Mental health in Germany: services and support

German healthcare professionals have been steadily increasing their emphasis on diagnosing and treating mental health issues. Indeed, what many once perceived as an invisible illness now receives more recognition on the national and regional level in Germany. The country offers many services dedicated to helping those with mental health problems. Since internationals are typically more susceptible to mental health issues, knowing how to access treatment is essential if you’re moving to Germany.

Learn how to get German mental health support by reading the following sections:

Overview of mental health in Germany

According to the German Association for Psychiatry, Psychotherapy, and Psychosomatics, almost 28% of Germany’s adult population is living with a mental health condition as of 2023. 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 those related to alcohol and drug consumption. In Germany, mental illness is the second most common reason for sick leave and the number one cause of early retirement.

In general, people living with a mental illness have a life expectancy of 10 years shorter than the general population. Approximately 9,200 people died by suicide in Germany in 2021. Between 50% and 90% of suicides can be traced back to the existence of a mental illness. In 2019, the suicide rate in Germany was 12.3 persons per 100,000 people.

German attitudes toward mental health

In Germany, there is a gap between perceived and personal attitudes surrounding mental health. While many believe that there has been a substantial increase in acceptance of people living with mental illness, personal attitudes have actually remained the same or worsened. Although the German public has been consistent in its stigmatization of mental illness, those familiar with psychiatric treatment believe things are changing.

German mental healthcare services

The German multi-payer healthcare system includes mental healthcare coverage. Statutory health insurance, known as Gesetzliche Krankenversicherung (GKV), currently covers about 88% of the population. This includes any legal residents who make less than €5,062 per month.

German residents have access to consultation with a psychiatrist, therapy, inpatient and outpatient care, emergency services, and medication. 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.

Is Germany the best in mental healthcare?

Germany has a very high capacity for mental healthcare patients. According to the World Health Organization, Germany has 274 mental health hospitals, 401 psychiatric units in general hospitals, and 63 mental health outpatient facilities (as of 2020). There are also psychosocial counseling centers and private practices throughout the country offering mental healthcare services to those in need.

An estimated 13,500 specialists in the psychiatry and psychotherapy fields provide care, treatment, and support for those living with mental illness, 50% of whom are female. There are more than 57,000 psychiatric beds available to adults in German hospitals and clinics, one of the highest number in the world.

How to access German mental health services

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.

For those with public health insurance, the statutory system covers outpatient psychotherapy. However, there are specific requirements to meet first, including official diagnosis of a mental disorder. Waiting times may be longer with public insurance than private, but the process is still relatively quick. GKV reports that 93% of therapy patients receive treatment within four weeks of first contact.

Insurance for German mental healthcare

Since 2009, it is compulsory for every resident of Germany to have health insurance, whether public or private. Regardless of employment status, public health insurance is available to everyone. Public health insurance now includes outpatient psychotherapy treatment in its range of services.

By contrast, private health insurance is available for students, people who are self-employed, and those who earn above a certain income. Many international arrivals to Germany also choose to take out expat-friendly insurance with a global health insurance company before they arrive. This can help give new arrivals peace of mind while they set up their new life in Germany.

Private health insurance providers

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:

• Allianz Care
• Cigna Global
• Ottonova

Psychiatrists, therapists, and psychologists in Germany

In Germany, psychiatrists are medical doctors 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, psychodynamic, and psychoanalysis. Only those who have a Kassensitz license can bill the public healthcare system, and this is expensive to purchase. 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

To find an English-speaking psychiatrist, therapist, or psychologist, check out the useful resources section of this article or use Expatica’s 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.

German drug and alcohol services

In Germany, there is comprehensive mental health 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 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
• Deutsche Hauptstelle für Suchtfragen: 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.
• Alcoholics Anonymous (Anonyme Alkoholiker): Support organization offering advice and group meetings for people with alcohol problems, available online and by phone
• Vista Berlin: Counseling and support for people with alcohol or drug addiction

Services dealing with eating disorders in Germany

Eating disorders can affect anyone regardless of their age, gender identity, body size, ethnicity, or background. However, research shows that trans and non-binary young adults are most at risk of developing disordered eating habits.

