Search for a depression retreat and the results are three different products under one word. What separates them is who decides whether you are treated at all, and who is still working with you a month after you get home.

Three different things sold as a depression retreat

The word describes a setting rather than a treatment. What separates the three is who decides whether you are ill enough to treat, and what the price is attached to.

Beside these sit the routes people search for in the same week: an outpatient course of ketamine near home, and a psychiatric ward, which answers immediate risk with round-the-clock observation and treats under those conditions, while a retreat is voluntary and time-limited. Beyond them sit hospital-based procedures a psychiatrist can offer, which are steps inside a treatment route rather than a choice you book.

A wellness week, a residential paid through insurance, a medical programme: what each is paid for

A wellness week is paid for as an experience. It is rarely built to change what your prescriber does next.

An insurance-funded residential is paid for by the day. Its page ends at an admissions phone number because that is the product: the bed, the supervision and the days you occupy them.

A medical programme is paid for as a course of clinical time, of which the residential part is the shortest piece. That is also why it can quote one sum in advance, and why what is legal and available for this treatment on Malta decides where such a programme can run at all.

Who a change of setting helps, and who needs something else

Leaving home matters for a specific reason. A course of treatment delivered near home returns you every evening to the environment the pattern lives in: the marriage that is ending, the job you cannot face, the room where the last two years happened. A residential week removes that variable for long enough to work on the pattern itself.

Who decides whether you are exhausted or depressed: a psychiatric assessment before you pay, with doctors you can look up

Most programmes describe the assessment without naming anyone. Ours is a medical assessment with two doctors, Dr. Peter Muscat, a consultant psychiatrist, and Dr. Christopher Gauci, an anaesthetist, and it happens before you are asked to pay. They look at your health, the medication you take and what you have already tried, and plan the week around what they find.

What that buys you is a decision made by doctors who have read your history, medication and previous treatment, so if the programme is not right for you, you find out before paying for it. You can send your history for a psychiatrist to read before committing to anything.

What comes next if antidepressants have not worked

The research population for ketamine is described as treatment-resistant depression, meaning depression that has not lifted on at least two antidepressants at a proper dose. Rules on who can get ketamine differ by country: in the UK it usually follows two antidepressants that did not work, and what that means for ketamine therapy elsewhere is set out on its own page. Our programme on Malta requires neither a referral from your GP nor a documented history of failed antidepressants.

What the ketamine numbers actually say

The trial figures are in the signed summary below. Outside trials, in a 2024 retrospective study of ketamine-assisted psychotherapy across eleven North American clinics (Yermus and colleagues, Psychedelic Medicine), between half and three quarters of the 346 people still in contact at three months reported a clinically meaningful improvement, and 82% of the original group had dropped out of follow-up by then, so the figure describes the people who stayed in contact.

Effect fades unless it is held. The signed summary below puts the decay at days to weeks without repeat dosing.

The evidence base for ketamine in psychiatry is specific: intravenous racemic ketamine in treatment-resistant depression, meaning depression that has not responded to at least two antidepressants taken at a proper dose for long enough to judge.

Where it started. The first controlled trial in depression was published by Berman and colleagues in 2000. The finding that anchored the field came from Zarate and colleagues in 2006 in Archives of General Psychiatry: a single intravenous infusion of 0.5 mg/kg over 40 minutes, given to patients whose depression had resisted other treatment, produced an antidepressant effect within two hours that was still measurable at 24 hours and faded over the following week.

Where it was confirmed. Murrough and colleagues repeated the question in 2013 in the American Journal of Psychiatry, this time against midazolam rather than saline. That is a harder comparison: midazolam produces sedation and so partly masks which arm a participant is in, though ketamine’s dissociative effects limit how well it does so. In 72 patients with treatment-resistant depression, depression scores at 24 hours (the primary outcome) were 7.95 points lower on ketamine than on midazolam (MADRS; 95% CI 3.20 to 12.71). Response rates were 64% and 28% respectively.

Where the evidence is thinner. Long-term data on repeated dosing over years is limited and much of it is observational. And the psychotherapy component specifically, the claim that structured therapy around the dosing adds benefit beyond the drug, has weaker evidence than the drug itself.

One methodological caveat worth knowing. Ketamine produces noticeable dissociative effects, so participants often work out which arm they are in. Trials using an active comparator such as midazolam address this; trials using saline do not.

This is where the evidence is strongest: onset within hours, effect measurable at 24 hours, and decay over days to weeks without repeat dosing. Treatment-resistant depression is the population studied most.

Checked for medical accuracy by Dr Christopher Gauci, MD MRCS(Ed) EDAIC on 1 October 2026. The check covers this section. Everything else on the page is written by our editorial team and verified against primary sources.

Two things follow for anyone comparing retreats. Most of them do not offer this treatment at all, so what you are choosing between is settings. And a programme that does offer it owes you the limits alongside the numbers, which is the part of our own answers we get asked about most.

What a full course covers

Our programme is quoted as one sum for the whole course, and it covers three weeks of online preparation, the residential week on Malta with the treatment and the medical supervision, the accommodation, the food and the activities, and three weeks of integration afterwards. Nothing is billed per night. The flight is the one thing not included; the airport pickup and the transfer to the house are arranged for you.

You are told the figure on a 15-minute introductory call with our concierge team, in writing, before you are asked to pay anything. Whether the programme is the right answer for you is decided after that, at the medical assessment with both doctors, and the programme is set out in full so you can see what it is you would be taking on.

What happens after you leave, in each of the three formats

What people say most often about this treatment is that it wore off: the window closed a few weeks later, the symptoms came back, and by then the place that treated you had stopped checking in.

After a wellness week, you go home with whatever you took from it, and the next clinical contact is the one you arrange yourself.

After an insurance-funded residential, cover ends when the days run out. Their pages close on an admissions line and say nothing about the weeks after discharge.

After a medical programme, follow-up is part of what you paid for. Ours runs three weeks of online sessions with the same clinicians who were with you on the island, and what those weeks involve is described in detail. You leave the island with your integration plan in writing, and what follows those three weeks is something you decide with the doctor.

That difference matters more than the brochure photography, because the week is the shortest part of any of these formats and the months after it are where the pattern either shifts or returns.

How our week on Malta works and what follows it

Hive Bio is a retreat centre with a ketamine-assisted therapy service on Malta, run by HIVE BIO Malta LTD (company number C 94710), with clinicians registered with the Medical Council of Malta. Four guests at a time, a room of your own, individual sessions, group integration and no group ceremonies.

What this changes against a course near home is who is around you. On an outpatient route the sessions, the therapy and the integration are usually bought separately from different people, and after each dose you go back to the same job and the same rooms. Here one team carries all seven weeks, the same psychiatrist and anaesthetist are with you all week, and the day after a session is left free so that what came up has time to settle before anything else is asked of you.

Whether the programme suits you is decided at the medical assessment, and the clinicians who make that call are named. The first step is a 15-minute introductory call, where your questions are answered and the sum is quoted in writing.

Common questions