Walk through Midtown Manhattan or Brooklyn Heights today and you may pass a gleaming new storefront offering ketamine-assisted therapy. These clinics — more than a dozen across New York City and counting — are part of a fast-growing mental health industry offering a novel treatment for patients struggling with depression, anxiety, PTSD and other conditions who haven’t responded to traditional approaches.
Their appeal is easy to understand. Around 30% of people with depression are considered treatment-resistant. Millions of Americans live with mental illness while waiting months for an appointment or hitting dead-ends with talk therapy and standard antidepressants. Into that void has come ketamine, a decades-old anesthetic with psychedelic and rapid, dramatic effects in many – but not all – cases.
The field is expanding quickly, and often without clear rules. Though the FDA has approved one ketamine-based nasal spray for depression, most clinics offer intravenous infusions of ketamine, an off-label use that isn’t formally sanctioned for psychiatric treatment.
Protocols are not universal, and clinics may set their own. Some patients get same-day appointments and are sent home after a dissociative trip with little follow-up. Others receive care in carefully managed clinical settings with mental health providers on-site.
The nasal spray is covered by most commercial insurance, but patients pay out-of-pocket for the IV. Prices are steep — often $500 to $1,000 per session — and the market is hot. A single company, Keta Medical, doubled its patient visits year over year and is now expanding across boroughs. Competitors are pouring in, some backed by venture capital, chasing a projected $6.9 billion national market by 2030.
This is a mental health gold rush. And like any gold rush, it’s driven by genuine need — but vulnerable to exploitation.
The opioid epidemic taught us that even widely accepted medical treatments can spiral into crisis when demand outpaces oversight. Back then, it was “pain clinics” and permissive prescribing. Today, it’s ketamine clinics and the promise of fast relief. Without clear medical guidelines and regulatory standards, history risks repeating itself in a different form.
The business community should care about the proliferation of ketamine clinics because they reflect a growing, lightly regulated corner of the mental health economy that raises both ethical and reputational concerns. As these clinics expand in commercial districts, they may affect neighborhood dynamics, employee well-being and broader conversations about responsible innovation in health care.
Patients deserve innovative solutions, especially in the face of a mental health system that too often fails them. But they also deserve safe, evidence-based care. That means guardrails. The city and state must take a closer look at how these clinics operate — what kinds of providers are involved, how risks are screened and how patients are followed over time.
