Improving access to novel treatments for treatment-resistant depression: The potential role of specialist clinics in Australia
Yash Giri, Paul Furst, Colleen Loo, Scott R Clark, Prashant Tibrewal
Australian & New Zealand Journal of Psychiatry May 26, 2026 DOI: 10.1177/00048674261450390 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Population | Australian mental health system |
| Interventions | Ketamine/esketamine Transcranial magnetic stimulation Psilocybin-assisted therapy |
| Topics | Depression |
| Citations | 1 |
| Key findings | Lack of public access to novel treatments for treatment-resistant depression in Australia could be addressed by establishing specialist clinics in the public sector. |
Abstract
Treatment-resistant depression is a condition with significant morbidity, despite the current standard of treatment, including traditional pharmacotherapy, psychotherapy, augmentation strategies and electroconvulsive therapy. While novel therapies have emerged, such as ketamine/esketamine, transcranial magnetic stimulation and psilocybin-assisted therapy, the uptake of these treatments is relatively low, particularly within public mental health services. Commercial clinics across Australia offer these treatments, but can only be accessed by those able to pay, leaving those unable to pay with limited or no access. We compare novel treatments for treatment-resistant depression and examine barriers to their implementation within the Australian mental health system. We also propose specialist treatment-resistant depression clinics as a potential model to improve access and build clinical expertise. We identified challenges in identifying treatment-resistant depression, lack of training and expertise, and regulatory and economic barriers. We propose that the lack of public access to these novel treatments be initially addressed by the establishment of specialist treatment-resistant depression clinics in Australia, including in the public sector, which will drive training and the development of expertise within public mental health.
Comparable studies
Other narrative reviews on depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Synaptic Dysfunction in Depression: Potential Therapeutic Targets | 2012 | Review | |
| Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse | 2003 | Review | |
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. General population | 2019 | Integrative review | |
| Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II—Clinical Applications and Guidelines | 2005 | Review |
Citations in the library
Cites 20
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
- Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry 2018
- Ketamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression. New England Journal of Medicine May 24, 2023
- Ketamine for the treatment of major depression: a systematic review and meta-analysis EClinicalMedicine August 1, 2023
- Molecular Mechanisms of Psilocybin and Implications for the Treatment of Depression CNS Drugs November 17, 2021
and 15 more in the library