🏥 Hospital stay and admission
In brief
The vast majority of inpatient treatments for depression are voluntary: You decide yourself to be admitted to a psychiatric or psychosomatic clinic, for example in case of severe symptoms, suicidal thoughts or when outpatient treatment is no longer enough. Admission against your own will (placement, Unterbringung) is the exception and possible only under strict conditions.
If you are thinking about suicide right now or are in acute danger: Call the emergency number 112 or the TelefonSeelsorge (telephone counselling service) immediately – free of charge, anonymous, around the clock: 0800 111 0 111 or 0800 111 0 222 (telefonseelsorge.de). You do not have to wait for an appointment to become free.
Step by step
- Clarify voluntary admissionYour GP, a psychotherapist or the emergency room of a psychiatric clinic can arrange an admission or admit you directly.
- Secure cost coverageHospital treatment is covered by statutory health insurance; for admission your insurance card is generally enough – a hospital referral is helpful but not mandatory in emergencies.
- In case of imminent danger: emergency room instead of waitingIn case of acute self-endangerment, the fastest route is the emergency number 112 or going directly to the emergency room of a psychiatric clinic.
- Placement only as a last resortOnly if there is a significant, present danger to yourself or others and no voluntary treatment comes about can placement be applied for under the relevant state law (PsychKG) or – if a legal guardian has been appointed – under § 1831 BGB.
- Exercise your rights in the placement procedureAffected persons are entitled to representation by a lawyer or another procedural representative and can appeal against the placement.
Deadlines
- Placement requires a concrete, present danger – mere need for treatment or unusual behaviour is not enough.
- The placement laws (PsychKG) are state law and differ in detail between federal states – but the principle of judicial reservation applies everywhere.
- Voluntary treatment always takes precedence over placement; affected persons can withdraw from voluntary admission at any time, unless the strict conditions for placement are additionally met.
- Without a power of attorney for care matters (Vorsorgevollmacht) or a court-appointed guardianship, relatives have no automatic right to decide about placement or treatment.
In depth · legal basis, figures and practice – for advisers and professionals
Voluntary treatment as the rule
The legal basis for hospital treatment is § 39 SGB V. A referral by a doctor with statutory insurance accreditation is usual but dispensable in emergencies; the clinic itself assesses admission. The costs are borne by statutory health insurance as part of hospital treatment.
Placement under state law (PsychKG) and under the BGB
Placement against the will of the person concerned is a significant interference with fundamental rights and is therefore subject to strict conditions: Because of a mental illness there must be a significant present endangerment of oneself (e.g. acute suicidality) or endangerment of important legal interests of others. Public-law placement is governed by the PsychKG/Placement Act of the respective federal state and is ordered by the competent local court (Amtsgericht). If a legal guardianship already exists with the area of responsibility of determining residence, civil-law placement under § 1831 BGB may also come into question – here too judicial approval is in principle required.
Judicial reservation
Under Art. 104 para. 2 GG, only a judge may decide on the permissibility and continuation of a deprivation of liberty. In case of imminent danger, provisional action can also be taken without a prior court decision; the court decision must then be obtained without delay.
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