Thirty psychotherapists called her sister, but for months she has not had a therapy place, many would not even have answered. This was told by a neighbor of my wife and asked her if not me, the chief physician of a large psychiatric hospital, could help in this case. We took the patient, she was severely depressed and with the nerves completely at the end. After a few weeks of intensive therapy, she was well again, and she was able to be released stable.
Almost everyone knows such stories, but very few people happen to have a psychiatric head physician living in the neighborhood. The maladministration has been known for years, but nobody does anything effective against it; the severely mentally ill do not have a lobby.
30 years ago, I received a psychotherapy appointment for every mentally ill person within three days; today, this takes five months in Germany. But who is really mentally ill, can not wait so long.
The experts agree that the serious mental illnesses have not increased at all. The unreasonable waiting time is due to a broken system, which promotes the treatment of healthy and the really sick leave out.
A shame for a civilized country
As you read this text, patients everywhere struggle unaided, relatives despair, and nobody helps. The collapse of outpatient psychiatric-psychotherapeutic care is a shame for a civilized country.
Now Minister of Health Jens Spahn (CDU) dared to try to change that. In a first bill, he spoke of a "graded and controlled supply," without specifying what he meant by it.
But even this hint has led to the outcry of the most powerful lobbyist organization in Germany, the Federal Psychotherapeutic Chamber (BPtK). These people have been successful for years in getting psychotherapists to "patients" - without any interest in how patients come to therapists.
Burn-out is not a disease
Burn-out campaigns, also sponsored by journalists for a long time, have contributed to yours. Burnout is not a disease, as you know. Rather, this controversial concept is a collection of various phenomena, including real depression, but also just mood disorders that have no disease value. Burn-out is a marketing term, with self-proclaimed burn-out experts and burn-out clinics, where stressed-out managers fight certain annoying water treading disabilities.
There are now 1.5 million psychotherapy patients in Germany, a billion dollar business. No wonder, then, that year after year BPtK reports long waiting times, from which it only ever derives a demand: more psychotherapists!
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The long waiting times are due to the fact that there is no effective control, whether a patient sits with a psychotherapist or a person in a life crisis. When a woman is suddenly abandoned by her husband, it is often worse than a severe depression; this is not a disease but a healthy emotional reaction to a terrible situation.
Such a woman may need a psychological counselor, but in any case no medical treatment at the expense of the solidarity community. But nobody controls that.
There is no effective control
The applications, which must be made for the so-called policy psychotherapy at the coffers, are waved for years to 97 percent; because the reviewers only see paper, not patients. And who has the arrogance to deny a person a therapy that he personally has not seen and a colleague in writing for urgent need of therapy explained. Such "patients" are now everywhere under the label "moderate depressive episode" at the psychotherapist - and for the really sick, there are no more therapy places.
Psychological psychotherapists do excellent work, and by far the vast majority naturally treat really sick people. But the system encourages the treatment of healthy people. Ask yourself what you would do if you had a free choice to treat a severely disturbed person for the same fee, or your healthy neighbor, who for some reason has a need for discussion. No wonder, then, that the psychotherapy system in Germany has become a self-service store for psychotherapists. That's the problem.
When I wrote an article about the collapse of outpatient psychiatric-psychotherapeutic care in Germany five years ago, I got a lot of encouragement from patients and relatives; but immediately an incredible shitstorm of psychotherapist functionaries broke through me, which I had never experienced before. There were false claims, insinuations, even threats. An editor told me not to get upset, psychotherapist officials are the worst.
The public is manipulated
An influential colleague congratulated me with the jesting remark as to whether I had already commissioned a security service, such a post is not published in Germany with impunity. Since I myself was never an official, had nothing to lose after almost 40 years of employment and was guided exclusively by the interests of the patients, that was a completely new experience for me at the time. Meanwhile, it makes me just angry, how unrestrained the public is manipulated - and all take cover, when again the Federal Psychotherapy Chamber starts a campaign. The price is paid by the seriously ill mental patients on the waiting lists of our country and the desperate relatives, who are shocked to see how nobody helps and obviously nobody cares about them.
If one thinks radically of the people who urgently need a therapy, and omits all professional vanities, there would be solutions that could be implemented quickly and easily. Reputable experts have come to the conclusion that it would be easy to reduce waiting times from five months to around three weeks.
For this purpose, a functioning mechanism would have to be set up to ensure that healthy people are shown other means of assistance in life crises. Therapy places would be free, so that especially severely mentally ill people could get help quickly.
Best: do nothing
But any discussion of whatever solution is being prevented, as it has been done now, in the beginning; because against every reform attempt the BPtK fights by all means. Immediately, a petition was brought against the Minister of Health, which reached 200,000 signatures in a very short time; because you obviously had no scruples, just clamp the patients. The wording was clever, against "hurdles", against "discrimination", for "free access" - who would not sign such claims? But in the end it was decidedly enough - nothing to do! In the face of desperate waiting-list patients, it was hard to beat cynicism, boldly claiming that "in Germany, it is treated with great success and to the high satisfaction of patients".
Politics is in a difficult position. On all fronts, the Federal Psychotherapeutic Chamber puts pressure on as soon as it goes against their interests. And these interests are: no control and more psychotherapists.
In fact, a leftist party such as the SPD would have to defend its very own clientele, the poorest of the poor, against such lobbyists and ensure that stressed managers, frustrated divorce victims and high earners who have taken over are treated at the expense of the solidarity community, but right ill.
Alone, but powerful
But will the SPD be able to resist the highly subtle advocacy of BPtK? The Greens, otherwise always restless fighters against lobbyist activities, are so far the most grateful victims of this cynical campaign. And even some journalists are not interested in the misery of patients, can be unilaterally "inform" and make themselves the speaker for the interests of a particular professional group.
Since psychological psychotherapists treat only about 50 patients a year, whereas psychiatrists, for example, treat about 1,000, the countless members of the BPtK, who now control all the crucial bodies, are by no means the ones who treat the most mentally ill. All other relevant expert associations, however, believe that something urgently needs to change.
The statutory health insurance companies have long known that the massive occurrence of BPtK obstructed for years adequate care of their mentally ill insured. Jens Spahn now wants to commission the self-governing body Joint Federal Committee to find a solution.
Whether this succeeds is uncertain, because even in this body, those lobbyists have a lot of power. But it is reasonable to make this attempt. So there remains the hope that the people's representatives on this important issue represent the interests of the people, namely the patients, and do not become henchmen of lobbyists who have been fooling the public for years.