An Australian-first trial will test whether ketamine combined with exposure therapy can improve PTSD outcomes in emergency service workers who have not responded to existing treatments.
Australian researchers will trial ketamine alongside psychological therapy in emergency service workers with persistent post-traumatic stress disorder (PTSD), as part of a new push to improve treatment options for frontline personnel who have not responded to conventional care.
The Black Dog Institute announced the Australian-first clinical trial at the National Emergency Worker Mental Health Roundtable held in Canberra on October 27, with recruitment expected to begin in 2027.
Delivered through the institute’s National Emergency Worker Support Service (NEWSS), in partnership with the UNSW Traumatic Stress Clinic, the study will investigate whether combining ketamine with exposure therapy can improve outcomes for emergency service workers and volunteers experiencing ongoing PTSD symptoms and depression despite previous treatment.
Exposure therapy is an established first-line psychological treatment for PTSD, but a proportion of patients continue to experience significant symptoms despite receiving evidence-based care.
The researchers hope to determine whether adding ketamine to exposure therapy can improve recovery in this group, potentially providing another treatment option for patients with persistent symptoms.
Black Dog Institute executive director and chief scientist Professor Sam Harvey said the trial reflected the need to develop new approaches for emergency workers who had not benefited sufficiently from existing treatments.
“Every day, Australia’s emergency service workers put themselves in challenging and often traumatic situations to keep our communities safe,” he said.
“While we have made significant progress in supporting their mental health, we know there are still people who continue to struggle despite receiving treatment.”
Professor Harvey said the institute had seen the benefits of timely psychological treatment through NEWSS but acknowledged that existing approaches were not effective for everyone.
“This research will investigate whether combining ketamine with exposure therapy can improve outcomes for people living with persistent PTSD symptoms,” he said.
“It’s about building on what we know works, while exploring new approaches that could help more of our emergency service workers recover and regain their quality of life.”
The trial will be the first in Australia to specifically investigate the combined treatment approach for PTSD and depression among emergency service workers.
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Ketamine has attracted growing research interest as a potential treatment for psychiatric conditions, particularly treatment-resistant depression, although its role in PTSD management remains under investigation.
The new study will examine whether combining the drug with an established psychological intervention offers benefits beyond existing treatment approaches.
The institute also announced a separate trial investigating the use of an artificial intelligence chatbot to deliver PTSD treatment to emergency service workers reluctant to access mainstream mental health services.
The study, described by researchers as a world-first, will evaluate the acceptability, safety and therapeutic potential of an AI-based intervention designed for frontline workers seeking anonymous, digitally delivered support.
Professor Richard Bryant AC, director of the UNSW Traumatic Stress Clinic, said the rapid uptake of AI mental health tools had outpaced the evidence supporting their clinical effectiveness.
“Millions of people are using AI tools for mental health support every day, but we don’t really know how useful they [are],” he said.
“We owe it to our emergency service workers to ensure that we develop an AI chatbot that is effective, safe, and meets the needs of our frontline workers.”
The research comes amid concerns that some emergency service workers remain reluctant to seek help through conventional mental health services, despite the availability of evidence-based PTSD treatment through NEWSS.
Researchers hope the digital intervention could provide an alternative pathway to care for workers who might otherwise avoid seeking support.
Recruitment for both studies is expected to begin in 2027.
People interested in the ketamine trial will be encouraged to discuss participation with their treating GP or psychiatrist before undergoing clinical eligibility assessment.
Screening will consider factors including previous treatment, medical history, and existing supports before formal referral and assessment.
Participants in the AI chatbot trial will be recruited nationally through social media, with eligibility screening undertaken before enrolment.
The trials were announced as representatives from government, emergency services, healthcare, research, and lived-experience organisations gathered in Canberra to discuss the mental health needs of Australia’s emergency workforce.
The roundtable coincided with preparations for another bushfire season and focused on strengthening mental health support for frontline personnel.
