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HEALTH

Robust Germany faces rising ‘burnout’ problem

Germany, holding up better than its eurozone partners in the current economic crisis, is battling the increasingly widespread phenomenon of "burnout" which is supposedly costing its economy billions of euros each year. AFP's Aurelia End reports.

Robust Germany faces rising 'burnout' problem
Photo: DPA

According to data compiled by the economic institute of the public-sector health insurer AOK last year, psychological illness is on the rise among Germany’s workforce.

Nearly one out of every 10 sick days in Germany in 2010 was due to psychological illness, the WIdO institute calculated. And between 2004 and 2010, the number of sick days related to psychological illness increased ninefold.

“Time pressure and stress are on the increase and the danger is that people will suffer burnout due to their jobs on the one hand and family pressures on other,” says WIdO’s deputy chief Helmut Schroeder.

Labour Minister Ursula von der Leyen has launched a campaign to raise awareness of the phenomenon and tackle it, particularly in small and medium-sized companies which form the backbone of the mighty German economy.

While big companies had already largely recognised the need to act, “70 percent of small and medium-sized companies aren’t doing anything. They often don’t know what to do,” von der Leyen told AFP in an interview.

“We’re losing a lot of time and money in Germany before businesses recognise that it’s not just about migraines or psychosomatic back problems,” she said, estimating burnout was costing businesses €8.0-10.0 billion ($10.5-13.1 billion) in lost output each year.

“Nothing is more expensive than sending a good worker into retirement in their mid-40s because they’re burned out. These cases are no longer just the exception. It’s a trend that we have to do something about,” she said.

In the past, the focus of the labour protection strategies developed by authorities, employers, employee representatives and insurers had been on the physical well-being of the workforce.

The new aim is to make psychological health a top priority from 2013.

Von der Leyen argued it was not about tightening legislation, as Germany’s current labour protection laws were already sufficiently strict and required employers to ensure the psychological well-being of their workers.

“But the laws aren’t sufficiently enforced, largely out of ignorance,” the minister said.

Asked what is making people ill, von der Leyen suggested a number of different factors, from monotony, time pressure, poor management, a lack of solidarity among workers, but also things such as open-floor office space and expectations that employees be available around the clock, receiving and answering work-related emails and phone calls even in their leisure time.

The powerful IG Metall labour union insists that concrete and binding regulations be drawn up to protect people’s mental health at the work place.

According to the union’s estimates, the health costs from burnout amount to €27 billion a year.

“While everyone is talking about burnout, neither firms nor policymakers are doing anything about it,” said IG Metall board member Hans-Juergen Urban.

Nevertheless, for some psychiatrists, “burnout” is simply a word in vogue, a fashionable and more acceptable moniker for what is simply a form of depression without the stigma attached to mental illness.

“Burnout is not a disease and never will be. It’s a vague, unclearly defined syndrome that for good reason is not included in the World Health Organisation’s International Classification of Diseases,” said psychologist Markus Pawelzik.

But the public health insurer AOK disagrees.

“The burnout syndrome is an illness that must be taken seriously,” it writes on its website.

It could bring with it serious complications, such as cardiac arrhythmia or gastro-intestinal problems, AOK said.

“It can also lead to manifest depression including suicidal thoughts. It is not merely as fashionable disease, but was diagnosed in around 10 percent of the workforce as far back as the 1960s and 1970s. And estimates see the proportion rising to around a quarter of the workforce in the coming years,” AOK said.

The term has certainly become a buzzword for the media in recent years, with weekly magazine Der Spiegel dedicating two issues to the phenomenon last year and the Society for the German Language ranking it sixth in its annual list of Words of the Year.

Recently, well-known personalities such as football trainer Ralf Rangnick and the former head of media giant Bertelsmann, Hartmut Ostrowski, have spoken openly about their affliction.

But the high-brow daily Frankfurter Allgemeine Zeitung questioned why burnout was being written so much about in Germany, while in France, which is economically a lot worse off, “it’s hardly a preoccupation at all.”

