00:00I got super aggressive, then started having suicidal thoughts, and just wasn't myself anymore.
00:07The number of German children and adolescents with mental health issues has been rising for years,
00:12but access to therapy is spotty at best.
00:15Then you get told you have to wait. You won't be treated. It's extremely distressing.
00:22Some people have to wait years to receive therapy,
00:25and due to cuts in healthcare funding, the situation could get worse.
00:30Is Germany's mental health being sacrificed to balance the budget?
00:36Marie's mental well-being deteriorated rapidly during the COVID pandemic, when she was 12 years old.
00:42Today, Marie, who's from near Cologne, knows she has ADHD.
00:48It got to a point where it was so bad, I was having really intense rage attacks,
00:54and constantly threatening to take my own life.
00:58She had to wait three months until she finally received treatment at a clinic.
01:02That was a difficult time for us, too.
01:09We were very happy when she finally started therapy.
01:13After treatment at the clinic, Marie had to wait another five months for regular therapy appointments.
01:21And though she considers herself lucky, she still found it hard to get through that time.
01:29I had my support railing and then lost it and had to keep going on my own.
01:34That was really hard.
01:36Child and adolescent therapist Sylvia Goeders is furious.
01:40Every week she has to turn away several, often desperate, parents.
01:44And she's already working more hours than she gets paid for.
01:48The current waiting time to become a new patient at her office is just under one year.
01:53And at the offices of some of her colleagues, it can be up to three.
02:00It's really absurd. Imagine if it was like this in somatic medicine.
02:05You come in with a child that has a physical health problem, urgent, maybe even life-threatening.
02:11And then you get told you have to wait. You won't be treated.
02:16It's extremely distressing. And it's gotten worse.
02:24Health issues can get worse when left untreated, and mental illnesses can become entrenched,
02:30with potentially fatal consequences, warns Goeders.
02:36What can happen is actually the most serious issue, an increase in suicides among children and adolescents.
02:45Suicide is already one of the leading causes of death among children and adolescents.
02:49in Germany.
02:50And it looks like this dire situation could soon get worse.
02:55Since April, public insurance reimbursements for therapy have been cut by 4.5 percent.
03:00Many fear that in the future, the cuts could lead to therapists having to further restrict
03:05the number of sessions they offer through the public health system.
03:10Demonstrations have been taking place across Germany for weeks.
03:13Sylvia Gura says the public needs to learn more about the worrying situation.
03:20The discontent, the anger over this, is enormous. I've never seen our profession speak out so loudly.
03:29We are here, we are loud, because you're killing therapy.
03:34We're in a state of emergency. And these fee cuts are the last straw.
03:40We therapists won't just let this happen, we're fighting for quality mental health care.
03:45Instead of cuts, we need investment in psychotherapy and people's mental health.
03:51The public insurance providers responsible for cuts declined to give an interview to DW.
03:57But they emphasize that they do not expect a deterioration in offerings and claim that by
04:02international standards, quality of care remains very high.
04:07But following a reform in psychotherapist training, it's currently unclear who is responsible for funding
04:13the mandatory advanced training after graduation. This has resulted in a shortage of training spots,
04:19and many graduates cannot advance despite having a degree.
04:24Overall, and that includes our class of students too, there's a lot of frustration with the way the
04:29system is right now. There are still no guaranteed training spots. So it's not clear to us whether we'll
04:36ever be able to offer outpatient psychotherapy at all, or how long it would take to get there.
04:43There's simply a lack of funding. More and more obstacles are being put in our path.
04:49So what's the government doing to improve the situation?
04:53The Ministry of Health responded to our inquiry in writing, saying,
04:58ensuring needs-based and timely therapy options remains an important health policy concern.
05:03The care situation is being kept under observation.
05:08The Ministry now aims to create additional treatment capacity in the child and youth care sector
05:14to reduce waiting times. For Goerdes, these improvements are long overdue.
05:23I'm very frustrated and hope that policymakers will make better decisions in the future.
05:28I want them to support this profession, which is important and systemically relevant,
05:36instead of undermining its funding.
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