We explain how to access different mental health services in Germany, as well as private health insurance, emergency support, and more.
In recent years, there has been a great deal more understanding of issues surrounding mental health in Germany, and beyond. Indeed, what has long been seen as an invisible illness, is now receiving the attention it deserves. Those living abroad are typically more susceptible to mental health issues. Therefore, it’s important you know how to access treatment if you’re moving to Germany.
It’s estimated that around one in four German adults suffer from mental health issues each year, including anxiety and addiction. However, the country has a number of facilities to help with mental health problems. To help you understand the mental healthcare system in Germany, and how you can access help, this guide includes information on the following:
- Overview of mental health in Germany
- German mental healthcare services
- How to access mental healthcare services in Germany
- Insurance for mental healthcare in Germany
- Psychologists, psychiatrists and therapists in Germany
- Drug and alcohol services in Germany
- Services dealing with eating disorders in Germany
- Care for people with severe mental health problems
- German mental healthcare for children and young people
- Mental healthcare services for special groups in Germany
- German mental health prevention and education programs
- Emergency support and crisis lines
- Useful resources
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COVID-19 in Germany
The COVID-19 pandemic has been a difficult time for everyone. Many expats find themselves separated from family and loved ones in their home countries. As a foreigner, it is also sometimes difficult to find critical information regarding coronavirus infection rates, local measures, and restrictions, and now, thankfully, vaccinations.
Overview of mental health in Germany
According to the German Association for Psychiatry, Psychotherapy, and Psychosomatics, more than a quarter of Germany’s adult population is affected by mental illness each and every year. This equates to 17.8 million people. However, only 18.9% of these people seek assistance from service providers. The most common mental illnesses include anxiety disorders, mood disorders, and disorders caused by alcohol and drug consumption. Mental illness is the second most common reason for sick leave and the most common reason for early retirement.
In Germany, people living with a mental illness have a life expectancy that is 10 years shorter than the general population. In 2019, approximately 9,000 people died by suicide in Germany. Between 50% and 90% of suicides can be traced back to the existence of a mental illness. In 2019, the suicide rate in Germany stands at 12.3 persons per 100,000 people.
German attitudes to mental health
In Germany, there is a gap between perceived and personal attitudes surrounding mental health. While many believe that, since 1990, there has been a substantial decrease in the devaluation and rejection of people living with a mental illness, personal attitudes have remained unchanged or even worsened in recent decades. Those familiar with psychiatric treatment believe things are changing while the German public has been consistent in its stigmatization of mental illness.
German mental healthcare services
The German multi-payer healthcare system encompasses care for mental health purposes. The statutory health insurance, known as Gesetzliche Krankenversicherung (GKV), covers roughly 88% of the population. This includes anyone who makes less than €5,062 per month. All residents have access to consultation with a psychiatrist, therapy, inpatient and outpatient care, emergency services, and medication. For more information on how this works and more, make sure you read our guide to the German healthcare system.
According to the World Health Organization, Germany has 274 mental health hospitals, 401 psychiatric units in general hospitals, and 63 mental health outpatient facilities attached to a hospital. There are also psychosocial counseling centers and private practices throughout the country offering mental healthcare services to those in need. The provision of services stands on the foundation of statutory and private insurers with social welfare offices and health departments of cities or districts administering them.
In Germany, there are an estimated 14,354 specialists in the psychiatry and psychotherapy fields providing care, treatment, and support for those living with a mental illness. This includes 6,119 on an outpatient basis and 6,712 on an inpatient basis. Of these specialists, 50% of practitioners are women. In 2019, there were 48,265 psychotherapists providing services for children and adolescents across Germany. For adults, there are more than 57,000 psychiatric beds available in specialist clinics or general hospital departments.
How to access mental health services in Germany
If you’ve just arrived in Germany, learning about the local healthcare system and how to access mental health services in your new home is important. Typically, this will depend on your circumstances and whether you have public or private health insurance in Germany. Any temporary visitors seeking mental health treatment in Germany may need to pay for any treatment out of pocket and then apply for reimbursement after the fact.
Your family doctor can refer you to a psychiatrist or psychotherapist. Your other option is to set up a consultation with a mental health professional directly. Whether you have public or private insurance can impact the type and availability of services. For example, there are fewer practitioners covered by public insurance, meaning you may need to cover the cost of therapy upfront and wait to be reimbursed. Furthermore, free therapy options often have longer wait times.
For those with public health insurance and who have been diagnosed with a mental disorder, you are covered for up to 25 sessions or two years, whichever comes first. After this, you have to wait two years until you can access this option again. Otherwise, you must pay out of pocket. The average cost for one hour of psychotherapy is between €60 and €100, and most people wait at least one month before they can access treatment.
