Health care Social psychiatric services – help with mental illnesses and crises

Mental illness can be extremely far-reaching and make everyday activities a major challenge. Despite numerous forms of assistance being available, it is not always easy for people with mental illnesses to take advantage of them. In some cases, they even find it hard to realize that they need help in the first place. 

Regardless of people’s situations, social psychiatric services offer low-threshold help and advice to people with mental illnesses and/or in mental emergencies. Social psychiatric services also support the people around the patients.

Social psychiatric services cover all areas of Germany, whether urban or rural. They are part of the public health services in cities and municipalities, and can belong to the local health authority or welfare associations, such as Diakonie or Caritas. 

Who works for social psychiatric services?

People from various different professional groups work together at social psychiatric services. These include psychiatrists but also social workers and people from the fields of psychology, nursing and occupational therapy. The social psychiatric service team also works closely with registered psychiatrists, GPs, advice centers and self-help groups.

Some social psychiatric services also employ people who have had experience with psychiatry themselves. These have usually completed special training to qualify them to advise and support other people with mental illnesses (this is known as “peer counseling”).

Social psychiatric services offer support and guidance to anyone with mental health problems or addictions. This can be the case in an acute crisis or conflict situation if someone has ended up in social plight due to mental health problems or before and after hospital treatment. Addictions, delusions, social anxieties but also dementia or depression can quickly lead to people being unable to cope with domestic tasks, experiencing issues with rent payments or public offices, ceasing social contact with others or failing to receive necessary medical treatments. Social psychiatric services can offer support in these and other situations.

The services are particularly aimed at people with chronic mental illnesses and addictions who other help and therapy services cannot or struggle to reach, or who do not use such services. 

People from patients’ social environments can also turn to social psychiatric services. This can be the case, for example, if relatives, neighbors or friends are concerned about someone dear to them who does not want to seek help. In the event of serious mental illnesses or addictions, the support and treatment can be extremely challenging for both relatives and therapists. Social psychiatric services may be able to offer support here.

The people who can contact social psychiatric services include:

• patients themselves
• relatives
• legal guardians
• friends
• neighbors
• people from places of employment, e.g. colleagues
• landlords
• authorities such as the police or employment agency
• medical personnel such as general practitioners

The services provided by social psychiatric services are free of charge. No entry requirements have to be fulfilled to contact social psychiatric services. For example, people do not need an official diagnosis or health insurance. Social psychiatric service employees are subject to the duty of confidentiality. Advice can also be provided anonymously.

Social psychiatric services are primarily tasked with providing advice and support to people with mental illnesses or addictions and their relatives and/or the people around them. This can include coordinating numerous help services, such as organizing follow-up treatment. 

Social psychiatric services can generally also intervene in the event of mental crises and emergencies. Their precise duties can, however, differ slightly depending on the federal state.

Advice and support

Social psychiatric services offer advice and support that are intended to be easily accessible for all. Advice can be provided in several ways: 

• by telephone
• through a home visit
• in the advice center

People with mental illnesses or addictions can sometimes find it particularly difficult to seek help or keep regular appointments. One special feature of social psychiatric services is therefore that the person in question can also be visited at home. This makes it possible to support people who would otherwise be very withdrawn and who could not be reached by health services. 

If someone contacts a social psychiatric service and expresses concern about the situation of a relative or other acquaintance, the social psychiatric service can offer help to the person in question of its own accord. This is a unique feature of social psychiatric services; other institutions that care for people with mental illnesses do not usually establish contact unbidden.

Depending on the situation, social psychiatric services can make contact in several ways: a telephone call, a written invitation to a consultation at the advice center or an announced or unannounced home visit. However, social psychiatric service employees are not permitted to enter people’s homes against their will.

The aims of the advice and support via social psychiatric services differ from case to case and primarily depend on the applicable person’s situation. Examples of aims can include: 

• increasing the willingness to take advantage of treatment and help services
• improving quality of life 
• helping people to lead a self-determined life that is as independent as possible
• instigating suitable social and therapeutic support
• initiating medical treatment
• preventing mental crises and hospitalization
• intervening in emergency situations and combating them with suitable measures
• strengthening participation in society
• supporting patients with their reintegration into working life

Social psychiatric services can also provide support with everyday tasks that people with mental illnesses may find particularly difficult. This can include helping them fill out applications, accompanying them to appointments or supporting them with organizational matters. 

Mental crises

In many regions of Germany, the duties of social psychiatric services include providing support in acute mental crises and emergencies. This also includes assessing potential hazards that could arise for patients themselves or those around them in the situation. 

Social psychiatric service employees generally start by trying to diffuse a situation through a consultation. The aim of this is to avoid compulsory admissions and hospitalization wherever possible. However, this is not always feasible, for example if a person poses a risk to others or themselves within the scope of a mental crisis. Such a risk exists if patients want to harm themselves or others.

For how long can support be received from social psychiatric services?

The frequency of contact with social psychiatric services varies. Some people may only want to receive one-off advice. In other cases, long-term support can be provided. This applies, for example, if people’s mental illness prevents them from taking advantage of other treatment services. 

More frequent appointments can also be made with social psychiatric services in the event of mental crises or particularly difficult social situations so as to ensure sufficient support. 

Further duties of social psychiatric services 

Depending on the region, social psychiatric services also take on other duties. For example, they can be responsible for coordinating various care services for people with mental illnesses within a municipality. The aim of this is to provide them with the best possible care. 

The responsible social psychiatric service depends on where people live or are currently staying. As social psychiatric services are often affiliated with local health authorities, people can contact these to find the appropriate social psychiatric service. 

You can find the responsible health authority by entering your postcode on the Robert Koch Institute website.

Initial contact with the social psychiatric service can occur by telephone, for example. Some social psychiatric services also offer drop-in sessions, where they can be visited without an appointment.