Germany's Green Party Demands Urgent Psychotherapy Reforms Amid Crisis
Green Party Calls for Fundamental Reforms to Improve Psychotherapy Access
Germany's Green Party is urging the federal government to overhaul mental health care, according to a motion tabled by its parliamentary group. The proposal calls for better needs-based planning, expanded outpatient services, and guaranteed continuing education for therapists. Green lawmaker Kirsten Kappert-Gonther—a psychiatrist and chair of the Bundestag's Health Committee—stressed the urgency of the reforms: "Support must be available faster and tailored to individual needs. Those who don't receive timely help face a higher risk of their condition becoming chronic."
The push comes amid planned cuts to reimbursement rates for outpatient psychotherapy—a move Kappert-Gonther slammed as "short-sighted," warning it would deepen existing gaps in care. Such cuts, she argued, send a disastrous signal to patients at a time when demand for mental health services is soaring.
Rising Demand, Strained System Psychological disorders have surged in recent years, fueled by overlapping crises. Children and adolescents are particularly affected: the latest "School Barometer" from the Robert Bosch Foundation reveals that roughly one in four now reports mental health struggles—up from one in five in 2024.
Yet the system is buckling under pressure. On average, patients wait 26 weeks for a therapy spot, while a University of Leipzig study found that wait times for minors have nearly doubled since the pandemic began. "For many," Kappert-Gonther noted, "this means enduring months without support during acute crises—with severe risks to their development, social participation, and future employability."
Rural Areas Hit Hardest Access disparities are especially stark between urban and rural regions. While cities have relatively more therapists, rural areas suffer from chronic shortages—despite similar prevalence rates of mental illness. The root cause? Outdated planning. The Greens are demanding reform.
Current outpatient psychotherapy allocation still relies on population ratios from the 1990s, even after partial updates. A 2018 expert report commissioned by the Federal Joint Committee (G-BA) concluded that Germany needs over 2,400 additional publicly funded therapy slots—yet in 2019, only about 800 were created. Since therapists without public health insurance approval cannot treat statutory patients, the shortage of slots prolongs wait times.
The Greens also advocate for dedicated planning for young patients, as more than half of all mental illnesses emerge in adolescence, disrupting education and social integration. Many minors cannot travel long distances alone and depend on local services.
While the governing CDU/CSU and SPD coalition pledged in their 2021 agreement to improve rural and youth mental health care, little progress has been made.
A Revolving Door of Crisis Care Patients with severe or chronic conditions—such as mental illness, addiction, or language barriers—often fall through the cracks, Kappert-Gonther warned. Without outpatient support, they end up in emergency rooms or hospitals during crises, only to be discharged without follow-up care. The result: a "revolving door" of readmissions that worsens their conditions. What they need, she argued, is reliable, multidisciplinary support embedded in daily life.
Though the G-BA introduced reforms in 2021 and 2024 to better coordinate care—including closer collaboration among professionals and smoother transitions between inpatient and outpatient treatment—high bureaucratic hurdles have stalled implementation, leaving gaps in the system.
The consequences extend far beyond those directly affected: according to the German Association for Psychiatry, Psychotherapy, and Psychosomatics (DGPPN), mental illnesses accounted for roughly 16 percent of all sick days in 2023 and were the leading cause of early retirement, responsible for 42 percent of cases. The costs run into the billions—both for the healthcare system and for society as a whole.
Federal Government Declines to Intervene
Kai Gehring warns that planned fee cuts could worsen existing gaps in care: "Financial pressure must not further restrict access to therapy."
Yet the federal government has no intention of stepping in. In a response to a parliamentary inquiry by the Green Party—obtained by our website—the Federal Ministry of Health stated that remuneration falls under the authority of self-governing bodies, with the ministry limited to legal oversight.
