Mental healthcare in Luxembourg

Luxembourg is a wealthy country with an extensive public healthcare system. In fact, it is ranked 12th globally for healthcare on the 2021 Legatum Prosperity Index. All residents of Luxembourg have state health insurance, which they can use to can access a variety of mental health services. Around 65% of residents also have some form of private insurance to cover any gaps.

Of course, mental health encompasses a wide range of topics. To help you navigate your way through what’s on offer to support mental health in Luxembourg, here’s a detailed breakdown of services. Sections include:

Mental health in Luxembourg

Provision for mental health care in Luxembourg has changed over the past few decades. Starting in the 1990s, it has moved slowly away from institutionalized care towards more community-based support. This consists of state-funded care, supplemented by some private and voluntary sector services.

Luxembourg is a relatively big spender on mental healthcare with what appears to be a positive effect; residents of Luxembourg report less psychological distress than the EU average. Some 13.4% of public health expenditure goes towards mental health, which is higher than the EU average. A 2013 EU report highlights good levels of funding and service provision. It also notes that Luxembourg relies heavily on expat workers in the mental health sector.

High rates of depression in Luxembourg

Luxembourg is a wealthy country with an undeniably high quality of life relative to other countries in the OECD Better Life Index. However, poor mental health is something that affects many residents. For example, according to a 2020 EU study, 9.5% of residents report suffering chronic depression. That is higher than the 27 member bloc’s average of 6.9%. Luxembourg also tracks higher than the EU average for deaths as a result of mental and behavioral disorders – 51 deaths per 100,000 residents. Again this is markedly higher than the EU average of 36.9, according to a 2020 report.

The suicide rate in Luxembourg is 8.6 per 100,000 residents as of January 2022. However, this can vary. For example, in 2019 the rate was 11 per 100,000, which is in line with the EU average. The suicide rate is almost twice as high in men (11.2) than in women (6.4) in Luxembourg.

Mental health in Luxembourg has become more of a concern since the start of the COVID-19 pandemic, with around one in three residents reporting a decline in mental health during lockdowns. The Ministry of Health (Ministère de la Santé) and the Luxembourg League of Mental Hygiene (La Ligue Luxembourgeoise d’Hygiène Mental – LLHM) responded to this by launching mental health first aid training in 2021. The classes aim to train family, friends, and coworkers to recognize symptoms of the most common mental illnesses.

Mental healthcare services in Luxembourg

The Ministry of Health is responsible for healthcare policy and budget in Luxembourg. It works closely with the LLMH. The League is a voluntary organization that offers mental health services, support, information, awareness, and training. The Ministry of Health also runs a health portal with information on health policy, prevention programs, and citizen healthcare rights.

In the main, primary care for mental health in Luxembourg is available through state-funded healthcare. It consists of GP support plus psychiatric services within hospitals that offer outpatient and short-stay inpatient care. Those needing longer-term psychiatric help usually receive treatment at the Neuro-Psychiatric Hospital Center (Centre Hospitalier Neuro-Psychiatrique – CHNP). Secondary care is available through specialists offering services through state-funded healthcare as well as a network of voluntary organizations and private providers.

State health insurance in Luxembourg also covers: treatment from GPs, medical specialists, hospital care, long-term care for the elderly and those with severe illnesses. It is worth noting that health insurance also covers prevention and educational programs for children and older residents.

How to access mental health services in Luxembourg

If you feel that you need mental health support in Luxembourg, you can contact your GP who may refer you for specialist treatment if necessary. Alternatively, you can access services and treatment directly without a referral. You can search for registered mental health specialists on the Luxembourg Society of Psychology (Société Luxembourgeoise de Psychologie asbl – SLP) web portal and Doctena Luxembourg.

However, do keep in mind that you will need a doctor’s referral for in-patient hospital treatment such as surgery or ongoing psychiatric care. You can contact the CHNP’s policlinic about a consultation. In addition, the Ministry of Health set up a COVID-19 hotline to offer psychological support in several languages (weekdays from 08:00 to 16:00).

Insurance for mental healthcare in Luxembourg

Residents in Luxembourg are entitled to mental healthcare through state health insurance. This is done through registration with the Joint Social Security Center (Centre Commun de la Sécurité Sociale – CCSS). Your employer will usually do this for you when you start work. However, self-employed workers need to enroll themselves. Once registered, everyone covered should receive a social security card and number.