AFP/mry

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HEALTH

How to find available therapists in Germany

It’s no secret that mental health care can be particularly tricky to access in Germany. Here are some helpful tips for anyone who is struggling to book an appointment for therapy.

How to find available therapists in Germany

The process to find psychotherapy in Germany’s urban centres is arduous – licensed therapists often have impossibly long wait times, and private practices don’t accept public health insurance.

A major reason that public insurance funded mental health care is hard to find in Germany comes down to regulations. Specifically the ‘coverage plan’ (Bedarfsplanung) that basically limits the number of licences available for publicly insured therapists in a region.

Germany’s maddening bureaucracy probably won’t be fixed any time soon. So residents in need of therapy will need to find a way through the system as it is.

So here are a few helpful tips for finding therapists, as well as how publicly insured patients can have private practice therapy costs reimbursed.

Look for therapists enrolled at academies

You’ll probably have a better chance getting an appointment with therapists who are currently in training, because not everyone knows that this option exists.

You can search for “Akademie für Psychotherapie”, to find one in your location. The Berliner Akademie für Psychotherapie, is one in the capital city, for example.

If you arrange an appointment this way, you can expect to be connected with a grad student therapist in training who needs to complete their supervised practice hours. In this case, you would see your therapist as usual, and they will be going through your session with an experienced therapist afterward.

The main advantages to seeking a therapist in training is that it may be cheaper and you can probably more readily find an appointment. A potential disadvantage is that the therapist you’ll be seeing is less experienced. 

But according to a Stockholm University study, student therapists who receive regular feedback from supervisors may be just as effective as licensed therapists at treating patients.

How to get reimbursed for going to a private practice

As mentioned above, therapists covered by public health insurance are few and far between, especially in many urban centres, and therefore regularly come with long wait times. But for those willing to do battle with the bureaucracy, there is an option to have your costs reimbursed for seeing a private practice therapist.

Specifically, public insurance providers are obligated to provide full reimbursement of costs in the event of a “supply emergency”. 

Waiting times of more than three months are considered unreasonable. So generally, patients can claim a supply emergency if they have contacted several therapists, and none of them offered available appointments within that time frame.

But you’ll want to make sure that your process is properly documented so that you won’t be stuck with the out-of-pocket costs.

First, you’ll need to document your need for psychotherapy. To get this, make an appointment for a psychotherapeutic consultation with a practice in your area, and be sure to collect a written recommendation for treatment (a PTV 11 form). 

If you don’t know where to start with this, look to the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung) for a database of therapists. You can also call 116 117 or use the 116 117 App.

After you’ve got your PTV 11 certificate, you’ll need to document your futile search for a licensed therapist. To do this, contact at least three to five therapists that have public health insurance approval. Keep a list of the names of therapists you contacted, as well as dates and times of contact and how long the waiting list for treatment is. 

Additionally, you should try to arrange treatment through the aforementioned Association of Statutory Health Insurance Physicians, and receive confirmation if it’s not possible. So you’ll need to call 116 117, or use the 116 117 App again. But this time go through the process to have them try to find you placement with a therapist. This should take a maximum of four weeks, but rarely happens.

Finally, if you have documented all of the above and have still not found a readily available therapist, then you can seek out a private practice. You’ll need to enroll as a self-paying patient initially, but then you can submit an application for an outpatient reimbursement (Kostenerstattungsverfahren) along with the previously collected certificates and proof of your search. Private practice therapists are usually familiar with this process, and may be able to help you with the application as well.

READ ALSO: What are the main reasons internationals in Germany turn to therapy?

Free phone consultations for students

Students in Berlin can also take advantage of a free 50-minute conversation with a therapist through StudierendenWERK.

For students elsewhere, it’s worth checking what kind of mental health support services your school offers. Many German universities offer mental health support to some extent, and if school counsellors can’t provide the care that you need, they may be able to offer helpful information about where such services are available in your area.

READ ALSO: Here’s how you can get mental health help in English in Germany

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