It's no longer a secret: Anyone looking for a therapy place in Germany usually needs a good deal of patience and perseverance. The waiting times from the diagnosis to the start of therapy range from at least a month in the city to a year in the country. It is actually obvious that this is problematic for those affected, after all, the symptoms of the mental illness do not wait until someone is finally there to take care of them. They stay - and continue to affect the lives of patients.
A research team from the Netherlands has now investigated how strong the effects of the waiting time really are. The scientists from Maastricht University, led by psychologist Dyllis van Dijk, examined the data of 715 patients who were being treated for a depressive episode. They were asked to answer questionnaires about their mental state at different times.
The result of the analysis was clear: the longer the participants had to wait for the start of treatment after the initial consultation, the less successful the therapy was after six months. However, the symptoms have not worsened. The reason for the poorer treatment success is therefore not an aggravation of the disease. Rather, the researchers suspect that progressive chronification sets in when treatment starts later. In addition, the waiting time can have a demotivating effect on those affected and weaken the self-healing powers of depressed people.
Previous research shows that depression is not the only condition where long wait times may be a problem. Anxiety disorders, personality disorders and eating disorders could also become chronic if professional help is given too late. For example, the German Society for Social Paediatrics and Adolescent Medicine only complained about the inadequate care of young autism patients in April - it sometimes takes longer than a year for the therapy to start.
The long waiting times are mainly due to the heavily regulated allocation of cash register seats for psychotherapists. In the city, a key from a health insurance therapist is currently valid for 3,000 people, in the countryside it is assumed that one psychotherapist is sufficient for 6,000 people. That's the theory. The reality is different. Although Federal Minister of Health Karl Lauterbach (SPD) made it his mission to expand the number of cash registers when he took office, very little has happened so far.
The importance of a quick start of therapy has not only been known in the industry since yesterday. Peter Henningsen, director of the clinic for psychosomatics at the Munich Klinikum Rechts der Isar, said in an interview with the "Tagesschau" in relation to the effects of the waiting times: "Then some patients will require inpatient treatment, which would not have been the case if they were faster in adequate outpatient therapy would have come."
The structural hurdles that currently stand between those affected and a quick place in therapy can only be resolved to a limited extent on an individual basis. And yet there are several ways for people who suffer from an acute mental crisis to bridge the difficult waiting time for the start of therapy in a meaningful way.
Anyone who is deep in a mental crisis can apply for acute therapy with the help of their health insurance company or family doctor. This is usually mediated by the patient service of the health insurance companies if there is a corresponding acute code on the referral. The waiting time should not be longer than two weeks. Acute therapy serves to stabilize the patient and lasts a maximum of 12 hours.
Going to the psychotherapist is often a big challenge, especially for people who suffer from depression or anxiety disorders. Anyone who is often rejected on the phone often loses hope of getting a place in therapy after all. Here, online therapies offer a sensible alternative to gently enter the therapy practice. Providers such as "Selfapy" or "BetterHelp" give those affected easy access to their program and work closely with psychotherapists. Patients usually get access via a prescription from their family doctor.
Help for self-help - that is the principle of self-help groups. And the exchange with other people who have similar problems as you do can be healing. And above all to be a valuable support while waiting for a therapy place, which can provide initial approaches on how to deal with one's own worries and symptoms. Incidentally, groups are not only good for bridging the gap, but also a good addition to psychotherapy.
The most important thing at the end: If you are looking for a therapy place, you have to be persistent and have a lot of stamina. This is often not easy, especially for people with mental illnesses. When in doubt, every single call costs energy that you should actually put into your own recovery. Nevertheless, it is worthwhile because it could be the first step in therapy and thus the first step towards improvement.
And if you don't manage to call the tenth psychotherapist yourself, you might dial a friend's number and ask if he can do it. In any case, we are most likely to find the most important form of support in our closest surroundings, once we overcome ourselves and communicate. Together, the waiting time until the start of therapy can be bridged more easily.
Do you have suicidal thoughts? The telephone counseling service offers help. She is anonymous, free and available 24 hours a day on (0800) 1110111 and (0800) 1110222. Advice via email is also possible. A list of nationwide help centers can be found on the website of the German Society for Suicide Prevention.
Sources: Study on the effects of waiting times, Ärzteblatt, ZDF today, Tagesschau