Health insurance in Luxembourg is managed by the National Health Fund (Caisse Nationale de Sante – CNS) which operates a reimbursement scheme. Most users need to pay costs upfront and then file for reimbursement from the state.

However, if you don’t work and cannot afford to make insurance payments, you can still access healthcare as a resident through your local social welfare office.

Wide coverage under state insurance

State health insurance in Luxembourg also covers dependent family members, who you need to list on your policy. Coverage includes:

• 88% of the cost of GP and specialist treatment
• In-patient hospital treatment, although you will need to pay a daily fee (currently €23.10) for overnight stays
• Prescription medicine costs are covered at the rate of either 100%, 80%, or 40% depending on the medication
• Full rehabilitation costs when recovering from certain serious mental conditions
• Long-term care costs if suffering from severe mental illness
• 100% treatment costs for children aged up to 18

But mind the state coverage gaps

However, it is important to note that state insurance does have exclusions. For example, children’s psychotherapy costs are not reimbursed by the state. In this case, you will need to have private insurance or pay these costs yourself. As usual, check with your private insurer regarding coverage rates.

Short-term visitors to Luxembourg from other EU/EFTA countries can access treatment through their European Health Insurance Card (EHIC). Other visitors and those not covered by public insurance will need to take out a private health insurance policy.

Private health insurance in Luxembourg

Unlike some other countries, Luxembourg doesn’t have a distinct division between public and private healthcare sectors. Instead, most health professionals work privately but have contracts with the CNS to provide public healthcare reimbursed by the state.

If you don’t have state health insurance in Luxembourg, you can take out private insurance to use the same public services and more. Many residents of Luxembourg have both types of insurance. Your private health insurance will enable you to: get treated by private-only professionals, cover 100% of your medical costs, and access treatments and services not covered by state funding. For example, most alternative therapies, sessions with psychotherapists, or a single private room in a hospital.

Most residents in Luxembourg supplement their state health insurance with a private insurance policy. There are a number of private health insurers operating in Luxembourg that offer global expat-friendly coverage. These include:

• Allianz Care
• Cigna Global

Psychologists, psychiatrists, and therapists in Luxembourg

You can find psychologists, psychiatrists, and therapists in Luxembourg working privately, through public healthcare, and also in the voluntary sector. All need a license from the Ministry of Health and have to sign up to the Collège Médical. Many are members of professional bodies, such as the SLP. Luxembourg has 21.5 psychiatrists per 100,000 people, which is the 8th highest in the EU.

The Prevention Depression website provides a good summary of the differences and overlaps between psychiatrists, psychologists, and therapists in Luxembourg. You can access all three without a referral. However, you will generally need a GP referral for in-patient psychiatric treatment in a hospital.

Psychologists and psychotherapists generally provide support and analysis through consultative sessions. They tend to work in health centers, clinics, hospitals, and private practices. Psychiatrists have a wider remit. They usually work in hospitals and can prescribe and monitor medication, make diagnoses and refer for medical tests.

You can find specialists such as child psychiatrists/psychologists, or those dealing with addiction issues. Psychiatrists generally work in the public sector, with 88% of costs reimbursed for most adults and 100% for children. Psychologists and therapists usually work privately. You can also find free support through charities such as the LLHM.

Psychotherapy and state insurance

It is worth noting that the state health insurer CNS draws a distinction between psychotherapy sessions and psychiatric care. As of 2021, psychotherapists had pulled out of talks with the CNS over reimbursements. The state did not agree to scrap certain exclusions, which stood as of January 2022. Psychologists and psychotherapists wanted:

• Three fully reimbursed introductory sessions with patients
• Full reimbursement for people who had previously received psychotherapeutic treatments in a hospital
• Reimbursement for people who had been taking antidepressants within the past three months
• Reimbursement for under 18s and over 60s

As it stands these state insurance exclusions mean you will need private insurance in place to assist in covering these costs. You can find a list of registered psychologists and psychotherapists, and whether their services are refundable, on the SLP portal. You can find updates on this at The Federation of Associations Representing Psychotherapists in the Grand Duchy of Luxembourg, FAPSYLUX (in French).

Sessions can last anywhere between 20–90 minutes. If you pay for treatment privately, expect to pay between €70–€140 per session.

