Ketamine-Assisted Psychotherapy in Northern Ireland
A structured, medically supervised pathway for people who haven't found lasting relief through standard treatments.
Individualised Ketamine Assisted Therapy
For some people, standard treatments for depression, PTSD, and related conditions provide genuine and lasting relief. For others, they do not. If you have been through multiple medications, courses of therapy, or both, without finding the improvement you were hoping for, it is worth knowing that there are other clinically supported options.
Ketamine-assisted psychotherapy is one of them. It is not a silver-bullet cure, and the evidence, while substantive in certain areas, is still developing. What it offers, for carefully selected individuals, is a different mechanism of action, a different kind of therapeutic opportunity, and for some, meaningful change where other approaches have not delivered it.
Mirabilis Health launched Northern Ireland's first ketamine-assisted psychotherapy programme in February 2026. We are regulated by the RQIA and licensed by the Department of Health. Our programme is led by Professor Paul Miller MD, Consultant Trauma Psychiatrist, who brings over 25 years of clinical experience in trauma-focused therapy and leads our psychedelic clinical research programme.
Our Approach
Our treatment pathway draws on best practices in trauma-informed care, depth psychotherapy, and psychedelic-assisted therapy to create a safe, respectful space for transformation.
All participants undergo a comprehensive screening and preparation process. Treatment is administered by licensed medical professionals, with psychotherapeutic support present.
About Ketamine
Ketamine is a medicine with a long history in clinical practice, most commonly used as an anaesthetic in both human and veterinary settings. Over the past two decades, a substantial body of research has examined its effects on mood, cognition, and mental health conditions that have not responded adequately to standard treatments.
ketamine acts primarily on glutamate pathways in the brain rather than the serotonin and noradrenaline systems targeted by conventional antidepressants. This distinct mechanism of action is clinically relevant: it helps explain why ketamine can produce meaningful effects in patients for whom multiple prior treatments have failed. Research indicates it can generate rapid changes in mood and affect, in some cases within hours of administration, and there is evidence that it promotes neuroplasticity: a transient state in which neural connectivity becomes more flexible and responsive.
It is within that neuroplastic window that the therapeutic work takes place.
Ketamine administered without a structured therapeutic framework can produce short-term symptomatic relief, but the effects are typically not sustained. What we offer at Mirabilis is not an infusion clinic. Ketamine is one component of a wider clinical pathway that includes thorough preparation before treatment and structured integration work afterwards. The aim is to use the pharmacologically induced window of openness to support therapeutic progress that may have been inaccessible through other means.
Clinical studies and systematic reviews indicate that ketamine administration can be associated with rapid changes in symptom measures in people with major depressive disorder, particularly in those who have not responded to other treatments. The magnitude, duration and consistency of these effects vary between individuals and study designs, and sustained benefits beyond several days or weeks remain an area of active investigation.
Is this treatment appropriate for me?
This programme is designed for adults who have not achieved adequate outcomes through standard treatment pathways and are seeking a clinically supported alternative. It is not a first-line intervention, and it is not appropriate for everyone. Careful assessment and screening are central to how we work.
The conditions for which the evidence base is strongest are as follows.
Treatment-resistant depression. This is the best-established indication for ketamine-assisted psychotherapy. For patients who have not responded to two or more antidepressant treatments, or who have not achieved lasting benefit from psychological therapy, ketamine can produce clinically meaningful reductions in depressive symptoms, often with a speed of onset that conventional antidepressants cannot match.
Post-traumatic stress disorder (PTSD) and complex PTSD. The evidence for ketamine in PTSD is substantive and growing, particularly for presentations that are severe, chronic, or resistant to trauma-focused psychological therapies. When integrated with skilled psychotherapeutic support, ketamine may reduce hyperarousal, increase psychological flexibility, and allow engagement with therapeutic material that has previously been difficult to access.
Severe anxiety disorders. Including generalised anxiety disorder, social anxiety disorder, and anxiety presentations with strong comorbid links to depression or trauma. The evidence base here is less extensive than for depression but is expanding.
There is emerging evidence for other conditions including obsessive-compulsive disorder, chronic pain with significant psychological comorbidity, and certain presentations of substance use disorder. These are considered on an individual basis during assessment.
Ketamine-assisted psychotherapy is generally contraindicated in individuals with a personal or family history of psychosis, unmanaged bipolar disorder, or active substance misuse. Our clinical team will assess each person carefully and will advise honestly if this pathway is not considered appropriate.
What the programme involves
Each person's treatment is tailored following an initial assessment. The standard pathway includes the following components.