Insurance for mental healthcare in Germany
Health insurance providers in Germany
There are a number of private health insurance companies operating in Germany. These include large multinational insurers as well as local German providers, offering full and supplementary policies. Health insurance providers in Germany include:
Psychiatrists, therapists, and psychologists in Germany
In Germany, psychiatrists are those with a medical doctorate who specialize in the treatment of people with mental health problems. Psychiatrists can provide treatment for those who require more than talk therapy, which often includes people with schizophrenia, severe depressive episodes, bipolar disorder, or borderline personality disorder. A consultation with a psychiatrist can be set up by talking to your family doctor. Following this, a treatment program can be established in tandem with a psychotherapist who provides talk therapy. This will be covered by public health insurance.
In Germany, public health insurance funds three types of therapy: cognitive-behavioral therapy, psychodynamic therapy, and psychoanalysis. Only those who have a “Kassensitz” license can bill the public healthcare system, which is expensive for practitioners to purchase outright. This results in a limited number of service providers when compared to the sheer volume of people who wish to access psychotherapy.
Be aware that waiting times for treatment can vary significantly throughout the country. In Berlin, for example, waiting times for these treatments can be anywhere between one and six months. Unfortunately, this sometimes comes too late for those in desperate need. Practitioners without a Kassensitz technically cannot bill the public healthcare system. However, if a client has tried multiple times to access therapy and been unable to, by law, a request for coverage can be made.
As psychologists do not have a medical degree, they cannot provide the same services as psychiatrists and psychotherapists. To access treatment with a psychologist, you have the option to receive a referral from a family doctor or to reach out to a service provider directly. You can also access emergency services where teams of mental healthcare workers can provide you with comprehensive care.
How to access English-speaking psychiatrists, therapists, and psychologists
The best way to access an English-speaking psychiatrist, therapist or psychologist is to use one of the many directories listed below or Expatica’s own German mental health services directory. These directories allow you to search for practitioners by language or provide an English-only list of professionals who can provide you with treatment and care. On top of this, some of the directories allow you to search for a provider not only by language but also insurance type. You can search for the service that best fits your needs and reach out to a mental health professional by phone or email to set up a consultation.
Drug and alcohol services in Germany
In Germany, there is comprehensive support for people struggling with addiction. This includes free services such as addiction counseling, prevention, and self-help. It also includes services that require approval from statutory and private insurers, such as withdrawal treatment, weaning, and integration assistance. The availability of services and wait times depend on the type of care you need and the urgency of demand. You can research service providers for more details. A family doctor can refer you to a specialist. Alternatively, you can reach out to a clinic or rehabilitation center directly.
Online resources for German addiction services
Whether you require urgent care or are simply doing research, the following is a selection of online resources for addiction services in Germany:
- German Red Cross: This organization provides professional support, addiction support groups and a nationwide hotline you can call Friday through Sunday and on public holidays.
- German headquarters for addiction issues V.: Find an online directory of addiction service providers.
- Guttempler: Support service for alcohol, medication, and drug problems available online and also by telephone. However, most consultants only speak German. You can also find local help.
- Alcoholics Anonymous (Anonyme Alkoholiker): Support organization offering advice and group meetings for people with alcohol problems. Available online and via telephone.
- Vista Berlin: counseling and support for people with alcohol or drug addiction.
German services dealing with eating disorders
There are a number of services available in Germany for those facing challenges associated with eating disorders. These include anorexia, bulimia nervosa, and binge eating. If you are living with an eating disorder, speak to your family doctor, who can provide assistance. They may offer you a referral to specialized care such as a psychosomatic clinic. You can also reach out to these clinics directly. Psychosomatic clinics provide comprehensive support, care, and treatment by teams of medical professionals to address your specific needs.
Organizations offering support for eating disorders
The German Society for Eating Disorders (Deutsche Gesellschaft für Essstörungen) is an interdisciplinary association of researchers and clinicians working towards prevention, early detection, diagnosis, and therapy of eating disorders and to represent the interests of those affected and their relatives in the best possible way.
The Federal Association of Eating Disorders (Bundesfachverband Essstörungen e.V.) is a nationwide association of outpatient counseling and therapy facilities, psychosomatic clinics, therapeutic residential groups, and psychotherapeutic practices.
ANAD is an organization offering help to people with eating disorders through advice and multidisciplinary therapy.
Hospitals and clinics providing care for people with eating disorders include:
- Schön Clinic Bad Arolsen
- Schön Clinic Bad Staffelstein
- LVR Clinic Essen
- University Hospital Freiburg
- Child and Youth Hospital AUF DER BULT
- University Hospital Heidelberg
- University Hospital Münster
- Clinic Dritter Orden Nymphenburg
- Die Filderklinik
- Diakovere Henriettenstift
Care for people with severe mental health problems Germany
For those with severe mental health problems, such as suicidal ideation, certain addictions, or psychotic symptoms, inpatient treatment may be required. Typically, there are two options available: psychosomatic clinics and psychiatric hospitals. Both of these can exist as standalone clinics or general hospital wards. Patients at psychosomatic clinics typically stay for four to six weeks. Psychiatric hospitals providing emergency assistance can offer treatment anywhere from days to months as well as outpatient services. In Germany, there is also a treatment called Tagesklinik that allows people to spend the day at the clinic while sleeping at home.
