Indigenous ketamine therapy: 5 Questions for First Nations mental health leader Emmy Manson

Manson discusses building partnerships between the Snuneymuxw First Nation and Roots to Thrive, and the role ketamine and psychedelics have played in her life.

Over her career, Emmy Manson has played many roles in the Snuneymuxw, a First Nation living in the center of the Coast Salish’s territory on the eastern coast of Vancouver Island. For years, she worked in the community’s youth program. Then in 2018, she was elected to the Snuneymuxw leadership council and became the director of health and wellness. In 2020, she was feeling burnt out from months of addressing the COVID-19 emergency, and decided to participate in a 12-week ketamine group therapy program run by a Canadian healthcare non-profit group called Roots to Thrive. The course was designed to help healthcare workers with treatment-resistant depression or PTSD. 

The experience changed her. Manson began collaborating with Roots to Thrive to fund another ketamine-assisted therapy cohort for members of the Snuneymuxw community. In 2021, 10 First Nations community members participated in three in-person group intravenous ketamine sessions and met online weekly for three months afterwards. In 2023, Manson and her non-profit collaborators published a paper in the Journal of Psychoactive Drugs about the process. The Microdose spoke with Manson about building partnerships between the Snuneymuxw First Nation and Roots to Thrive, and the role ketamine and psychedelics have played in her life.

How did your collaboration with Roots to Thrive come about? 

I was in a ketamine cohort during COVID. After I did the 12-week program, I asked for a meeting with Roots to Thrive leaders Phil and Shannon Dames. I’d interacted with them during those 12 weeks on Zoom, but I didn’t really know them at all at that point. A few months later we got funding from the First Nations Health Authority to run this pilot and they came to the health center to start delivering sessions, then we wrote up the paper. 

There’s still a lot of stigma around psychedelics; it’s hard to explain if you’ve never gone through it, so we knew we needed data to know if there was change for participants. This was the first group of all Indigenous people in one of these cohorts — we wanted to sell this not only to potential funders but to our community. Among the participants, we had some who wanted to quit, and some who didn’t continue, but others have only gotten more curious about psychedelic drugs.

And what about you — has your relationship to these substances changed?

Ketamine has been life changing for me. I used to keep it more hush-hush because I didn't want people to judge me, but now I don’t keep it a secret. If anybody I love wants healing, I tell my story. Some people are shocked and some are curious, but I have let go of any shame of trying to heal. Like if I had diabetes or cancer, I would do whatever I could to get well, and that's what I think about psychedelics; I think of it as a medicine.

After my ketamine cohort I also got interested in psilocybin and how our people use mushrooms. I started asking elders and one told me they used to give it to women during childbirth! I thought, “Oh my god, that’s crazy,” but knowing that my people had uses for it made me want to do psilocybin with other Indigenous healers. 

How have Snuneymuxw community members reacted to these ketamine-assisted therapy programs?

There have been around 25 or 30 people who have gone through it now. Our youngest is 25, and we had an elder who is about 75. I was shocked when the elder wanted to do it, but after, he said it was the most profound thing he’d experienced. Seeing my elders experience peace and letting their inner child heal has been the best; I have seen so many elders die with trauma and pain. 

As I’ve learned more about these psychedelic medicines, my next big goal is thinking through how to bring it to our youth, people between 19 to 30. I know I’ve been in talk therapy and tried to heal, but I wasn’t able to get to a deeper level until I took psychedelics. My dream is to offer this medicine to younger people in hopes they don’t have to suffer for years the way I did. I know it’s not a fit for everyone, but if there are people who feel it works, maybe they don’t become 40 before they actually find joy and peace, to get unstuck in their trauma. 

In your paper, you and your co-authors discuss lessons gained through collaborating on this ketamine-assisted therapy program. What has the experience of relationship-building been like from your perspective?

I joined the board of Roots to Thrive because I don't want to complain that I'm not part of the process. I'm going to try my hardest to infiltrate tables I’m not invited to, and to be a person who can challenge the status quo in a good way. I want to bring my Indigenous knowledge to the table as a gift; we don't always have voices at some of those tables.  

It's tiring to volunteer for all these things, but I feel like if I want to see systematic change, I have to become part of the system. I've been very welcomed; being authentic and sharing frustrations and joys has strengthened our relationship. And sometimes that has meant doing things that make me uncomfortable. For instance, attending some of their community events, I’ve felt awkward, like what am I doing here? But I realized: how else do I get to know these people? So I pushed myself to go, and I do think that this type of relationship-building is creating something bigger than the container of the work that we're doing through Roots to Thrive. It's making a commitment to one another, and that while it will get rocky, if we're in the canoe together, we'll support each other. And those collaborators have been really good support for me and the participants; some of those participants are still in touch with their facilitators. It’s cool to see that relationship building working, and the effects of that rippling out through the community.

What lessons could the larger psychedelics field draw from this work you are doing in your community and in collaboration with this non-profit group Roots to Thrive?

Creating change is about building authentic relationships. The relationships have to be foundational to a project like this; you have to have that in order to challenge each other in difficult ways. I call myself a bridge builder; you have to go over the bridge to create change, and it’s not always easy. In the beginning, I felt a lack of trust, because of what I’ve experienced with some other organizations.  I wondered, “Are people just including me because I'm an Indian, so they could tokenize me and say, ‘An Indian sat here’?” I actually shared that with my collaborators and they were like, “Okay, that's valid, but we never thought of it like that.” 

Over time, I realized that Roots to Thrive operates from teachings that align with my Indigenous worldview. So the best revelation from this, for me, has been that these kinds of relationships can be win-win. You may bring your truths about challenges or your heartaches as an Indigenous person, but that doesn’t mean you can’t trust anybody. That’s been helpful not only in my work and career, but also my friendships.

This interview has been edited and condensed for clarity and length.

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