Post a Comment Print Share on Facebook
Featured Banken und Internet kmpktBerufscheck Marxismus Fachblatt Science Constantin van Lijnden

"Mothers with babies are absolutely undersupplied"

People in a mental crisis often have to wait a long time for treatment.

- 3 reads.

"Mothers with babies are absolutely undersupplied"

People in a mental crisis often have to wait a long time for treatment. "The situation is often particularly difficult for young mothers with newborns, because they also have to take care of their babies," says the Berlin psychiatrist and psychotherapist Britta Janßen. Places in mother-child wards in psychiatric clinics are rare and usually only available after long-term registration. In the Berlin district of Marzahn-Hellersdorf, Janßen and colleagues are now also specifically visiting such patients at home.

“Mothers with babies are grossly underserved when it comes to psychiatric treatment. We only see these patients in the hospital when they are so seriously ill that there is really no other way," says Janßen, who works at the Vivantes Clinic for Psychiatry in the Kaulsdorf Clinic. This is how the idea came about to help these women at home as early as possible.

One of her patients was Franziska Zellmer, who had her first child in March. Half an hour of sleep per night was not possible for her in the first few weeks after the birth. "I lay in bed like a Duracell rabbit and just waited for the little one to have to be breastfed again," recalls the 35-year-old.

The young mother was increasingly affected by the constant lack of sleep. "I had trouble breastfeeding, was just angry with myself and at some point I was afraid of harming myself or the little one. At some point I collapsed and went to the emergency room hyperventilating," says Zellmer.

The doctors there put her in touch with Britta Janßen's team. Two days later, therapists came to the patient's home. “I had visitors every day for a few weeks. It was always like a ray of hope and helped me a lot,” says the young mother, who was diagnosed with postpartum depression and an adjustment disorder.

The doctor Janßen is supported by a multi-professional team, which also knows and arranges further offers of help. “A team of two always visits the patients at home in different compositions, including at the weekend,” she explains.

The concept, which enables the treatment of mentally ill people at home, is called ward-equivalent treatment (Stäb) and has been approved in Germany since 2018. The prerequisite is that the patients have an indication for inpatient treatment and that the therapy goal can best be achieved in the home environment.

More and more clinics are offering this type of treatment for different target groups. According to a joint report by insurance and health insurance associations and the German Hospital Society (DKG), there were 36 hospitals nationwide in 2020. 13 hospitals nationwide started in 2018. The number of cases increased from 400 in the first year to 2437 cases in 2020. The patients were mostly adults, but also children and adolescents. According to the DKG, more recent nationwide figures are not yet available.

Janssen estimates that the need for treatment is very high overall. “Around 1,000 children are born in the Kaulsdorf hospital alone every year. And postpartum depression occurs in about 10 to 15 percent of mothers.” The care is currently insufficient. “The women sit at home and develop symptoms. We will reach our limits with the available places, but we wanted to make a surcharge first, ”said the doctor.

The staff is only one building block in the care of mentally ill patients. "But we can't intercept everything and treatment in hospital will still be necessary in many cases," says Janßen.

Franziska Zellmer says she is relieved that she received the support: "I have my life under control again, I take care of my baby and the household." From the beginning she received a lot of help from her mother-in-law. “But the baby turns life completely upside down. Simple things like eating when you're hungry, showering when you want to, or sleeping when you're tired – none of that can be taken for granted anymore.”

The project, in which the experts also work closely with midwives, is also about early detection. "We don't want it to go as far as possible that the women have to go to a hospital," says Christoph Richter, chief physician at the psychiatric clinic in the Kaulsdorf Clinic, where the project is based. He sees home visits as a form of therapy for the future. In many countries, such as Scandinavia, the trend is towards fewer beds in hospitals and towards outpatient treatment at home.

In this country, however, the cash registers see the concept critically. The central association of statutory health insurance companies, for example, points to rising costs. In addition, the minimum requirements are not always met. According to a spokeswoman, the required indication for inpatient treatment is not always available. The association is therefore in favor of placing the form of care in the hands of psychiatric institute outpatient clinics (PIA), which are part of the psychiatric care at the hospital.

"There has not been a single closed case nationwide in which there was no need for treatment," says Gerhard Längle, spokesman for the Stäb working group within the German Society for Psychiatry and Psychotherapy, Psychosomatic Medicine and Neurology (DGPPN). And: “The PIAs are funded inconsistently nationwide and are nowhere equipped in such a way that they could carry out intensive outreach treatment to the extent of the staff.

According to Längle, around half of the Stäb patients would not get an inpatient therapy place despite the urgent need for treatment. “So many previously untreated people are being reached. That should be in the interests of society – and the health insurance companies – even if it naturally costs money,” emphasizes the doctor.

"Aha! Ten minutes of everyday knowledge" is WELT's knowledge podcast. Every Tuesday and Thursday we answer everyday questions from the field of science. Subscribe to the podcast on Spotify, Apple Podcasts, Deezer, Amazon Music, among others, or directly via RSS feed.

Avatar
Your Name
Post a Comment
Characters Left:
Your comment has been forwarded to the administrator for approval.×
Warning! Will constitute a criminal offense, illegal, threatening, offensive, insulting and swearing, derogatory, defamatory, vulgar, pornographic, indecent, personality rights, damaging or similar nature in the nature of all kinds of financial content, legal, criminal and administrative responsibility for the content of the sender member / members are belong.