Everyone who is or was suffering and who is or was finally ready to look out for a therapist, at least in Germany, knows the great pain of finding someone in a reasonable time. It is already insanely tough to admit having some issues and to finally bringing up the energy to look for one. But then it’s always the same. You call 10, 15, 20 offices. Some of them don´t even pick up the phone, some of them are very rude and give you the feeling you´ve done something wrong by just calling them and some will put you on a waiting list for a long term treatment. These waiting lists are insanely long and it might take up to 6-12 months or even longer to have the chance of a suitable place. And lastly, some of them will only offer you one to three sessions for evaluation, but also make it very clear that they don´t have long term treatment options afterwards. So you basically sit there, spill out your life story to a stranger and then, after the last session you say goodbye. Goodbye Forever. Maybe with a quick diagnose or something similar, being left with the feeling under this pressure you couldn’t even get your own story straight as it´s surely not enough time to explain what you are feeling and why you are feeling this way. You feel angry, discouraged and sad at the same time as rejection is one thing nobody wants to experience when reaching out for help. But this is the reality, especially here in Berlin.
In 1999, the Psychotherapist Act specified how many psychotherapists were allowed to work in Germany. The number of therapy practices was based on the needs at the time. Apart from a few minor changes concerning the law, not much has changed since then. The range of therapies on offer no longer meets the current high demand. In easy words, there would be enough qualified therapists but they are not able to get a “Kassensitz” e.g. being able to treat patients with statutory health insurance. They can only offer private, out of the pocket payable treatments.
Even though the number of affected people is on the rise, the law makers are not making any move to change anything. It almost seems like they are in total denial that mental health issues are real illnesses and need to be treated. The numbers of suicides are on the rise and the affected are left alone with their suffering. It’s a disgrace and it’s getting worse, if there will be no change. Mental illnesses must get more attention, they need be destigmatized and law makers and people in decision making positions need to finally accept that mental issues are equal to physical illnesses.
That being said, there are some options left for people in need to get help faster and beat the current system.
The first option is to look at educational institutions for psychotherapist in your city. There are different ones and not everyone is offering therapy, but most of them do. You will find there therapists that are psychologists or doctors in advanced, part-time psychotherapeutic training, as well as licensed psychological psychotherapists and medical specialists. Find a fitting institution and reach out to them. The people I´ve talked got into treatment very fast.
Another option is the so called “Kostenerstattungsverfahren”. Anyone who embarks on the call odyssey of different therapist in your city should document the path well. According to § 13 paragraph 3 SGB V, health insurance companies are obliged to cover the costs of treatment by private psychotherapists under certain circumstances. Meaning, if none of the called, licensed therapists can offer you a place, your health insurance will pay for a private treatment (that mostly have no waiting period). For that, it must be proven that 1) psychotherapy is absolutely necessary and 2) unsuccessful requests have been made to at least three to five therapy practices. In order to prove the latter, the name of the therapist, the day and time of the rejecting request, and the specified waiting time should be noted for each call. In order to document the urgency of the situation, one should attend one of the acute consultation hours that licensed psychotherapists have had to offer since 2017. There you will get an assessment of your situation, which you can enclose with the application for reimbursement to your health insurance.
If you are already on a waiting list for your chosen therapist there are also some options to cover at least the waiting time. One option is using an app that offers online therapy, skill training etc. Depending on your health insurance the cost will be covered for apps like Selfapy, Mind-Doc; Deprexis24 and much more. There are usually no waiting times and most features of the app are available every time you actually need them.
Another option is to get in contact with psychological counseling centers. They often offer individual counseling as well as group therapies, seminars and lectures on specific topics - free of charge or for a donation. Suitable counseling centers can be found through the social welfare office, the social psychiatric service, the welfare organizations or church communities (e.g. Caritas, Diakonie etc.).
A last option are self-help groups and online forums to connect with link-minded people. On https://www.nakos.de/ you can find addresses for your city or online offers. This page not only offers help for mental issues but also for different physical illnesses.
Regardless of these tips, the search for a fitting treatment is exhausting, frustrating and covered with sweat and tears but giving up is not an option. You deserve this help and you deserve to heal.