How to find psychologists, psychiatrists, and therapists in Luxembourg

You can search for these medical professionals in Luxembourg in a number of different ways. For example:

• Search on Collège Médical by specialty profession. 
• Use the Doctena Luxembourg website or app to search by specialty, location, or language. 
• Find registered psychologists and therapists on the SLP website.
• Contact one of Luxembourg’s many specialist hospitals. 
• Find details of specialists that provide services in your native language, by contacting your embassy or consulate in Luxembourg.

You can also find details of counseling services, many of them free, on the Prevention Depression website.

Drug and alcohol services in Luxembourg

According to 2019 EU statistics, Luxembourg has the third-highest rate of heavy episodic alcohol drinking in the EU. That is, 34% of the population engage in heavy drinking at least once a month. And just over 5 per 1,000 people (aged 15–64) are categorized as high-risk drug users.

You can access addiction support through state health services. The simplest way is to contact your GP who will refer you to specialist support if necessary. Of course, you can also contact specialist support at hospitals, clinics, and rehabilitation centers directly. However, you will usually need a referral for long-term inpatient care.

The CHNP has the Rehaklinik that offers rehabilitation for sufferers of alcohol and drug addiction. This includes:

• Outpatient support at the ÄDDI·C Center
• Inpatient treatment at therapeutic centers specializing in either drug or alcohol recovery
• The Orangerie 2 rehabilitation unit for those with long-term alcoholism issues.

Other public health sector support includes addiction consulting services, emergency night accommodation for drug addicts, and a consumption room that offers controlled and legal drug use.

Between 80%–100% of public service costs are usually covered through health insurance. Emergency care is covered in full. Therapeutic outpatient treatment from CNS-registered providers is usually reimbursed at 88%.

In addition, there are drug and alcohol support groups and organizations that provide free services to residents. These include:

• Alcoholics Anonymous Luxembourg
• Narcotics Anonymous Luxembourg
• Youth at Drogenhëllef Foundation (Jugend- an Drogenhëllef Fondation) provides support to young people
• National Center for Addiction Prevention (Centre National de Prévention des Addictions – CNAPA)

The government health portal has sections on both alcohol and drug prevention services, advice, as well as techniques.

Services dealing with eating disorders in Luxembourg

Eating disorders are on the rise in Luxembourg, as they have been in many countries. Anorexia nervosa affects around 1% of female adolescents, with around 90% of sufferers of all ages being female. Bulimia nervosa affects between 1%–2% of all young people, while Binge Eating Disorder affects around 3% of the adult population with around 60% of sufferers being female.

Unfortunately, there are currently no specialist public facilities and there is a lack of trained professionals to deal with eating disorders in Luxembourg. If you have an eating disorder, or have a child with a problem in this area, you should contact your GP or the child’s school health team. Additionally, you can get in touch with Kanner-Jugendtelefon (KJT) who can offer support and advice to children and families.

There are a couple of support groups that also run sessions in Luxembourg. Anorexics and Bulimics Anonymous (ABA) currently run online meetings on Mondays. Overeaters Anonymous also hold sessions in Diekirch and Luxembourg City.

Mental healthcare for people with severe mental health problems in Luxembourg

Those with severe or acute mental illness in Luxembourg usually receive treatment from psychiatrists or other mental health specialists in hospital settings, either as inpatients or through outpatient services. There has also been a growth in supplementary community-based programs to help with rehabilitation and reintegration in recent years.

Luxembourg has 74 psychiatric beds per 100,000 inhabitants, which is about the same as the EU average. The number of beds has reduced as alternatives such as daycare and community support have improved. The CHNP is the main facility for those with severe mental health problems in Luxembourg. Its Rehaklinik is a national rehabilitation center and provides services including:

• Rehabilitation for those with psychotic disorders
• Specialist intensive care for those with acute conditions
• Outpatient psychiatry and psychotherapy
• Juvenile psychiatry
• Psychiatric support for conditions related to old age
• Supervision and support in prisons and detention centers

Support is mainly through the public healthcare system covered by state health insurance. Between 80–100% of costs are covered by state funds, with children and those unable to make contributions themselves receiving the full 100% funding.

Mental healthcare for children and young people in Luxembourg

Children receive free healthcare in Luxembourg via the health insurance of their parent or guardian. They generally see a family doctor as the first point of healthcare but don’t need a referral to access pediatricians or pediatric healthcare specialists. In fact, you can choose to have a pediatrician rather than a GP monitor your child’s health and development.

