Proposals by the GKV-Spitzenverband ignore the reality of the healthcare situation in Germany

28.07.2025 16:55

Plans to regulate psychotherapy fall short: The umbrella organization of statutory health insurance funds has made a number of proposals, such as limiting the number of statutory health insurance practices or psychotherapeutic training and their financing, as well as external control of psychotherapy, which takes neither the reality of care nor the proven effectiveness of psychotherapy into account.

In this context, numerous psychotherapy associations point out that efficient management already takes place within the framework of psychotherapeutic consultations!

The demands now published by the GKV-Spitzenverband (National Association of Statutory Health Insurance Physicians) for the mandatory reporting of available therapy places to the appointment service center to improve psychotherapeutic care, as well as other proposals, are intended to solve the problem of long waiting times and the fundamental shortage of therapy places in Germany.

From the perspective of psychotherapy associations in Germany, given the scarcity of resources in the healthcare system, efficient management of psychotherapeutic care is essential to ensure the best possible patient care. Existing gaps in care must be closed, and existing human and financial resources and funding must be used and distributed wisely. However, this requires, above all, a focus on current data and a sense of proportion.

In this context, the associations point out that the "psychotherapeutic consultation hour" (introduced in 2017) is already an efficient management tool for identifying needs and indications and opening up care options for statutory health insurance holders seeking advice and therapy. Psychotherapists (medical and psychological psychotherapists, as well as child and adolescent psychotherapists) are also highly qualified to conduct diagnostics, determine indications, and provide psychotherapeutic treatment.

At the same time, a demographic perspective is needed. Psychotherapeutic care has significant gaps in some regions, such as structurally weak areas and the Ruhr region. Waiting time studies confirm this. Even the current provision of information on available therapy places cannot solve the problem. Here, as in many other areas, there is an urgent need for management geared to the current care situation. A further shortage of practices with statutory health insurance is unacceptable.

The GKV-Spitzenverband's call for a limit on training and continuing education capacities in the field of outpatient psychotherapy, citing a fundamental increase in the number of psychotherapists, is too simplistic and does not reflect reality, as many colleagues now work on half-time positions with statutory health insurance. The age structure of the professional group—many older psychotherapists will retire in the next 10 years—is also not taken into account. The research is clear on this point, and reducing psychotherapy costs by reducing the number of contracted psychotherapists, as demanded by the GKV-Spitzenverband, is short-sighted. A limit on admissions is already stipulated in the needs planning guidelines. There is indeed an urgent need for reform here, as in many places there is a calculated oversupply while in fact there is a de facto undersupply and, at the same time, long waiting times.

The statutory health insurance (GKV) assessment that, unlike primary care, there is no need to finance continuing education in the field of psychotherapy is also ineffective if we want to avoid gaps in care due to a shortage of skilled workers in the future. It has long been known that continuing education in psychotherapy is at risk due to a lack of financing concepts. A sufficient number of specialist psychotherapists trained in various therapy methods will continue to be needed in the future to provide the best possible care for patients with diverse needs.

It is now well documented that only a fraction of those affected receive adequate treatment, and even in times of destigmatization of mental illness, care has only increased slightly compared to previous years, failing to meet the actual need. Studies show that contributions invested in psychotherapy pay for themselves at a factor of 3:5. This, too, represents a successful management approach!

Last but not least, the GKV-Spitzenverband proposes lower pay for psychotherapists in the future. How this will improve the healthcare situation remains questionable. The fact is: psychotherapists are already paid below average compared to other physician groups, despite scientifically proven effectiveness of "talking medicine" for patients.

As psychotherapeutic associations, we are committed to providing quality care for people with mental illness and are aware of our responsibility in the individual process as well as in the societal context. Concrete and sensible proposals for how psychotherapeutic care can be made more efficient already exist. Making access to the profession more difficult and artificially restricting psychotherapeutic services overall are not among them!