Ketamine for Treatment-Resistant Depression: The Doctor Who Left Medicine to Build a Clinic Network

hi I'm Lauren I'm the founder of Good Mind Therapeutics and this is founders in motion you were a certified medical doctor in New Zealand spending your time working across mental health and emergency medicine settings you had this insanely prestigious career that took years of education sweat and pain to build up but at one point you decided to leave medicine what was the moment I do actually now that you say I do actually really remember the sweat and the tears it was six years of university and then I did three years after I had qualified and I guess that's almost a decade of my life there was no specific moment I had always known from quite early on in university that I wanted to work outside of the hospital for me that was about the way that medicine is designed and the necessity of the system to minimize risk and to be really protocol driven so what you're optimizing for is that the patient gets the right outcome the first time and then subsequently every single time and so that reduces the scope for creativity and and innovation and trying something new and and I really wanted to be in an environment that was like I wanna try that and see if it works I need to flex the creative side of my brain you were a medical doctor for three years worked at a consulting firm for 18 months a few startup scale UPS in the health space for three years at one point you decided to join Good Mind Therapeutics you didn't start Goodmind from Day 1 you joined an existing team so talk to me what was the company back then and what made you say yes the reason why I went to that meeting was I always wanted to get back into the mental health space I think it's like a fertile ground for opportunity and I went to that first meeting and they had a slide and the the top of the slides is something like novel treatments and then they had this kind of idea that maybe they do something with a platform or maybe they do something with clinics and there was like this 4 by 4 of hey where where can we do something and I was like oh this is pretty this is like chaotic in this company we're running I think it has been probably six months or a year before I got there and you could see that there was a group of investors who saw an opportunity with novel treatments but didn't know what that opportunity was and so what made me say yes was actually that I'd been reading around the lobbying for ketamine treatment and that was something that I was really excited about and wasn't big in Australia and so I thought if I can be a first mover here that'll be a really interesting business to build okay so you are now the co founder and navigating current day Goodmind through all the UPS and downs talk to me from the moment you joined to now like April 2026 what are the seasons that good mind have been through and what is it today at the moment Goodmind we have um a hybrid of telehealth and in person delivery system for novel mental health treatments and um we have five clinic sites across the country at the minute the first season was kind of oh my god what the hell am I gonna do here there was nothing there and so I turned up and I was like right let's do this it was that was really really fun and creative so that was great that was like summer yes from seasons wise and then it was hard because then we had six months where we were like if we build it will they come yeah and before you know the answer to that question you're essentially just spending a lot of time and energy with a lot of self doubt and so there was probably six to nine months where I was like I have no idea like I've got a hypothesis but until we've built it we won't know and there were a lot of dark nights of the soul um and then it's only probably in the last couple of months where I would say the last three or four months where we have had the signal that we're what we're doing is right yeah and that's given us a lot of confidence and relief um for where we are today the shell company was originally set up around psilocybin potentially MDMA therapy which Australia is well known as being the only country in you know in the western world where that's illegalized therapy pathway um if you don't know much about it the way that it's been regulated here is an incredibly governance heavy model and again rightly or wrongly so from a safety perspective very very early doors the research is is still inconclusive about what those results will look like for patients and I think if you're not used to working in the regulatory space in Australia mm hmm there is a long journey to change and so um it took quite a long time and sort of gentle messaging towards like the team there at the minute to be like look I I it's not that I don't like this idea it's that you can't bat on what the TGA is gonna maybe do in the next five years you can't build a business on an idea that maybe something will change and so that would that's a very exciting potential vertical for the future but it's not one that we're exploring today and so that's when we pivoted into what's accessible what can we make accessible from from now we spoke a lot about these kind of novel therapeutic treatments for mental health so um for someone who has no idea what ketamine treatment for mental health actually looks like what happens from the moment that they call you to the moment that they walk out of a clinic people think of treatment resistant depression as a niche illness and it is so far from from the truth because if you think about the fact that like probably one 1 in five depending on which