People with mental health problems in Germany have to wait a long time for treatment, on average almost five months. Especially in the countryside, where there are often less established psychotherapists, the waiting time can even be significantly longer. Health Minister Jens Spahn (CDU) wants to improve the supply.

His idea: In the future, specially trained doctors and psychotherapists should pre-screen patients with mental health problems and decide who gets which therapy. This emerges from the draft law on the appointment service and care law (TSVG), with which the Bundestag should deal on Friday in first reading.

The problem: Psychologists, doctors and psychotherapists are not very enthusiastic about Spahn's plans. On the contrary, there is a lot of resistance. Almost 150,000 people have signed a petition to overturn the planned innovation. The Federal Council also rejects the intention of the Minister of Health. Spahn himself is now willing to compromise. "I do not rule out that we find other regulations," said Spahn on Wednesday in the ARD Morgenmagazin.

The psychotherapist Ariadne Sartorius had the idea for the petition. In an interview with SPIEGEL ONLINE she explains how it came about and where Jens Spahn is mistaken from her point of view.

SPIEGEL ONLINE: The Minister of Health wants that in future specially trained experts decide who gets which psychotherapy. Especially people with serious problems should get help faster. What is so bad about it?

Ariadne Sartorius: Spahn's bill denounces and discriminates against people with mental health problems. For example, my patients come to me specifically because I was recommended to them or because they have addressed my homepage. So when we meet for the first time, there is already some basic trust. Spahn's plan would fundamentally change that. Patients can no longer choose their therapist, but have to convince an expert that they really need help - and within a short time. There is no time to build trust.

SPIEGEL ONLINE: Is not this a legitimate requirement to avoid unnecessary therapies?

Sartorius: Spahn puts people with mental health problems under suspicion with his plans. They would have to prove in the future that they need a therapy and not just a friend. That creates enormous pressure. Especially people who really need urgent help, are deterred even more. Many of my patients take a long time before they can talk about intimacy and how much they suffer. No therapist can conjure up the appropriate therapy plan for everyone after just one interview.

SPIEGEL ONLINE: There are enormous bottlenecks in the care of people with mental health problems. If not with Spahn's suggestion - how else can they be solved?

Sartorius: It has already improved a lot. For a good one and a half years there are psychotherapeutic consultations, to which everyone can come with mental health problems. The instrument has proven itself so far. The waiting time for a first conversation has shortened significantly. We should continue on this path and not strangle it right away.

The psychotherapeutic consultation

Since April 2017 psychotherapists are obliged to offer consultation hours. As a result, especially people with serious mental health problems should reach a place of therapy much faster. Here you can read more about it. According to a study of the Federal Psychotherapeutic Chamber, nearly 60 percent of those seeking advice receive psychotherapeutic treatment. Every sixth of them experiences such a severe mental crisis that an acute treatment is necessary. The other 40 percent of patients, however, receive no therapy. For example, because from the point of view of the therapist they do not need any or because there are not enough places. During the evaluation, 240,000 patient data were evaluated.

SPIEGEL ONLINE: Currently get 40 percent of the patients after the acute consultation no therapy place, shows an investigation of the Federal Psychotherapeutic Chamber. Partly because they do not need therapy, but also because there are not enough places. The office hours alone can not solve the problem with the lack of supply so obviously. What other ways are there?

Sartorius: What we need are more psychotherapists who can settle their benefits through the health insurance, so more cash, especially in rural areas. In addition, it often lacks the coordination between psychotherapists, doctors and psychiatrists, because this can not be billed. Therefore, we have to voluntarily make such arrangements in our free time.

Controversial Psychotherapy Reform "Patients are caught in a loop"

SPIEGEL ONLINE: The health insurance companies criticize, the existing approvals would not be sufficiently used. Accordingly, many psychotherapists only work part-time, although they occupy a full cash register. Should the psychotherapists in the field not simply work more?

Sartorius: The idea of ​​the psychotherapist, who picks out only the pleasant cases and works only half the day, is simply wrong. Apparently Mr. Spahn was also sitting on this error. There is a definition of a maximum busy practice of the Federal Social Court: This means for a psychotherapist to treat 36 legally insured patients per week. This is hardly possible, because with a 50-minute conversation per patient, it is far from over. We also need to prepare for the patient, evaluate the interviews, accurately document the therapy, and so on. One third of our working time is spent on this. A psychotherapist is only fully utilized when he works at least 55 hours. Few can afford that, especially with such a responsible job.

SPIEGEL ONLINE: Why is your criticism only now?

Sartorius: The change in the proposed law has taken us by surprise. Mr. Spahn did not talk to us in advance. We have the feeling that the passage should secretly still be housed in the bill. We will not take that and will not be satisfied until it is canceled.