Ambulante psychotherapeutische Versorgung von Patient*innen mit chronischer körperlicher und gleichzeitig vorliegender psychischer Erkrankung – die Sicht von Psychotherapeut*innen und Hausärzt*innen

Abstract

Background

Patients with both mental illness and chronic physical conditions (medically complex patients) represent a large (more than 5 million people in Germany) and particularly burdened group of patients. This study describes how psychotherapists and general practitioners perceive the current care for these patients and the impact of the 2017 structural reform of psychotherapy guidelines for patients with complex disorders.

Methods

We used a nationwide survey to assess the perceptions of psychotherapists (N = 2,015) and general practitioners (N = 1,364) regarding psychotherapeutic care for complex patients.

Results

Most psychotherapists and general practitioners agree that complex patients are still undersupplied with psychotherapy (>80 % agreement). The structural reform of the German psychotherapy guideline in 2017 has led to merely small improvements of care. From the perspective of care providers, further structural changes, such as the expansion of group therapy services, the consolidation of video-assisted therapy services, and the billability of consultative case discussions, could improve care.

Conclusion

Even after the structural reform, providers continue to consider the care provided to patients with complex disorders to be inadequate. Psychotherapists show a great willingness to meet the special needs of these patients. Nevertheless, further low-threshold services and networking between the professional groups involved are required. Given the size of the group of complex patients, we need to focus more on improving care structures.