statistics you read Australians will have depression in their life um the first line treatment for depression is tablet antidepressants they work for about half of people who have depression if you take one and it doesn't work for you the chances of the second one working are significantly diminished and then by the time you're trying a third one like it's not gonna work essentially and so it's by the time we get towards that third antidepressant we're talking people are treatment resistant so the idea of treatment resistance came around before we had other therapies so before we had ECT and TMS brain stimulation type therapies these patients could not be treated so they were treatment resistant so it's kind of like it's a hangover from a system that's that's not today's system and so when we talk about treatment resistant depression we're talking about millions and millions of Australians we're not talking about like a few people who have this weird disorder we're talking about a huge group of of Australians today who aren't getting the best care for them so in terms of what happens when people find us um often patients reach out to us directly we tell them all about the treatment that we offer we get a GP referral we do the patient psychiatry assessment and then that patient comes to us for a series of in person treatment sessions in one of our clinics um over the course of 3 to 6 months yeah and then over that period of time they have a really positive neuroplastic effect in their brain as well as a direct antidepressant effect from the ketamine and you know again depending on which literature you read about 70% of those people will have their depression treated or cured and could you talk to me maybe very broadly about the science behind how ketamine helps with fighting mental health Ketamine's got two actions it's first action is it's got a direct antidepressant effect on neurotransmitters in your brain and the neurotransmitters that ketamine targets are different to the ones that are targeted by tablet antidepressants so that's why when people sort of fail tablet antidepressants ketamine will still work for them mm hmm the other thing is that tablet antidepressants take a really long time to work ketamine will work for most people within sort of 48 hours of treatment and so can be really fast intervention and the second really really sexy thing about ketamine really exciting thing about ketamine is that it stimulates the growth of new pathways in the brain so this is an area of research that is just kind of burgeoning around how our thought patterns over a period of time are becoming grained in our brain networks and so if you wanna change a habit that's bloody hard to do like as an individual and then you get ketamine and you get this burst of fertility for growing new pathways and that is the most exciting thing about this drug and so then you find these research things where you're having the ketamine and it's combined with a behavioral activation or psychotherapy and suddenly your therapy actually works for you because you're like oh no shit that thing happened and maybe I should change my behavior and all of that kind of stuff that is actually really difficult to generate in a brain that's had chronic pathways for a really long time Australia made a pretty specific regulation call to subsidize medication through Medicare patients still bear the nursing cost so so with that how much does a patient actually pay when we started um the only people that were really funding this was the department of Veteran Affairs cause they saw the benefit for their um veterans who were coming back with sort of PTSD and depression really difficult to treat so they have been funding this since before it was on the PBS and the medication itself cost between 800 and 1,000 dollars a dose so hugely expensive it's put on the PBS halfway through last year and then suddenly all patients are paying for is coming into a supervised setting and having it having it given to you under the care of nurses to make sure that you're safe yes um so over course of three to six months of treatment a patient would pay privately about three to five thousand dollars out of pocket which is getting towards a stage where that's actually achievable for a group of people so we see we have seen like a huge number of private patients who are now coming to our doors and being like that is that is the price that I'm willing to pay to have my life back essentially so we're finding a lot of insurance are getting on board now being like I can see the ROI on treating these patients um because we can get them back into our into our workforce and mine was originally like you mentioned built around uh silosivan silosivan MD yeah MDMA therapy um then Australia Australia legalized it and then added significant regulatory rigor then you did a big pivot of the business and around the same time the original co founder left yeah you're sitting there with angel funding your co founder left broken model like how did that feel like how how was those first few weeks I did a lot of crying um it was really lonely it was so lonely and I think I had moved from always being an employee and the difference between being an employee and being responsible for other people's jobs and like it's a big shift that's a huge chef and I am naturally a positive person so I was like to everyone I was like this is great I'm so excited we got a model that can work and then all of a sudden I was like oh god that was a tough few months and I at the other thing that I really struggled with was you know I think the perennial imposter syndrome um I was like what