Ask a veteran in St. Peters where they would go for depression care and the first answer is often another question: how far is it? A drive east on I-70 toward the city is a real consideration for a lot of people in St. Charles County, and so is the question of whether a newer treatment can happen in a clinic down the road or on a laptop at the kitchen table.
This summer our publisher funded a poll that reached 443 adults across ten states, Missouri among them, with a question about the setting they would pick for newer depression treatments such as ketamine and esketamine. Respondents came from the general public; veterans were not singled out. But the numbers tell a story that matters to veterans and their families here, and it is worth reading closely. All of the survey figures below are the final, validated ones.
The headline: people want a building
Offered four ways to receive this kind of treatment, respondents put an in-person clinic near home well out in front, at 44 percent. Home telehealth drew 22 percent. A mixed approach, beginning at a clinic and carrying on from home, drew 23 percent. Just 11 percent said they did not care.
That means the share of people who wanted in-person care as part of the deal, either from start to finish or at the beginning, came to 67 percent when you combine the two groups.
For a St. Peters veteran, that preference lines up with how the one FDA-approved medication in this family works. Spravato, which delivers esketamine as a nasal spray and carries FDA approval for treatment-resistant depression, is administered only inside certified healthcare settings, with the patient monitored afterward and driven home. There is no mail-order version. For the particulars, the Brain Recovery Centers site has a rundown of Spravato visits.
Close to home ranked second, behind one thing
The survey also asked people to name their top two considerations in a provider. Insurance coverage beat everything else, named by 85 percent. Proximity came second, named by 43 percent. Well back came FDA approval, 27 percent, then quick results, 24 percent.
For veterans, "covered" can mean several things: TRICARE for retirees and families, Medicare, an employer plan, or MO HealthNet. In the payer question, which let people choose more than one answer, TRICARE was 5 percent of the sample. Commercial insurance, Medicaid, and Medicare were far larger.
"Close to home" is the part veterans in St. Charles County feel most. When a treatment requires a ride after every visit, a twenty-minute trip and a fifty-minute trip are not the same thing, especially early in treatment when visits can be frequent.
Where people said they would start
Another question asked for the first stop someone would make when looking into this kind of treatment. The family doctor dominated, with 56 percent. Next, at 23 percent, came psychiatry or another mental health specialty. Twelve percent would begin with an online search, and 5 percent owned up to having no starting point at all.
Only about 2 percent of respondents were veterans or active-duty military, 29 people even with first responders counted, too few to report alone, so this is the general public's map rather than a veterans' map. For a St. Peters veteran on TRICARE, Medicare, or an employer plan, the primary care office is a practical first door: it can screen, review past medications, and refer to a psychiatrist who can evaluate for newer options. TRICARE users should ask whether their plan requires a referral before a specialist visit, since the rules differ by plan.
Where trust comes from
The survey's most lopsided finding was about influence. Asked who could get them to go ahead with a new depression treatment, 74 percent answered: my own doctor. Relatives and friends came second, 18 percent. Veterans or responders with an online following managed 4 percent. Podcast hosts managed only 1 percent, and advertising 2 percent.
For a veteran, "your own doctor" might be a TRICARE network physician or a family doctor in town. Whoever it is, the data suggest that conversation is where decisions actually get made. A post in a veterans' group can start the thought. The exam room is where it becomes a plan.
A lot of people are carrying this
One more number puts the rest in context. Nearly three respondents in four, 72 percent, said standard medication had come up short against depression, anxiety, or PTSD in their own life, in the life of someone close, or both. For 37 percent, the person was themselves alone.
That is the general public, not a clinical group. If you are a veteran who has tried two or three medications and still feels flat, you are in large company, and you are allowed to ask about what comes next.
What a St. Peters veteran can do with this
- Start with your primary doctor and ask plainly whether your medication history makes you a candidate for evaluation for esketamine or another next-step treatment.
- Ask about distance up front. Find out where the nearest certified site is and how often early visits happen before you commit.
- If you use TRICARE or other insurance, ring the number on your card to learn if esketamine needs prior authorization and which clinics nearby are in network.
- Plan the ride. Anyone receiving Spravato needs a driver after each visit. Line that up before the first appointment.
- Know the difference between Spravato, off-label IV ketamine, and telehealth ketamine for home use. You cannot swap one for another, and only the first is FDA-approved for depression.
Take this as general reading rather than medical advice; no treatment helps every patient. PTSD, specifically, is not an FDA-approved use for esketamine. Whether any option fits you is something to settle with a clinician who knows your record.
If things have gotten dark enough that suicide has crossed your mind, please do not sit alone with it. Reach 988 by call or text; if you served, pressing 1 is an option. Family members may contact the line for you, and a counselor answers at any hour.
Methodology
Funding came from the publisher, which commissioned this survey. Pollfish drew the sample from its consumer panel, and fielding ended June 23, 2026 at n=443. Respondents were adults 18 to 64 from Wisconsin, Minnesota, Nebraska, Oklahoma, Kansas, Iowa, Missouri, Indiana, Ohio, and Illinois. It did not target veterans, and they were too few for a separate figure. Pollfish's validated export supplies every final number here.