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Alternative mental health benefits that some employers offer

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The pandemic shined a bright light on the mental health issues that workers face, and many employers are expanding their benefits packages to address the struggle. One of the newer – and somewhat controversial – approaches is the use of psychedelic-assisted therapies.

Some research has shown that psychedelics such as MDMA [ecstasy] and psilocybin [“magic” mushrooms], and similar substances such as ketamine, can effectively treat depression, anxiety, substance abuse, PTSD and other mental-health conditions

“I’ve experimented with psychedelics myself, and I could see how it could be helpful to people,” Jorge Yant, founder of Plexis Healthcare Systems, told the Wall Street Journal. His company recently began covering psychedelic-assisted therapy for its employees through Enthea, a benefits startup that contracts with providers to receive discounted rates. For employers, the therapy results in lower costs over time and a happier, more productive workforce, says Yant.

Enthea clients currently can get ketamine-assisted therapy covered. In coming months, they will be able to obtain psilocybin if they are based in or willing to fly to Oregon, which has legalized the drug for supervised medical use. If MDMA receives FDA approval, it will be added to Enthea’s offerings, the company said.

In 2023, 17% of employers said they were investing in psychedelic-assisted clinical therapy solutions to support their employees’ mental health, according to a survey by NFP, a benefits consulting firm. Enthea CEO Sherry Rais said more than a dozen employers have signed up this year, and an additional 50 have signed letters of intent.

However, some companies have concerns about ketamine treatment, because there can be risks when it is not used in a clinical setting but is prescribed for home-use instead, said David Feifel, a psychiatrist and medical director of Kadima Neuropsychiatry Institute in La Jolla, Calif. The drug made national headlines earlier this year when actor Matthew Perry’s official cause of death was listed as the acute effects of ketamine, which investigators said he was using for therapeutic treatment for anxiety and depression.

Although doctors can legally prescribe ketamine, the FDA hasn’t approved it for mental health treatment, which means individual practitioners must develop their own treatment protocols. The result is wide variability among providers, with some favoring gradual, low-dosage treatments while others advocate larger amounts that can induce hallucinations, because the drug is psychedelic at certain doses. “Ketamine is the wild west,” said Dustin Robinson, managing principal of Iter Investments, a venture capital firm specializing in hallucinogenic drug treatments.

The nasal spray Spravato, a close chemical relation to ketamine made by Johnson & Johnson, is FDA-approved for adults with treatment-resistant depression and is covered by some insurance companies, but it is far more expensive. Feifel said the economics are starting to move in favor of larger insurance companies making an exception and agreeing to cover ketamine for off-label use



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