Advancing PTSD Treatment Is One Thing. Ensuring Access Is Another.

Research, lived experience, and the responsibility to support injured first responders.

What is the value of developing better treatments if support systems for injured first responders cannot make timely decisions about access?

This question arose after the Black Dog Institute announced, as reported by ABC Australia on 27 October 2026, a proposed 2027 clinical trial examining ketamine combined with exposure-based therapy for emergency service workers with persistent PTSD.

I welcome this initiative and encourage current and retired emergency service personnel to learn more about the research and its eligibility requirements. However, my interest in these treatments began much earlier.

In 2016, while serving as AFP Commander Americas in Washington, DC, I met a US Air Force doctor through my professional relationship with the Air Force Office of Special Investigations (AFOSI). He introduced me to the potential of ketamine and stellate ganglion block (SGB), and the possibility that these approaches could complement each other in treating psychological trauma.

At the time, these discussions were of significant professional interest. After decades in policing, including international and conflict-zone operations, I was increasingly concerned about the psychological well-being of those who serve.

A decade later, having personally undergone both ketamine treatment and SGB, I now view those early conversations differently. What began as professional interest has become part of my own experience seeking treatment for psychological injury.

International research has examined ketamine for PTSD for years, including studies with US military personnel and veterans. The US Department of Veterans Affairs has supported research into ketamine and prolonged exposure therapy and provides supervised esketamine treatment for eligible veterans with treatment-resistant depression. These are important developments, though ketamine is not yet a routine treatment for PTSD, and evidence for combining ketamine with SGB is still under investigation.

The Black Dog Institute’s proposed trial will examine ketamine combined with exposure-based psychotherapy, not SGB. It aims to investigate this approach among Australian emergency service workers, including those whose symptoms persist despite previous treatment.

I am encouraged that the expression-of-interest process includes retired emergency service personnel. Psychological injuries often persist after retirement, resignation, or leaving the service, and their effects can continue long after an operational career ends.

However, scientific progress and institutional responsibility must advance together.

In my case, I have waited almost 18 months for Comcare to resolve reimbursement for ketamine treatment already received and to approve ongoing treatment. These issues are closely connected. Without timely decisions, injured workers may face uncertainty about incurred expenses, treatment continuity, and their ability to follow their clinicians’ recommendations.

For those already living with significant psychological injury, prolonged administrative uncertainty can add distress to an already challenging recovery process.

I raise this not to diminish the Black Dog Institute’s important work or to suggest approving emerging treatments without proper clinical assessment. Rigorous evidence, safeguards, and informed decision-making are essential. However, rigorous clinical assessment and timely administrative decisions can and should coexist.

We cannot invest in better treatments while overlooking the systems that help injured workers access care. Research, clinical practice, workers’ compensation, and institutional responsibility must work together. Thank you to the Dog Institute and its research partners for undertaking this work. I encourage serving and retired police officers, firefighters, paramedics and other emergency service personnel who may be interested to investigate the proposed trial and discuss suitability with their treating clinicians.

Ultimately, we should measure progress not only by the treatments we develop, but also by whether those who need them can access appropriate care in a timely, evidence-based, and compassionate manner.

Researchers, clinicians, employers, compensation authorities, and governments share this responsibility. We cannot afford to lose sight of it.

Further information

ABC AM, 27 October 2026 — Ketamine trial targets PTSD in first respondershttps://www.abc.net.au/listen/programs/am/ketamine-trial-targets-ptsd-in-first-responders/107312508

Black Dog Institute — National Emergency Worker Support Servicehttps://nationalemergencyworkersupportservice.blackdoginstitute.org.au/

Suggested hashtags: #PTSD #FirstResponderMentalHealth #KetamineResearch #BlackDogInstitute #PoliceWellbeing #Comcare