania, Nevada, Virginia, Arizona, Colorado, Texas, and Utah. 

"Mental healthcare was the no. 1 public health crisis in America before COVID, and the pandemic's omnipresence in our daily lives has made the problem worse," says Dylan Beynon, Founder and CEO of Mindbloom. "Mindbloom is on a mission to transform lives to transform the world. We're doing this by radically increasing access to the next generation of mental health and wellbeing treatments."

But the real key to what these new upstarts are offering is the experience of the drug combined with integration coaching. (Most Mindbloom guides have some training in "psychedelic integration" from schools like the California Institute of Integral Studies. In addition to the post-treatment talk sessions, clients can text with their coaches.)  

Field Trip Health is a similar clinic with locations in Toronto, New York, Chicago, Los Angeles, and Atlanta. Unlike Mindbloom, which went completely virtual in September of 2019, Field Trip offers an in-person ketamine experience at their spa-like facilities. Put The Wing, a Manhattan therapy office, and a yoga studio in a blender, and you'll get the vibe.

After a virtual visit with an M.D. to discuss your health history, you can sign up at Field Trip for "ketamine-assisted psychotherapy." A $2,500 treatment package at Field Trip includes 6 ketamine "exploratory sessions" (an in-office IV drip dose of ketamine with a licensed medical provider by your side), plus 3 "integration" sessions with a licensed therapist with psychedelic medicine training to process your experiences. (Field Trip's licensed therapists use research-backed psychotherapy techniques, the company says.)

"With ketamine in particular, it's a dissociative anaesthetic," says Ben Medrano, M.D., an integrative psychiatrist and Field Trip's medical director. "It allows you to dissociate enough from this level of identification with the painful emotions, so you can begin to look at that pain from different angles with the structure of the therapy."

It's not a totally out-there idea: Decades of research have shown that talk therapy (and talk therapy in combination with medication) is effective for mental health issues like depression and anxiety, as well as helping someone cope through other tough stuff like grief or a global pandemic. Research has shown that ketamine can help reduce even severe depressive symptoms within 24 hours. In 2019 a new version of ketamine ("esketamine") was FDA-approved specifically for treatment-resistant depression, though most clinics still use the original version of ketamine.

Some experts still see plenty of reasons for caution—at least for the time-being—and say it might not be the right treatment for everyone.  "It seems to induce a one to 2 week alleviation of depression," said Charles S. Grob, M.D., Professor of Psychiatry and Pediatrics at UCLA School of Medicine, who has studied therapeutic uses of psychedelics. "The issue is, the depression returns."

As for the value of ketamine-assisted therapy, Dr. Grob said, "I have not seen much in the way of research that it works, or that it works more effectively than just ketamine alone." 

There are also real risks to using ketamine. It is not recommended for people who have schizophrenia or certain heart issues, among other things. (FieldTrip and Mindbloom point out these issues are why they have screening performed by licensed providers in place.) But on top of that, there is a risk of becoming dependent on the drug. While it's not physically addictive in the same way opioids are, some people can develop a psychological dependency, Dr. Grob says.

Those currently making use of these services say they've had positive experiences.

Peter, a 40-something healthcare professional who asked that Insider conceal his identity, has been struggling with severe depression for the past two years. "In my lowest lows, literally, I was in the fetal position unable to get up off the floor for days," Peter says. 

He started working with a traditional therapist three times a week, but did not want to try antidepressants."I don't think traditional medications allow you to work through your pain. They just allow you to function," he says. When he found out about Field Trip, he was immediately drawn to it because he'd read about ketamine's unique method of action in the brain, and he felt it could offer something other treatments couldn't. He wanted a chance to experience it legally, and with professional supervision.

After two sessions, he's already reporting profound benefits. "The experience of ketamine is far beyond what words can capture," he says. "For me, it helped me see a bigger picture, and that I don't have to ruminate. I can let go." 

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