Mental health services in Germany - Structures, outcomes and future challenges

被引:0
作者
Wiegand, Hauke Felix [1 ,2 ]
Hoelzel, Lars [1 ,3 ]
Tuescher, Oliver [1 ,2 ]
Lieb, Klaus [1 ]
Falkai, Peter [4 ]
Adorjan, Kristina [4 ,5 ]
机构
[1] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Psychiat & Psychotherapy, Mainz, Germany
[2] Martin Luther Univ Halle Wittenberg, Univ Med Halle, Dept Psychiat Psychotherapy & Psychosomat Med, Halle, Germany
[3] Oberberg Grp, Hlth Serv Res, Berlin, Germany
[4] Ludwig Maximilians Univ Munchen, Univ Hosp, Dept Psychiat & Psychotherapy, Munich, Germany
[5] Univ Bern, Dept Psychiat & Psychotherapy, Bern, Switzerland
关键词
Mental health services; Germany; care models; psychiatric care; COVID pandemic; NORMATIVE DEFINITION; CARE; DISORDERS; DEPRESSION; IMPACT; NEEDS;
D O I
10.1080/09540261.2025.2479601
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
This narrative review provides an overview of the structure, financing models, and challenges facing the German mental healthcare system for adults. The German mental healthcare system is divided into distinct sectors, including inpatient, outpatient, rehabilitation, and regional complementary services, each with its own financing mechanisms. Statutory health insurance, covering about 88% of the population, funds the majority of the system. Germany allocates 13% of its GDP to healthcare-one of the highest proportions globally-with over 10% of this directed toward mental health. Key challenges include an overemphasis on inpatient services, poor coordination between inpatient and outpatient sectors, insufficient severity-based treatment allocation, limited adherence to clinical guidelines, and a lack of digitalization and routine outcome evaluations. The COVID-19 pandemic led to a temporary reduction in service use and intensified issues with inter-sector collaboration. In the long-term, a healthcare workforce shortage further complicates care delivery. Proposed solutions include regional budgets for integrated care, outcome-based quality assurance, stepped-care models to optimize treatment allocation, and digital infrastructure improvements for better data sharing and transparency. These reforms aim to enhance patient-centered care, improve outcomes, and make more efficient use of resources.
引用
收藏
页数:18
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