There are a number of services available in Germany for those facing challenges associated with eating disorders. 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. 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. They also aim 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.

German hospitals and clinics that provide 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 in Germany

For those with severe mental health problems, such as suicidal thoughts, certain addictions, or psychotic symptoms, inpatient treatment may be recommended. Typically, there are two options available: psychosomatic clinics and psychiatric hospitals. In Germany, these exist as either standalone clinics or wards within general hospitals.

Patients at psychosomatic clinics typically stay for four to six weeks. Psychiatric hospitals providing emergency assistance can provide treatment anywhere from days to months as well as outpatient services. Germany also offers a hybrid treatment model called Tagesklinik that allows people to spend the day at the clinic and go home at night to sleep.

You can access emergency services at hospitals or clinics whether or not you have health insurance. If you do not have insurance to cover your treatment, you will receive a bill. For smaller hospitals and clinics, you may need a referral or to check in advance of your visit what services are available.

German mental healthcare for children and young people

In Germany, children and adolescents have multiple options to access care and treatment. 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 may include lack of motivation, negative mood, and attention issues. After such a test, they may receive a referral for specialist treatment.

Public health insurance covers all children until the age of 18. Pediatricians generally treat children until age 12, when a family doctor takes over. Public health insurance typically covers consultation with a psychiatrist, short-term therapy, and most of the costs. Those with private insurance may have to pay the fees upfront and file a claim for reimbursement. 

Mental healthcare services for special groups in Germany

Many organizations provide dedicated support to specific communities in Germany. Here are just some of these groups:

• StudierendenWERK: This Berlin-based organization provides counseling for students on personal conflict situations and study-specific topics
• Schwulenberatung Berlin: This organization for gay men and trans people provides one-on-one and group counseling on coming out, mental health, age-related problems, alcohol and drug use, addiction, and HIV/AIDS
• Frauentreffpunkt: This organization provides women who are victims of domestic violence personal and/or telephone advice, crisis intervention and security planning, shelter and housing support, free legal advice, and more. Counseling is available in English, Spanish, and German.
• GLADT: GLADT specifically supports people of color in the LGBTQIA+ community. They offer counseling, social events, training, and workshops.
• Teilhabeberatung: Using this service, you can find access to disability-specific counseling services and support across Germany. This includes speech disorders, mental impairments, learning disabilities, blindness, deafness, and other forms of neurodiversity, such as autism.

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.

The Ministry of Happiness and Wellbeing (Das Ministerium für Glück und Wohlbefinden) is an independent initiative and a multimedia campaign in German-speaking countries that champions personal fulfillment, mindfulness, mental health, and coexistence. You can access interactive sessions and speeches, workshops, discussion panels, online resources, and care packages.

Mental Health Awareness Week (Woche der Seelischen Gesundheit) is held every year in Germany. It includes events across the country both digitally and in-person that provide information to the public about suicide prevention and mental health awareness. In 2023, Mental Health Awareness Week will run from 10–20 October.

Emergency support and crisis lines in Germany

• 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 Suicide Prevention Hotline: Dial 0800 1110 111 or 0800 1110 222 toll-free to speak to a volunteer counselor
• Berliner Krisendienst: They provide around-the-clock phone assistance and in-person help from 16:00–00:00, with service in multiple languages including English. Krisendienst has nine different numbers (listed on the website) depending on from which region of Berlin you’re calling.

Useful resources

• Therapy Route – directory of psychologists in Germany
• KV Berlin – map of doctors and psychotherapists who accept public health insurance
• Therapie.de – search for a therapist search by location, gender, language, and more
• It’s Complicated – find in-person or online therapy according to your language and insurance type
• ACT Berlin – list of Berlin-based therapists and counselors with short bios and languages listed
• Doctolib – search for doctors in Germany by specialization, including psychologists
• Coalition for Mental Health – an alliance of 125 member organizations working to destigmatize mental illness
• German Depression Aid Foundation – non-profit organization that helps those living with depression find support
• German Society for Psychiatry and Psychotherapy, Psychosomatics, and Nerve Medicine – Germany’s largest medical-scientific specialist society for mental illness