[Utilization of outpatient psychotherapeutic treatment : A secondary data analysis]. / Inanspruchnahme ambulanter psychotherapeutischer Versorgung : Eine Analyse von Sekundärdaten.

BACKGROUND: In spite of a well-developed and complex mental healthcare system in Germany, problems remain in the capacity of psychotherapeutic care with an undersupply and long waiting times for provision of outpatient psychotherapeutic care. OBJECTIVES: The analyses address the current level of psychotherapeutic care and the role of individual medical specialties in outpatient psychotherapeutic care in Germany. MATERIAL AND METHODS: The analyses are based on secondary data from three statutory health insurance companies and the German pension funds for the years 2005-2007. Anonymized treatment data from 3.3 million insured persons with a diagnosis of a mental disorder (ICD-10 groups F0-F5) were analyzed. RESULTS: In outpatient treatment 9,670,588 psychotherapeutic accounting codes were analyzed of which 33 % were psychiatric, psychosomatic or psychotherapeutic consultations that are not covered by the scope of psychotherapy according to the standard regulations (psychotherapy guidelines). The most frequently used psychotherapeutic services were verbal interventions (accounting codes 35.100 and 31.110) and psychiatric consultations (accounting codes 14.220, 21.220 and 21.221), independent of the mental disorder. Of the patients 5.9 % received directive psychotherapy. The provider-specific analysis showed a great variation in the kind of accounting codes, which were brought into account by the different providers. CONCLUSION: With regard to the reform efforts in psychotherapeutic care, longitudinal trends in the utilization and quality of psychotherapeutic care in the individual fields of treatment should be analyzed in follow-up studies.

[Mental healthcare in Germany--current situation and perspectives]. / Die Versorgungssituation bei psychischen Störungen in Deutschland: Aktueller Stand und Perspektiven.

For several years, there has been a significant increase of the utilization of health care due to mental disorders in Germany. Epidemiologic studies dealing with the prevalence of mental disorders show that the prevalence of mental disorders haven't increased. In consideration of the relative stable prevalence, currently there are only speculations about the reasons for the increasing service utilization. The capacity of psychiatric-psychosomatic-psychotherapeutic health care services is increasing. Despite the fact that capacity is increasing, in the outpatient and inpatient sector it comes apparent that there is an increasing burden, indicating that the demand for mental health care is not met by the capacity of psychiatric-psychosomatic-psychotherapeutic health care services. Health care provision by general practitioners and somatic disciplines predominate, going along with low cross-disciplinary and coordinated cooperation. So far, cooperative, intersectoral care models for mental disorders have been realized only in individual projects. Valid data are lacking, which need to reveal the causes and especially the consequences of this situation of mental health care provision and provide reference standards for an optimized, need-based care planning. For this reason, it is imperative to advance quality management for the care of mental disorders. With a view to the high rates of somatic comorbidity, an expansion of cooperative forms of mental health care appears essential.