- An initial assessment and screening appointment: a comprehensive clinical review of your history, current presentation, treatment background, and suitability for the programme.
- A therapeutic preparation session: establishing a safe therapeutic relationship, reviewing clinical goals, and preparing you for the ketamine experience.
- One medically supervised ketamine session: prescribed by a consultant psychiatrist and administered by a registered nurse, with your therapist present throughout.
- Two follow-up integration sessions: structured therapeutic work to help you make sense of the experience and apply any insights to your ongoing recovery.
What to expect on the day of treatment
On arrival, you will be received into a calm, professionally staffed clinical environment. Prior to treatment, the clinical team will carry out standard observations including blood pressure, heart rate, and weight, and will conduct a brief pre-treatment review to confirm it is safe to proceed.
The ketamine will be prescribed by a consultant psychiatrist and administered by a trained nurse via intramuscular injection into the upper arm. The dose is individually calibrated and carefully monitored throughout.
You will then be settled into a low-stimulation therapy room. Most patients choose to lie down; a blanket and eye mask are provided. A curated therapeutic soundtrack is played throughout the session. Your therapist will remain present and within close proximity for the duration. They will not direct the experience or conduct formal psychotherapy during the period of acute drug effect. The session is yours to experience at your own pace, with therapeutic support available as needed.
The acute effects of ketamine typically resolve within approximately one hour. You may then rest quietly or speak with your therapist, according to your preference and readiness. There is no expectation to move quickly. Refreshments are available, and the team will liaise with your pre-arranged transport when you are ready to leave.
A clinical team member will contact you by telephone the following day. A structured integration session with your therapist will be arranged within the same week.
The evidence base
The evidence for ketamine-assisted psychotherapy is encouraging, particularly in certain diagnostic categories, but remains an active field of investigation and we consider it important to represent it accurately.
The evidence is strongest for treatment-resistant depression. Multiple randomised controlled trials and systematic reviews have demonstrated that ketamine produces rapid, clinically meaningful reductions in depressive symptoms in patients who have not responded to standard pharmacological or psychological interventions. Response rates and the durability of effects vary between individuals and across study designs. The integration of psychotherapy into the treatment pathway is in part a clinical response to the typically transient nature of ketamine's effects in isolation.
For other indications, the evidence base is more limited. We draw on emerging research and informed clinical judgement, and we discuss the state of the evidence openly with each patient during the assessment process.
Below is a historical overview and systematic review written by four psychiatric centres in Europe. For a full breakdown of research done in this area, this is a great place to begin.
https://www.sciencedirect.com/science/article/pii/S0272735826000152#ab0010
Highlights
• Ketamine-assisted psychotherapy shows promising outcomes across psychiatric disorders.
• Ketamine may support psychotherapy by improving compliance and treatment outcomes.
• Few studies used ketamine-only control groups, so the added value of psychotherapy remains unclear.
• Psychotherapeutic approaches and ketamine treatment varied widely across studies.
• Common factors of ketamine-assisted psychotherapies include preparation, attentive supervision and integration.
Mirabilis Health also contributes to this evidence base directly through our psychedelic clinical research programme. Learn more about our research
Initial treatment
£1,500
Includes:
An initial assessment and screening visit to explore suitability and safety.
1 x 2 hr therapeutic preparation sessions focused on preparedness and goals.
1 x medically supervised ketamine session supported by clinicians and therapist.
2 x 1hr follow-up therapeutic support and integration planning.
Financial Assistance
A small number of reduced-fee places are available for individuals who are unable to meet the full cost. This will not affect the standard of clinical care provided. Please raise this at the point of referral if it is relevant to your circumstances.
Insurance Assistance
A number of insurers are known to approve part or all of this therapy. On application, advise our team of your insurance status and we will direct you in your application.
Additional treatments
£900
Includes:
Our alumni program is designed to continue your journey towards healing. Building on the foundation of your previous experience, we can use additional treatments to foster ongoing growth and healing.
1 x 2 hr therapeutic preparation sessions focused on preparedness and goals.
1 x medically supervised ketamine session supported by clinicians (if clinically indicated) and therapist.
2 x 1hr follow-up therapeutic support and integration planning.
FAQ’s
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An initial assessment and screening visit to explore suitability and safety.
2 x therapeutic preparation sessions focused on preparedness and goals.
1 x medically supervised ketamine session supported by clinicians.
2 x follow-up therapeutic support and integration planning.