According to a 2020 UNICEF study, 16.5% of young people aged 10–19 in Luxembourg suffer from mental disorders, which is higher than the global average of 13%. Children’s mental health in Luxembourg is monitored from around the age of two and continues through the early years and school years. If problems with mental health are identified, help is available through the Early Rehabilitation Service ((Hëllef fir de Puppelchen) which supports children up to the age of four.

If you have concerns about your child’s mental wellbeing, you can contact your GP, a specialist such as a child psychologist, or the school healthcare team. As mentioned children’s psychotherapy costs are excluded from state health insurance reimbursement. However, children can also get confidential support independently from their GP or support services such as Kanner Jugendtelefon (KJT).

Other organizations offering mental healthcare support include:

• National Children’s Office (Office National de l’Enfance – ONE) – offers psycho-social support to children and young people aged up to 27 years.
• Socio-Medical League (Ligue Médico-Sociale) – runs health and social support services from 12 socio-medical centers across the country.
• Psycho-social and School Support Center (Centre Psycho-social et d’Accompagnement Scolaires – CEPAS) – public sector body that provides support to individual families and through schools.
• Elizabeth Group Ambulatory Service (SIPO) – services include support and advice to children, young people, and families experiencing mental health problems, including those with disabilities.

Support services for special groups in Luxembourg

There are non-profit organizations in Luxembourg that offer mental health support specifically for females. Women In Distress (Femmes en Détresse) provides counseling, advice, and refuge accommodation for women experiencing domestic violence. There is also the Pro-Familia Foundation that offers psycho-social advice and temporary accommodation to women in a range of difficult situations.

People in Luxembourg with disabilities can contact Info Handicap Luxembourg, which is the national disability council. They will provide information on what mental health support is available. For refugees, Caritas gives free psychological support sessions at its refugee centers throughout Luxembourg.

Mental health prevention and education programs in Luxembourg

The Ministry of Health has set up a number of websites to support mental health. There is a general mental health portal, and another site specifically around managing mental health during COVID-19. There are also three prevention websites covering depression, panic attacks, and suicide.

The government also has a prevention section on its health website that contains a range of information and resources, plus a web portal with details of activities to protect family health and wellbeing during coronavirus lockdowns. The LLHM also has an information and prevention department that runs workshops and training around wellbeing and reducing stigma.

There are a number of resources to support good mental health among older people in Luxembourg. These include a free national dementia prevention program and a network of state-funded seniors clubs aimed at reducing isolation among over-50s. Voluntary organization geroAKTIV offers free activities, events, and learning opportunities to help older people stay healthy.

Many activities beneficial to mental health are run at the local level, such as community-based social projects or mindfulness workshops. You can find information on local activities on many of the official communal websites in Luxembourg. You can also search for local groups in your area on the Meetup website.

Emergency support and crisis lines in Luxembourg

The medical emergency number for Luxembourg is 112. You can also access emergency care at many of the hospitals in Luxembourg or visit one of the out-of-hours Medical Houses (Maisons Médicales).

Crisis lines in Luxembourg include:

• SOS Distress (SOS Détresse) – general crisis line for people needing help or feeling suicidal. Call 45 45 45 (hours are 11:00–23:00, open until 03:00 Fridays and Saturdays)
• Children and Youth Line (Kanner-Jugendtelefon) – crisis line for children and young people. Call 116 111
• Women in Distress (Femmes en Détresse) – 12344
• Domestic violence helpline – 2060 1060 (seven days a week between 12:00 and 20:00)
• Ministry of Health COVID-19 Hotline – 8002 8080 (Monday to Friday 08:00 to 16:00)

Some of these lines may not have English-speaking options so you may need a French or German interpreter with you if you’re not fluent in one of Luxembourg’s national languages.

Useful resources

• National Health Fund (Caisse Nationale de Sante) – for information on public health insurance in Luxembourg
• Sante.lu – the government health portal with information on prevention (in French)
• Luxembourg League of Mental Hygiene (La Ligue Luxembourgeoise d’Hygiène Mental) – a voluntary organization that offers mental health services, support, information, awareness, and training in Luxembourg (in French)
• Luxembourg Society of Psychology (Société Luxembourgeoise de Psychologie) – you can search for registered psychologists and therapists in Luxembourg