Psychotherapy: truancy is not based on solidarity – not only when vaccinating

Imagine it’s the vaccination appointment and nobody goes there. Unfortunately, this happens all too often in Germany’s vaccination centers. For those who have still not got hold of any protection against Covid-19, this rightly brings tears of anger or despair to the eyes. You have to wait unnecessarily longer, some valuable vaccine is thrown away and the entire vaccination campaign is slowed down. The call for punishment for truants is all too understandable – and yet wrong. Because threats are certainly not a good strategy if you want to get as many people as possible to vaccinate.

And yet sanctions would be enormously important in another area, which is also about the waste of rare health goods: in psychotherapy. The problem of missing appointments has been there for years, and the consequences are serious. Since 2017, psychotherapists with health insurance approval have had to offer part of their appointments via the appointment service points of the Association of Statutory Health Insurance Physicians, which are accessible to all insured persons. But it is precisely those people who receive a therapy session via this anonymous system that do not appear in large numbers; every third of these appointments fails.

Every missed hour of therapy means unnecessary suffering for society

This is a drama for all patients who urgently need a place in therapy. And there are far too many: As there has been a failure in recent years to promote the expansion of treatment offers for the soul in view of the growing demand, patients often have to wait months for help. The condition usually worsens during this time, it is all the more difficult to treat, and therapies ultimately take longer. In this way, all the more of the scarce resources are burned.

As a rule, the therapy consultation cannot be saved. In doctor’s offices, patients who have come spontaneously are always waiting to be pushed in between. Psychotherapy practices, on the other hand, are purely ordering practices: They reserve one hour each for an individual patient. A session that is not held means lost fees for the therapist – and untreated suffering for society.

The interaction between people has recently become less binding. In some areas this means a gain in casualness and freedom, but especially when it comes to helping the sick, non-commitment is simply indecent. Wherever insight does not help, sanctions are therefore necessary. Of course, especially in people with psychological problems, one cannot always assume negligence or malevolence if they miss appointments – in individual cases there will be good reasons for this. But all in all, it is important to ensure psychotherapeutic care for as many people as possible. Sanction options such as paying for failed meetings are therefore overdue.