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While research in this area is still relatively early, the strongest and most accepted indications at present are:
Treatment-resistant depression
This is the best-established indication. Ketamine can produce rapid antidepressant effects, often within hours to days, in people who have not responded to multiple antidepressants or psychotherapy.Post-traumatic stress disorder (PTSD)
Evidence supports ketamine for PTSD, particularly where symptoms are severe, chronic, or treatment-resistant. When combined with psychotherapy, it may help loosen rigid trauma narratives, reduce hyperarousal, and increase emotional flexibility.Severe anxiety disorders
Including generalized anxiety disorder, social anxiety, and existential anxiety, particularly when linked to trauma or depression. The evidence base is smaller than for depression but growing.Chronic pain with psychological comorbidity
Conditions such as complex regional pain syndrome and fibromyalgia, especially where central sensitisation and trauma are involved. Psychological benefit and pain relief often interact.Obsessive–compulsive disorder (OCD)
There is emerging evidence for short-term symptom reduction, particularly in severe or refractory OCD, though this remains a more specialist and experimental indication.Substance use disorders (adjunctive)
Early evidence suggests benefit in alcohol use disorder and some other addictions, particularly when ketamine is embedded in structured psychotherapy aimed at motivation, meaning-making, and behaviour change.Acute suicidal ideation
Ketamine has a unique role in rapidly reducing suicidal thoughts, sometimes within hours. This makes it clinically valuable as a short-term stabilising intervention while longer-term treatments are put in place. It is not a standalone suicide treatment but can be life-saving in acute settings. We do not function as an emergency service and if there’s any chance you feel you might hurt yourself, get support right now:Samaritans (UK/ROI): call 116 123 (24/7)
If you’re in immediate danger: 999 or go to A&E.
A few important clinical caveats, especially relevant in trauma-focused work:
Ketamine is most effective when paired with skilled psychotherapy, not as a purely pharmacological intervention.
Careful screening is essential. It is generally avoided or used with extreme caution in people with a history of psychosis, unmanaged bipolar disorder, or active substance misuse.
The therapeutic model matters. Set, setting, preparation, and integration strongly influence outcomes.
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This pathway is designed for individuals who feel stuck despite previous treatments and are exploring other clinically supported options.
Our team will work with you through an initial assessment to explore your needs, hopes, and readiness, and answer any questions you have.
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This is a historical overview and systematic review written by four psychiatric centres in Europe. For a full breakdown of research done in this area, this is a great place to begin.
https://www.sciencedirect.com/science/article/pii/S0272735826000152#ab0010
Highlights• Ketamine-assisted psychotherapy shows promising outcomes across psychiatric disorders.
• Ketamine may support psychotherapy by improving compliance and treatment outcomes.
• Few studies used ketamine-only control groups, so the added value of psychotherapy remains unclear.
• Psychotherapeutic approaches and ketamine treatment varied widely across studies.
• Common factors of ketamine-assisted psychotherapies include preparation, attentive supervision and integration.
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On the day of your session, you will be welcomed into a calm, supportive clinical environment. Before treatment begins, the team will carry out routine observations such as blood pressure, heart rate, and weight, and will review any relevant clinical checks to ensure it is safe to proceed.
A psychiatrist will prescribe the ketamine, and a trained nurse will administer it via a small intramuscular injection into the upper arm. The dose is carefully tailored and clinically monitored.
You will then settle into a low-stimulation therapy room with a choice of sitting or lying down. Most people choose to lie down on the sofa with a blanket and an eye mask, both of which are provided. A carefully selected soundtrack is played to support the experience. Your therapist will remain close by throughout, within arm’s reach, offering a reassuring presence.
For safety, a minimum of one doctor and one nurse are involved in monitoring. Your physical observations are checked at regular intervals before dosing and during the first 90 minutes after ketamine administration. Your oxygen levels are monitored continuously.
The acute effects of ketamine usually wear off within around an hour. After this, you may choose to rest quietly or, if it feels helpful, have a gentle conversation with your therapist. There is no pressure to rush, and the space is held at your pace. Refreshments are available once you feel ready.
When you are ready to leave, the team will coordinate with your pre-arranged transport, such as a taxi or a trusted friend or family member, and support you as you depart.
The following day, a member of the team will check in with you by phone. A follow-up integration session with your therapist is arranged that same week to help you reflect on the experience and integrate any insights into ongoing therapeutic work.
During ketamine dosing sessions, therapists provide non-directive psychological support. You are encouraged to follow your own inner experience. If challenges arise, therapists may offer gentle reassurance or grounding support, but do not engage in formal psychotherapy or trauma processing during the acute effects of ketamine. Deeper therapeutic exploration can take place during integration sessions afterwards.
Register your interest
If you are interested in learning more, fill in the expression of interest form below.
Our team will contact you to discuss suitability and provide further information.
(Availability from April 2026)