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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.

Mental health button
Button reads "mental health". Seeking acute help through psychotherapy. is one way to take care of your mental health. Photo: picture alliance/dpa/pro psychotherapie e.V. | momius /stock.adobe.com

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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FAMILY

How to find mental health resources in Germany for children

As mental illnesses and behavioural disorders among children and teenagers continue to rise, it can be difficult for international parents in Germany to know where to find resources.

How to find mental health resources in Germany for children

Whether it’s school stress, adjusting to a move abroad, low self esteem, a personal crisis, hormonal changes or family issues, there are plenty of things that may make it hard for young people to cope with everyday life. 

A survey screening child anxiety disorders, found children in Germany ages 11 to 17 with symptoms of anxiety more than doubled over the course of the pandemic from under 15 percent before the pandemic to nearly a third of children surveyed exhibiting symptoms in January 2021. 

And social media has only added to the problem. According to a recent DAK study, media addiction among children and young people in Germany has nearly tripled from numbers before the pandemic. 

Girls and boys with heavy social media use reported more depressive symptoms, anxiety and a higher level of stress than children with less media usage. The parents of the affected children and young people also reported more dissatisfaction with communication within the families.

While Germany has a large capacity to care for mental healthcare patients, it can still be tough to find resources for children, especially if there’s a language barrier. Here’s a guide to finding mental healthcare for children and youth in Germany:

Is mental health care covered by insurance in Germany?

Yes, Germany’s state health care system covers mental healthcare. Statutory health insurance currently covers nearly 90 percent of the population. This insurance gives residents access to consultation with a psychiatrist, therapy, in- and outpatient care, emergency mental health services and medication

READ ALSO: How to receive help for a mental health issue in Germany 

Where should you start?

Parents should start by reaching out to their children’s paediatrician or family doctor. After explaining how your child is doing, they will likely refer you to a child psychiatrist to further evaluate treatment options. Treatment can include prescribing mediation, talking therapy, or a combination of both. You can also directly set up a consultation with a mental health professional for your child.

Insurance type, public or private, can also impact the type and availability of services. Public insurance covers fewer practitioners, meaning you may have to cover the cost of therapy for your child upfront and wait to be reimbursed.  

Whether you have public or private insurance can impact the type and availability of services. Public insurance covers outpatient psychotherapy, but patients must meet specific requirements for coverage. Doctors can also write a letter that parents can submit to their health insurance to access up to six therapy sessions, with the possibility of extension

Families using public insurance may also have longer wait times. Nearly half of all patients must wait three to nine months before receiving care, according to Germany’s Federal Chamber of Psychotherapy

A school girl at a Leipzig school. Photo: picture alliance/dpa | Hendrik Schmidt

This problem is worsened because public insurance does not cover all mental health professionals. Practitioners must have a ‘Kassensitz’ licence to bill public health insurance. These licences are regulated by the government and are limited. The cost of this licence, along with the waiting time for it, is often a deterrent to some practitioners. 

Another option could be to talk to your child’s school. Some schools employ social workers and psychologists who can screen and provide resources to children. These professionals can screen young people who exhibit symptoms of mental and emotional distress or hyperactivity in the classroom. They can also refer you to additional resources for more specialised treatment. 

What mental health resources are available?

As of 2022 there were more than 55,000 child and adolescent psychologists working across the country, according to data from the German society for psychiatry and psychotherapy, psychosomatics and neurology (DGPPN). The majority of these health professionals work in outpatient facilities, and the remaining 15 percent work in inpatient or day-care facilities. 

Germany has 274 mental health hospitals, 401 psychiatric units across general hospitals and 63 mental health outpatient facilities, according to the UN’s 2020 Mental Health Atlas. The country also started granting more specialist titles, including in child and adolescent psychiatry, in 2022.

Germany has also launched a helpline called “Nummer gegen Kummer” (number against grief) to support children facing mental health issues, whether it’s to do with getting bad grades or dealing with unrequited love.

READ ALSO: ‘Being honest helps’: How expats have overcome loneliness

The free help line – which is accessed by calling 116 111 – is active Monday to Saturday from 2pm to 8pm daily. Children can anonymously speak with volunteer consultants who range from the elderly to students ages 16 to 21. It is important to note that this resource is intended for children comfortable speaking German at an elementary level.

Other resources to consider include:

  • Online directory Therapy Route features English-speaking psychologists and social workers across Germany
  • It’s Complicated connects users to in-person or virtual therapeutic care based on your language and insurance type
  • Online directory Therapie.de lists around 600 English-speaking therapists currently working in Berlin, 150 in Frankfurt, around 230 in Hamburg, and 240 in Munich
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