qualification do I have that was tough because I was like I was doubting myself at that point because I was like do I have the skills to make this work and then I think that actually gave way to a lot of clarity that was like well actually you know if people can sell peptides surely I can make a business of something that actually works like I didn't have any skills in performance marketing I did not know what a Google Ads dashboard look like yeah you can learn that shit on YouTube like you can learn everything so that was the thing I've picked up so many skills in the last 6 months I now know how to do like back end website design one thing I'm I'm really curious to understand so from a medical doctor perspective what's your beef against peptides this is the hill that I will die on is people being sold things that do not work there's probably two of them that have some evidence and then there's this whole bunch of shit out there that you're like why why would anybody believe that that works when I talk about peptides to clarify I don't mean like the scientific term I mean like the pop culture term of peptides which is like a number of libido enhancing appetite reducing sleep enhancing skin rejuvenating back to a good mind so you're at five clinics you are at break even what's the next problem that you're actively trying to solve right now yeah we're at the end of phase 1 and the phase 1 question for us was if we build it will they come yeah and they have come which is great and so I'm I think there's an interesting bifurcation that will happen in healthcare and specifically mental health where you'll have everything that is low acuity that can be done by telehealth and potentially somewhat subsidized by AI well that that will all be cannibalized very quickly commoditized and and they'll still be like a telehealth model in there but whatever will happen there and then you'll have this layer which is just beyond that which is in person instances of care that somebody needs to build the way to integrate an interface between those two effectively and then also have enough centers to make it a really easy and pleasant experience for patients so for us we've built that that's great now we've got to scale from five to 50 clinics without breaking a really nice customer experience and so I think for us is trying to find the platform that enables us to stay as like a really lean team make sure that we don't erode our margins make sure that there's still like four or five people and then thousands and thousands of instances of really standardized pleasant patient care we've touched on this throughout the podcast um the founder journey is really tough what do you remember as one of the lowest days when I was talking about the the very the very first season um when things were were getting kind of hard and quite lonely and I was literally by myself trying to run this business and I remember one day I was at home with my parents in New Zealand and I was scrolling through my Instagram feed always no no it wasn't Instagram it was LinkedIn and I was going through and I was reading everybody else's stories about what they were building and how they were building it and I think that environment can be quite competitive agree and so I remember sitting there and being like everybody is doing so much cooler stuff than I'm doing and they're so much more qualified to do it and they've got this experience or that experience and they know this person or that person and they've raised this many million dollars or that many million dollars and I was just like it can you can get on there and it's almost like the same as Instagram where you see like Instagram versus reality and I think there's this thing which is like LinkedIn versus reality and I was like after that day I was like I'm not gonna be on LinkedIn like on an inactive way because I know that for my mental health I need to just be like why what am I doing in my lane I'm trying to do it like this and I'm trying my best and that's all I can do and yeah I may not be as smart or as qualified as this person or whatever but I'm you know you actually if you can get over those thoughts and questions about your own ability then I think you actually like and you try your hardest you actually can can get a really good outcome and I don't think you necessarily need to have this you know this great background of I've been at this company or that company and I know all these people in order to actually deliver something pretty cool so the only person you should be comparing yourself to is you of yesterday and trying to be 1% better every day rather than anyone else on this universe I feel like you've went through so many seasons within the last year maybe you signed up for something that you didn't expect it was going to be this way if you were to come back to that moment when you made the decision to join Good Mind in the first place would you still have done it oh absolutely I think even if even if our hypothesis had been wrong even if I was sitting here today and I built these five clinics and nothing had worked I would have grown and gained so much in the past year that unless you've done it and you've tried it and you've tried to build something by yourself like I I couldn't have got those skills elsewhere yeah and so that for me was an invaluable experience and the fact that we've come out the other side with you know quite a cool little idea is just kind of a bit of a cherry on the top I'm really excited for what's next and I'm just excited for more novel therapies in medicine and just more innovation within the medicine space in general thank you