The Germans have never been as mentally drained as they are today. Covid lockdowns, stress in the home office, worries about health, economic uncertainty – all of this has left deep marks in the souls of many people. The consequences are fatal: the number of mental illnesses keeps reaching new highs.

In 2021, employees were on sick leave for an average of around 2.8 days in Germany due to conditions such as depression, adjustment disorders or anxiety disorders, as reported by the health insurance company DAK. That was 40 percent more absent days than ten years ago. But: Therapy places are hard to find. In many cities, mentally ill people wait an average of more than half a year for treatment.

Where so much is amiss, there is room for improvement. A whole series of entrepreneurs have lined up to fill this space. They pick up patients and customers where they already spend a large part of their time: on the Internet. They set up online self-help groups, find therapists, measure brain waves and invite people to virtual yoga sessions. They want to help people, of course. But they also want to make money. The medical requirements are different.

Inspiration comes from the USA. Mental health support has long been a billion dollar market there. Providers such as Talkspace or BetterHelp, who place therapists on the Internet, have over a million users. According to the CBInsights database, $5.5 billion in investment flowed into mental health and wellness tech companies worldwide last year.

Business in Germany is still in its infancy. “But the future also belongs to hybrid offers in this country: apps with technological support – accompanied by therapeutic care for people.” Henrik Emmert is convinced of that. He observed the healthcare market for the management consultancy BCG for years, founded an app for the treatment of obesity patients himself and is now deputy chairman of the Association of Digital Health Apps in Germany.

Emmert says: One hurdle for start-ups in this country is the narrow legal regulations. “In Germany, the market for digital therapeutic content that can be billed to health insurance companies is extremely tightly regulated. At the same time, however, there are far too few cash register seats for psychotherapists. As a result, the offer for patients is kept artificially short.”

The Federal Chamber of Psychotherapists (BPtK) evaluated 300,000 insured person data for 2019. 40 percent of patients who had already been diagnosed with a mental illness were still waiting at least three to nine months for treatment to begin. After Covid, that much is certain, the situation has deteriorated significantly.

Internet offers can build bridges until therapy begins. But they are also aimed at people who want to prevent it. And to those who are ill but would like to help themselves with low-threshold offers. Some are purely digital, others work with direct contact to human supporters.

In the case of depression, this contact must always be given, warns the psychiatrist and chairman of the German Depression Aid Foundation, Ulrich Hegerl. “Even mild depression is a serious brain disease.” The life expectancy of those affected is on average ten years less than that of healthy people. Heart attack, stroke, suicide – many risks are significantly increased. Therefore, the treatment, also with the help of online tools, must be urgently monitored by a family doctor or psychotherapist. They are also able to prescribe medication.

As an indication of the quality of different commercial apps, the psychiatrist cites a possible assumption of costs by health insurance companies. As a rule, these offers are scientifically sound and have high data protection requirements.

For laypeople, the quality of different online offers is difficult to understand. Because even if therapists work there, everyone in Germany can call themselves “therapists” – even people with different lengths of training. The same applies to the term “coach”.

The professional title psychotherapist, on the other hand, is legally protected. In order to obtain this, a medical or psychological degree is required, plus several years of further training leading to a license to practice medicine. Pure psychologists may have completed a degree, but did not do this additional training.

WELT presents eight offers for mental health from Germany.

iFightDepression

The free online program was developed by the German Depression Aid Foundation. It is aimed at people aged 15 and over with mild forms of depression. In various workshops, those affected learn how to deal better with the symptoms and receive practical tips for everyday life. Prerequisite for participation is: A treating family doctor or a psychotherapist activates the patient and accompanies him through regular appointments.

Selfapy

Selfapy is comparatively one of the established companies in the young market for mental health in Germany, because the start-up was founded by three women in Berlin in 2016. Twelve-week online courses are on offer for people with psychological stress such as depression, generalized anxiety or panic disorder. Doctors can prescribe these courses on prescription, the statutory health insurance companies cover the costs.

The courses include texts, videos and exercises based on methods of behavioral therapy. The offer is expressly not aimed at “serious cases”, but at people who are waiting for a therapy place or want to prevent relapses. For 180 euros, you can also book the support of a psychologist. He or she provides support on the phone and answers questions via email.

Clay Health

The young app (launched in 2021) also comes from Berlin and, according to the two founders, is a “training club for mental health”. With personalized training plans, Clay Health wants to help users to better cope with psychological stress from everyday life – from low mood and stress to topics such as sexual harassment at work to libido problems or menstrual problems. There are videos, live workshops, coaching and exchange with like-minded people. The lifestyle app costs just under 120 euros a year.

Whylab

Predating Clay Health by a year, Whylab has a similar approach. The app wants to be the “digital fitness studio for mental health” – according to the founders Luca Lea Kleene, Nikola Berkmann and Sarah Kim Reitz. Customers with similar personal challenges are brought together in virtual groups.

Accompanied by a coach, they work on their topic together in weekly 90-minute sessions, for example “mourning”, “desire to have children” or “self-confidence”. In addition, the app wants to support users with regular exercise sessions and personal “check-ins” by the coach are planned. Half-yearly membership costs 390 euros.

Dear Employee

Dear Employee is not aimed at private individuals, but at companies. In 2017, the founding team developed a digital platform for them that measures the psychological stress on employees and recommends measures for their health. Regular online surveys deal, among other things, with the motivation, satisfaction and stress levels of employees. This results in recommendations for health courses, psychosocial emergency aid or leadership coaching.

In addition, charts provide managers and the HR department with an overview of how the workforce is currently doing. What about the corporate culture? In which departments do employees feel particularly valued? Where is burnout prevention needed? The company cooperates with a number of universities, including the FU Berlin, where the founder and her two partners come from. Customers include companies such as the insurer Axa or the online retailers Amazon and Zalando.

Wellsome

The company Wellsome, founded in Berlin in 2021, is also aimed at employers. The three founders have young, multinational companies from the Internet economy in mind as customers and offer consulting sessions in 18 languages. This is preceded by self-tests and questionnaires that employees fill out every two weeks. Online training, relaxation exercises and meditations are then suggested to them and they can also request personal advice in their native language.

HelloBetter

HelloBetter is one of the pioneers on the German market. Founded in 2015 by a psychology professor from the Technical University of Munich and two psychologists with doctorates, the company now offers ten therapy programs.

They range from prevention to the treatment of depression, anxiety or panic disorders, burnout, vaginismus or chronic pain. Five online courses are approved by the Federal Institute for Drugs and Medical Devices and are free of charge for all adults with health insurance on prescription. HelloBetter is based in Hamburg and Berlin and now has more than 100 employees.

Brainboost

Brainboost’s online offering is still in its infancy. The Munich doctor Philipp Heiler has been working with the so-called neurofeedback method to treat patients with ADHD or depression since 2015. Brain wave curves are measured and displayed on a computer screen. The patients should actively influence them.

Brainboost is now developing its own games and software with a team – and is also working on prototypes to make the hardware for measuring brain waves more affordable. The idea is that patients could then practice at home in regular sessions to shut down their brains and avoid chronic fatigue.

Die Macher is WELT’s career podcast. In this podcast, Inga Michler finds out what drives people who are successful. She shows which obstacles they have overcome and collects tips for the way to the top.