Depression, burnout or addictions – Mental problems like these are no longer uncommon. However, those seeking help with a psychotherapist often have to wait months for an appointment. To change this, numerous new regulations have been in effect since the beginning of April. But for the psychological psychotherapist, Andrea Benecke is not enough.
People with mental health problems should be helped faster in the future. Therefore, since 1 April 2017, psychotherapists must, inter alia, offer regular consultations and advise patients in an initial interview. In addition, further new regulations came into force, such as a simplified application procedure and the introduction of an acute treatment.
For Dr. Andrea Benecke of the LandesPsychotherapeutenKammer Rheinland-Pfalz is indeed a first step in the right direction. In an interview with finanzen.de, however, she explains that the innovations for long-term therapy should also bring disadvantages. In order to fundamentally improve the treatment as well as to avoid months of waiting time, in her opinion the obsolete needs planning for psychotherapy has finally to be adopted.
Miss Dr. Benecke, do the months of waiting for psychotherapeutic treatment for patients in your view put an end to these changes?
Dr. Andrea Benecke: First, one has to distinguish whether patients are waiting for an appointment for the psychotherapeutic consultation, ie the first contact with a psychotherapist, or for a long-term therapy place. As a result of the new obligatory consultation hours, patients will at least get an initial interview with a psychotherapist, sometimes even faster. In this context, they receive an assessment of their complaints or even a diagnosis, if one exists. Serious mental illnesses can be detected earlier.
Despite the quick feedback, however, it may be that those affected then wait months for a suitable therapy place. Because many practices are overcrowded and the office hours do not create more treatment capacity.
What do you think will change with the new guidelines for treating psychotherapists? Does the number of therapy places possibly go back because of the additional burden?
Dr. Andrea Benecke: From a purely mathematical point of view, I think, yes. For example, suppose a psychotherapist offers approximately 30 therapy sessions per week, treating 30 patients. Due to the new regulations, this psychotherapist now has to be available at least 100 minutes a week for the consultation. His original therapy time is reduced to around 28 hours. If he does not work more every week that he has done so far, in the long run, he will be able to treat fewer patients.
How could the care of patients be guaranteed and expanded in the long term?
Dr. Andrea Benecke: Basically, we need a different requirements planning. For the current planning is based more or less on data from the year 1999. At that time, simply the previously existing therapist seats were accepted as a requirement. That may have been reasonably plausible at the time. Now this bill is obsolete.
About 20 years ago, becoming a psychotherapist was a taboo for many people. Instead of seeking help, many sufferers have played down their complaints and hoped that they will pass. Thus, the need for treatment should already have been higher than assumed in the planning. Today, sufferers are much more likely to seek help, so the number of patients admitted is greater. From the “Study on adult health in Germany” of the Robert Koch Institute shows that the prevalence of mental illnesses has remained virtually the same. From the reports of the health insurance companies, however, it is known that more and more people visit a psychotherapist and take treatment.
In addition, the current distribution of committed cash register seats for psychotherapists still depends on where they worked in 1999. Thus, disproportionately many seats were created in larger cities, since there were hardly any therapists in the country. We at the LandesPsychotherapeutenKammer Rheinland-Pfalz have long been calling for planning instead to focus on morbidity. Most seats should be fixed where the actual need is greatest.
According to the Rhineland-Palatinate Association of Radiation Physicians (KVRLP), the number of psychotherapists in the state increased sharply from 2005 to 2015. Why do many patients still have massive problems getting an appointment?
Dr. Andrea Benecke: The results of the KVRLP refer to the number of psychotherapists, but not to the corresponding cash register seats. So there are now many colleagues who share a seat in pairs to reduce their own burden. For example, some do not want to work full time due to family planning or their age. Although there are more psychotherapists, the number of cash registers is not enough to meet the need for treatment.
So the psychotherapists are just badly distributed, as criticized, for example, the GKV-Spitzenverband?
Dr. Andrea Benecke: The GKV-Spitzenverband makes it a bit easy here. It is true that a certain distribution problem cannot be denied. However, this is not caused by the psychotherapists but is due to the established seats. If one of these cashier seats becomes free, psychotherapists can apply for it. In Rhineland-Palatinate, as in many other regions, however, only a re-occupation takes place. New seats do not arise.
Even if more psychotherapists are being redistributed to rural areas, there is still an imbalance. Because the need remains the same. Even in the cities, where currently many psychotherapists work, the practices are usually fully utilized. There is again a lack of therapy offers when a cash register seat is relocated.
The KVRLP also concludes that more than half of the psychotherapists in Rhineland-Palatinate are at least 55 years old. Is there a young talent problem here?
Dr. Andrea Benecke: Fortunately, we do not have any problem with junior psychotherapists. Despite the high demands, many young people are choosing this profession. However, a majority of them are waiting to be given a free seat after completing their training. The committed seats are usually filled with age. This means that young psychotherapists often cannot settle until an older colleague retires.
Thank you for the interview, Dr. med. Benecke.