42 – Care provision for people with mental disorders

Fact sheet no. 42

The World Health Organisation describes mental disorder in the following terms: “a psychological or mental disorder is a considerable deviation from the norm in experience or behaviour that affects thoughts, emotions and actions”.

There are many people who suffer from mental disorders or are affected by mental health issues and it is often not easy for the individuals themselves, their relatives or their social sphere. Home care can become problematic and taking care of everyday chores is no longer possible without outside assistance.

Examples of mental disorders and ways these can be identified and diagnosed

Depression,   anxiety   and   panic   disorders,   obsessive-compulsive   disorders,   manic- depressive illness, psychosis, schizophrenia.

It is generally not easy for a person suffering from a mental disorder to confide in someone. A visit to a doctor or psychiatrist represents a considerable obstacle. Family members too will find it difficult to consult a professional. Many mental health issues can be treated and alleviated, however, but for this to happen, a medical diagnosis is generally required, and this is best coming from a neurologist/psychiatrist. This will make it possible to access the support and care that is available, and provides an initial entry point into the help system.

Social-psychiatric service

Every district of Berlin has a social-psychiatric service (Sozialpsychiatrischer Dienst, SpD), a centre providing advice for adults with mental illnesses, dependencies or dementia and their relatives. Advice  and support  is available  from  medical, psychological  and  social  work professionals, even in acute crisis situations. Anyone with mental health issues, anxiety, difficulties with alcohol, drugs or pills or who is in an acute crisis situation may come to the SpD. Advice is also available for the relatives, neighbours or friends of those seeking help. In discussion, we can identify which options for help may be appropriate e.g. access to supervised accommodation, visiting a day centre, in-patient treatment or further options.

Berlin Crisis Service

The  crisis  service  principally  offers  anonymous  advice  over  the  telephone  during  the evening, at night and in crisis situations (4pm – 12am). Anyone seeking advice may call an adviser or visit the nearest centre during these hours.

Supervised accommodation/assisted single living

Accommodation options such as assisted single living quarters, assisted apartment living quarters and therapeutic communities are available for people affected by mental disorders. The district management committee decides how these accommodation and assistance places are assigned on an individual basis according to need.

Individual case workers can help people affected by mental disorder at home for several hours during the week. The SpD/district office will decide on assigning an individual case worker. Individual case workers can help with taking care of everyday chores and accompanying individuals on visits to support offices and doctor’s surgeries or on shopping trips.

Day centres for people with mental disorders

People with mental disorders can visit day centres during the day. These provide people suffering from mental health issues with a reliable structure to their day and support in planning and achieving their personal goals.

Contact and Advice Centre (KBS) for people affected by mental illness

People affected by mental illness will be facing a whole range of issues, especially after in- patient psychiatric treatment. Their life situation is often in a process of change, which can have an extremely unsettling effect on those involved. In such cases, the KBS can provide advice, support and help for every issue of importance to you. The KBS’ services are openly available and include leisure facilities and opportunities to meet people for those affected.

Out-patient psychiatric healthcare

The aim of psychiatric healthcare is to help patients with severe mental illness lead an independent life at home and avoid hospitalisation. The specialised option of Home Healthcare is paid for by health insurance providers. A GP may provide the initial referral, but longer-term care must be prescribed by a neurologist or psychiatrist.

Psychiatric outpatients clinic care

Outpatient care is formulated for patients who, because of the nature, severity or duration of their mental illness, require the provision of complex therapy beyond the capabilities of a neurology practice; this is delivered by an interdisciplinary team. Outpatient clinics often provide special consultation hours e.g. consultation hours for general psychiatric and geronto-psychiatric treatment, memory-related conditions and dependence. A referral from a specialist is required.

Day clinics

A day clinic provides opportunities to receive intensive treatment throughout the whole day. The skills acquired may be practised at home during evenings and weekends. This is an option for people requiring more intensive medical and psychotherapeutic treatment than they can receive  as an  outpatient.  Day clinics  stays  are  paid for  by health  insurance providers and a referral from a specialist is required.

Inpatient treatment

Once a patient has been admitted to a clinic by the attending physician and thoroughly examined, a wide range of different therapy options matched to the appropriate individual pathology is available.

Non-medicinal therapy

These are therapy options that do not involve medicines, such as psychotherapy or sociotherapy, for example.

Other support options

People with a recognised required level of care (Pflegegrad) are entitled to a range of support in their everyday lives. (Please refer to information sheets 2, 4 and 31)