VA is offering esketamine, a new treatment for Veterans with treatment-resistant depression and acute suicidality. Administered under the supervision of trained clinicians, esketamine is delivered through an intranasal spray. Patients receive treatment in a clinic, where they are monitored for two hours before being cleared for discharge with approved transportation. Dr. Sarah Canoy, a psychiatrist at Truman VA in Columbia, Missouri, emphasizes that esketamine is one of the most effective FDA-approved antidepressant therapies available, especially for those who have not responded to other treatments. Since its introduction at VA facilities in 2022, the availability of esketamine has increased, aided by the opening of a new treatment room in January 2024. Treatments typically occur twice a week for the first month, with frequency adjusted based on the patient’s response. Esketamine offers a chance for significant symptom reduction, providing hope for those who have struggled with depression. Veterans interested in this treatment can request a referral from their mental health provider.