Who can you turn to first if you have mental health problems?

We’ve put together a list of places where you can get help in Germany. Even if you aren’t sure whether you actually need treatment, they can give you some ideas about what to do next.

Psychotherapy practice

You can go here for an initial consultation, known as a "psychotherapeutische Sprechstunde." During this consultation, the therapist will assess whether you might have a mental illness and whether psychotherapy (talk therapy) would help – or might even be urgently necessary. Sometimes, other forms of support might be more suitable. This can be things like a support group or a counseling center (Beratungsstelle).

Psychotherapy practices must reserve a certain amount of their time for these consultations. To get an appointment, you can either contact the practice directly or use the appointment service offered by the German Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung). You don’t need to be referred by a doctor. Public (statutory) health insurers will cover the costs of an initial consultation. You don't have to apply for the costs to be covered.

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In Germany, there are two categories of psychotherapists: psychological and medical psychotherapists. The differences are explained in our “Psychotherapy providers in Germany” article.

Social psychiatric services (Sozialpsychiatrische Dienste)

These services help when people need treatment for acute or chronic mental illnesses. They generally don’t provide therapy themselves but they do have staff who are able to say whether someone has an illness that requires treatment. They also offer support to people who are currently in therapy or have recently been in a psychiatric hospital. Home visits are possible too if needed.

The social psychiatric service teams are also made up of doctors, care workers, psychotherapists, and social education workers. In Germany, these services are run by local health authorities and can be used for free.

Social psychiatric services are open both to people with mental health problems and to their loved ones. This can be helpful for people who think someone they know needs help, or if they're finding it hard to cope with the mental illness of someone close to them. There are also social psychiatric services specifically for children, teenagers, and their parents.

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The people who work in social psychiatric services and psychosocial counseling centers are required to keep all of your information confidential – just like therapists are.

How can you find a psychotherapist in Germany?

There are various places that can help you find a psychotherapist. These include:

• the “Patient service 116 117,” run by the Association of Statutory Health Insurance Physicians,
• health insurers,
• psychosocial counseling centers,
• the chambers of psychotherapists (Psychotherapeutenkammer) in Germany’s federal states,
• the medical associations (Ärztekammer) in Germany’s federal states, and
• social psychiatric services.

You can also look on the internet for psychotherapist and doctors’ practices near you. For instance, you can look for doctors and psychotherapists in your postcode area using databases on the websites of Patientenservice 116 117, the German Association of Psychotherapists, the chambers of psychotherapists, and the medical associations.

If you would like to have therapy in a language other than German, you can usually filter the search results to find therapists who speak other languages. Sometimes there are other search criteria too – things like whether the therapist's practice can be accessed by people with a disability or whether it offers certain services.

How can you find out whether a therapist is a good match for you?

You and your therapist will work together very closely, so it’s important that you feel comfortable with them. Don't hesitate to contact a psychotherapy practice if you’re interested in their approach or want to find out more about the therapist (like how long they’ve been in the profession and what their specialist areas are). Many practices also offer information about this on their website.

Other questions you might want to ask the therapist include:

• Do you have experience with people who have similar issues to mine?
• Which type of psychotherapy or medication can help with my illness?
• What possible side effects could the therapy or treatment have?
• How long do the different psychotherapy options take? How often would I need to come to your practice?
• What if I don’t have psychotherapy? Would it be enough to seek help elsewhere – for example, at a psychosocial counseling center?

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Before you start the actual psychotherapy sessions, you can have several trial sessions to see whether the therapist is a good match for you. You will find more information about this in our article called “What is psychotherapy and what does (more...)

How long will you have to wait to start therapy?

It can take several weeks or months to start therapy at a psychotherapy practice. It is possible to get an appointment for an initial consultation or acute therapy sooner. If treatment is urgently needed, acute therapy can start straight after an initial consultation.

People who have public (statutory) health insurance can use the Patientenservice 116 117 to schedule an appointment. The Patientenservice then has one week to arrange an appointment for an initial consultation. The appointment itself must take place within the next four weeks. If you’ve already been to an initial consultation, the Patientenservice can also arrange appointments for trial sessions or acute therapy based on what the first therapist recommends. The wait for acute therapy mustn't be longer than two weeks.

Who can help in an emergency?

If you’re having a mental health crisis, you need help straight away – especially if you might harm yourself or others. Then you can get help here:

• the emergency services (112 in Germany and many other countries, 911 in the U.S.): If you or others are at immediate risk – for example, due to potential self-harm or even suicide – you can call the emergency services. German emergency services can provide help in English too.
• 116 117 – Medical on-call service (ärztlicher Bereitschaftsdienst): They can help when doctors' practices are closed, like at nighttime, at the weekend, or on public holidays. They’ll refer you to the closest practice (psychiatric practice, for example) that is currently open.
• Outpatient psychiatric clinics (psychiatrische Ambulanz) or emergency departments (Notaufnahme): These are found in hospitals and medical care centers.
• Local crisis support service (Krisendienst) or emergency service for children and teenagers (Kinder- und Jugendnotdienst): Look for services in your local area.

There are also various telephone and online counseling services in Germany:

• 116 123 – the Telefonseelsorge telephone hotline
• 116 111 – the Nummer gegen Kummer telephone counseling hotline for children and teenagers
• 0800 11 10 55 0 – a telephone counseling hotline for parents
• Online counseling for children and teenagers: Chat-based help is available from places like Krisenchat, Jugendnotmail and bke-Jugendberatung.

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You’ll find a list of numbers for crisis helplines that are run in English and other languages on the Telefonseelsorge website.

What can you do if you find it difficult to seek help for psychological problems?

Some people find it difficult to seek help from a psychotherapist. The reasons for that may vary. Some are scared of being labeled mentally ill or they’re reluctant because they don't know what happens during psychotherapy. Others doubt whether psychotherapy can really help them. But people who have started or completed therapy often say they wish they had done it sooner. It is not easy to challenge and change your own thoughts and behavior – it can actually be quite hard work. But it's very often worth the effort because getting over depression, OCD or an anxiety disorder will considerably improve your quality of life.

If you're feeling hesitant, you could try the following things:

• First walk past the building where the practice is and see what it looks like – it’s often helpful to get an impression of the surroundings.
• Call a psychotherapy practice anonymously, or have a look at their website if they’ve got one, and find out what the therapy they offer typically involves.
• Look for a psychotherapy practice in a different area, further away from your home.
• Ask a friend or family member to go to the first appointment with you.
• Talk to other people who have had similar therapy in the past. You can do this at a support group, for example.

Sources

• Deutsche PsychotherapeutenVereinigung (DPtV). Report Psychotherapie 2021. 2021.
• Hauth I, Falkai P, Deister A. Psyche Mensch Gesellschaft. Psychiatrie und Psychotherapie in Deutschland: Forschung, Versorgung, Teilhabe Medizinisch Wissenschaftliche Verlagsgesellschaft; 2017.
• Robert Koch-Institut (RKI), Statistisches Bundesamt (Destatis). Psychotherapeutische Versorgung. (Gesundheitsberichterstattung des Bundes; Heft 41). 2008.

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.