Families in St. Louis ask us some version of the same thing again and again: my loved one's depression is not getting better, they have heard about ketamine therapy, and they cannot decide whether to look into it. What do I do with that uncertainty?
This FAQ collects the questions parents and other relatives ask most. Where we cite figures, they trace to one source: a poll of 443 Midwest adults, funded by our publisher. Each number here is from the survey's final, validated release.
My daughter says she is "not sure." Is that a no?
Usually it is not. "Not sure" is the most common place people land. "Cautious but open" was where roughly a third of our respondents, 34 percent, landed when the subject of ketamine care for depression or PTSD came up. Counting the hopeful or curious group, 18 percent, alongside them puts the combined open-leaning share at 51 percent. The group that reacted negatively was small, at 9 percent.
We cannot tell you how your daughter will decide. But being unsure puts her among the most typical responses, and it usually means she wants more information and more time.
What is she actually unsure about?
Ask her. Common worries include safety, whether it is legitimate, what a session feels like, what it costs, and what others will think. Each has a different answer, and guessing wrong wastes the conversation. A simple question like "What's the part that makes you hesitate?" often gets further than an explanation.
What exactly is ketamine therapy?
The phrase covers different things. The FDA-approved option is esketamine, which comes as a nasal spray under the brand Spravato. Its approval covers adults whose depression has held out against earlier medicines, plus adults in major depression with acute suicidal thoughts or actions. Doses happen only inside certified centers, and staff watch the patient for two hours or more afterward. IV ketamine drips and telehealth ketamine you take at home are both used off-label for depression, and federal regulators have raised concerns about home use with no one watching.
Most people have not heard of the approved product. The name Spravato was new to 73 percent of our respondents.
Is my loved one likely to be a candidate?
That call belongs to a clinician. As a rule, esketamine is considered after two or more antidepressants have been tried without enough improvement. Certain conditions, including uncontrolled high blood pressure and some blood vessel problems, can rule it out. A doctor will weigh medical history, current medications, and other factors.
Who should they talk to first?
The obvious first call is a doctor they already know. Our survey had 56 percent starting with a primary care doctor and 23 percent heading straight to a psychiatrist or similar specialist. More telling still, 74 percent said their own doctor's word is what would move them to try it. You can help most by encouraging that appointment.
Can I go to the appointment with them?
If your loved one is an adult, it is their choice. Many people appreciate company. If they want you to receive information from the clinic between visits, they can sign a release. Ask before the visit what role they want you to play.
Where would treatment happen around St. Louis?
To find certified esketamine centers, use the Spravato maker's online search tool or ask your loved one's insurer. Locations across the metro vary, and a center that looks close on a map can take a long time to reach at rush hour. Our respondents feel that: 43 percent put a short trip from home in their top two when picking a provider. Brain Recovery Centers has a page explaining Spravato treatment that you could read together.
What would the schedule look like?
Most people start with twice-weekly visits for around a month, move to once a week, and then settle into weekly or every-other-week visits, guided by their response. Each session includes a minimum of two hours of monitoring. Plan for a half day each time once you count travel.
Can they drive home?
No. After an esketamine session, the patient should skip driving, and anything else that needs full alertness, until a night's sleep has passed. If you are able to drive, offering that is one of the most practical kinds of support you can give.
Will insurance cover it?
Many plans, including Medicaid plans such as MO HealthNet, commonly require prior authorization for esketamine, usually showing that earlier medications were tried. The phone number on the insurance card is the quickest way to find out. Coverage mattered most to our respondents: 85 percent placed it among their top two priorities, and for 65 percent it would weigh heavily or settle the matter outright when deciding whether to try it.
We are a family of a first responder. Does that change anything?
More than a quarter of our respondents, 29 percent, said they are the parent or another relative of someone who served or works as a first responder, so you are far from alone in this survey. That group of 129 parents and relatives leaned open at 55 percent, a little above the full sample. The medical questions are the same. Practical ones may differ: shift schedules, the no-driving rule after sessions, and concerns about privacy at work are all worth raising with a clinician. Military families may also have TRICARE, which is worth checking before you choose a clinic.
What if they decide not to?
Accept it and keep the door open. A decision made under pressure rarely sticks, and your relationship matters more than any single treatment. Other options exist, including medication changes, therapy, and treatments like transcranial magnetic stimulation. Those decisions also belong with a clinician.
What if I am scared for their safety right now?
Do not wait. When a loved one speaks of wanting to die, or you think self-harm is possible, phone or text 988 to get through to the Suicide and Crisis Lifeline. Relatives are welcome to call about someone else, whatever the time, and get guidance on what to do.
Methodology
Every number in this FAQ is from one study: a survey that our publisher commissioned and financed. Pollfish carried it to panelists and wrapped the fieldwork on June 23, 2026. It counted 443 completed answers, all from adults in the 18 to 64 range, living across Minnesota, Nebraska, Ohio, Illinois, Oklahoma, Missouri, Iowa, Kansas, Indiana, and Wisconsin. Pollfish's validation of every response is complete, so these are final figures, and the family group is big enough to report on its own.