You can access emergency services at hospitals or clinics whether or not you have health insurance. If you do not have insurance that covers your treatment, you will receive a bill for your visit or stay. For smaller hospitals and clinics, you may need a referral or to check in advance of your visit what services are available. You may be subject to a wait time depending on how urgent a demand there is for treatment.
German mental healthcare for children and young people
In Germany, children and adolescents have multiple options to access care and treatment. Firstly, there are mental health hospitals with wards to treat children and adolescents. Here, teams of mental health consultants, psychologists, and therapists work together to provide care for specific mental illnesses and eating disorders. These hospitals typically also provide emergency and outpatient care. Parents and/or guardians can discuss options with a family doctor and receive a referral for specialized care. Alternatively, they may wish to reach out to psychiatrists or psychotherapists directly and set up a consultation.
In schools, children displaying symptoms of psychological distress may undergo a screening test by social workers or psychologists. These symptoms include emotional problems or hyperactivity. After this test, they may receive a referral for specialist treatment.
Public health insurance covers all children until the age of 18. Treatment of children is generally done by a pediatrician until the age of 12. After this, a family doctor takes over. Consultation with a psychiatrist, short-term therapy, and most of the costs are typically covered by public health insurance. Those with private insurance may have to pay the costs upfront and file a claim for reimbursement.
Mental healthcare services for special groups in Germany
There are a number of organizations that provide more dedicated support to certain communities in Germany. Here are just some of these groups:
- StudierendenWERK counselling services: This Berlin-based organization provides counselling for students on personal conflict situations and study-specific topics. Due to high demand, new appointments are assigned weekly on Mondays.
- Schwulenberatung Berlin: This organization for LGBTQ+ people provides one-on-one and group counselling on coming out, mental health, age-related problems, alcohol and drug use, addiction and HIV/AIDS.
- Frauentreffpunkt: This organization provides women who are vicims of domestic violence personal and/or telephone advice, crisis intervention and security planning, shelter and housing support, free legal advice and more. Counselling is available in English, Spanish and German.
- GLADT: GLADT provides support for the LGBTQ+ community, particularly those from minority backgrounds. They offer counseling, social events, training, and workshops.
- Teilhabeberatung: Using this service, you can find access to disability-specific counselling services and supports across Germany. This includes speech disorders, mental impairments, learning disabilities, blindness and visual impairment, deafness and hearing loss, and cognitive a and other impairments.
German mental health prevention and education programs
As awareness of mental health issues in Germany grows, so does the number of programs aimed at education and prevention. These include the following:
The Ministry of Happiness and Wellbeing: an independent initiative and a multimedia campaign in German-speaking countries that champions personal fulfillment, mindfulness, mental health, and successful coexistence. You can access interactive sessions and speeches, workshops, discussion panels, online resources, and care packages. Inquire by email for more information on pricing and availability.
Mental Health Awareness Week: Held every year, events across the country will happen digitally and in-person providing information to the public about suicide prevention and mental health awareness. Registration for the kick-off event is available online.
Emergency support and crisis lines
- German emergency services: You can reach ambulance and fire services by phone at 112 or the police at 110.
- Germany Suicide Hotline: 0800 181 0771
- Telefonseelsorge Deutschland National Hotline: 0800 1110 111 Hotline: 0800 1110 222 Website: telefonseelsorge.org.
- Berliner Krisendienst: They have nine neighbourhood-specific offices through Berlin. Berliner Krisendienst provide assistance over the phone around the clock and in-person from 4pm to midnight with service in multiple languages including English.
- German Network for Mental Health – directory of mental health professions available online
- Therapy Route – directory of psychologists in Germany
- AllAboutBerlin – directory of English-speaking psychiatrists and psychotherapists in Berlin
- KV Berlin – directory of doctors and psychotherapists who accept public health insurance
- Therapie.de – directory that allows you to search for a therapist search by language
- It’s Complicated – directory that allows you to search for a therapist by language and insurance type
- ACT Berlin – directory of therapists with language information available
- Doctolib – directory that allows you to search for doctors and therapists by language
- Doctena – directory that allows you to search for doctors and therapists by language
- Coalition for Mental Health – an alliance of 125 member organisations working together to de-stigmatise mental illness
- German Society for Psychiatry and Psychotherapy, Psychosomatics and Nerve Medicine – the largest medical-scientific specialist society for questions of mental illness in Germany