It is late, the dishes are done, and you are the one with the laptop open. Your husband, your sister, your grown son has been sinking for months. They have tried the pills. They say they will "bring it up next time" with the doctor. You are not willing to wait that long without knowing what to bring up, so you type something into a search bar and start reading.
If that is you, a survey we ran this summer has something to tell you about the person you are helping, and about your own role in what comes next.
What the numbers say about the first move
Our June 2026 poll, 443 adults drawn from ten Midwest states that include both halves of the St. Louis metro, asked for the first place they would turn if they wanted ketamine or esketamine care for depression. Their answers, in the final validated data:
- Their family or primary doctor: 56 percent
- A psychiatrist: 23 percent
- Looking it up online alone: 12 percent
- No idea where to start: 5 percent
- Asking a friend: 1 percent
Add the first two lines together and 79 percent of respondents would begin with a clinician of some kind. Searching the internet ranked a distant third.
Two different jobs, one household
The person you care about is most likely waiting for a doctor to guide them. You are gathering information. These are not competing approaches. They are two halves of the same process, and the data suggests the handoff between them is where things tend to stall.
Here is why. Most people have no vocabulary for this treatment yet. Spravato, which is esketamine in a nasal spray and is approved for hard-to-treat depression, was unknown to nearly three in four of our respondents, 73 percent. A patient who has never heard the name is unlikely to ask for it by name. They are more likely to say something like "nothing is working" and hope the doctor fills in the rest.
We saw that pattern directly. In an open question, 319 respondents typed out what they would search for, and they wrote about feelings and needs, never drugs. One of them was "how to help someone with depression," which may be very close to what you typed tonight.
Why the doctor's word still carries the most weight
We also asked whose recommendation would actually tip someone into trying this kind of care. Their own doctor won that question with 74 percent of respondents, about three quarters. Second place, at 18 percent, went to a close friend or family member. Advertising barely moved anyone, at 2 percent.
Notice that second number. You are the runner-up voice in this decision, well ahead of ads, podcasts, or online personalities. Your influence is real. But the survey is clear that, for most people, the final nudge comes from a clinician. Your search is most valuable when it prepares the doctor visit rather than trying to replace it.
Turning your research into something the doctor can use
Everything you read tonight will be more useful if it lands on a single page your loved one can carry into the exam room. Try building one with them, not for them:
- A medication timeline. Each antidepressant, the rough dates, the dose if known, and the result. This is often the most important thing a doctor needs to judge whether depression is treatment-resistant.
- What has changed. Sleep, appetite, work, withdrawal from people. Concrete examples help more than adjectives.
- One question, written plainly. Something like: "Standard medication has not worked. Are there other approved options, and should I see a psychiatrist?"
- The insurance card and plan name. Coverage came up constantly in our survey. Knowing the plan saves a step later.
The St. Louis wrinkle
The St. Louis region has large hospital systems, and academic psychiatry, which is more specialty care than many parts of the Midwest can offer. That can make it tempting to skip primary care and call a specialist directly. Sometimes that works. Often, though, new psychiatry appointments take time to get, and some specialty programs expect a referral.
That is part of why starting with the primary doctor, as most respondents said they would, tends to be a sensible route here. The primary office already has the chart, can start a referral, and can document the medication history that insurers commonly want to see before approving a treatment like esketamine.
If your loved one is covered through TRICARE as a military retiree or family member, call the number on that card before the appointment and ask how mental health referrals work under their plan. In our poll, 5 percent of respondents carried TRICARE, a small group whose plan has rules of its own.
When the person you love will not go
A small slice of our respondents, 5 percent, picked the answer that amounts to "no clue where I would even begin." That is a small number in a survey and a very large feeling in a household. If your loved one is stuck there, a few things tend to help:
- Offer to make the call and book the appointment.
- Keep the goal small. "Just tell the doctor the pills are not working" is easier to agree to than "go ask about ketamine."
You cannot make the decision for another adult. You can remove most of the friction standing between them and the person who can help them decide.
The limits of this piece
Everything here comes from research on care-seeking, not clinical guidance. Spravato, the esketamine brand, is approved for adults whose depression outlasted other treatment, with each dose supervised in a certified clinic. For families, Brain Recovery Centers explains how Spravato treatment works for patients and families. Ketamine that web-based prescribers mail to people's homes is a separate, looser arrangement. Whether any option fits your loved one is their clinician's decision.
And if the sinking you are watching includes talk of not wanting to be here, the appointment can wait but that cannot. Either of you can reach a Suicide and Crisis Lifeline counselor through 988, text or voice, at any hour, and caregivers calling for guidance are welcome.
Methodology
Pollfish fielded survey 395586438 through its consumer panel, with the last response taken June 23, 2026. We have 443 completes, every respondent between 18 and 64, spread over Illinois, Missouri, Minnesota, Indiana, Ohio, Iowa, Oklahoma, Wisconsin, Kansas and Nebraska. Its results are validated and final. This site's publisher paid for and commissioned the research.