🆘 When professional help is needed
In brief
Loneliness alone is not yet a crisis. It becomes one when hopelessness, withdrawal from all contacts, neglected basic needs (food, sleep, hygiene) or thoughts of suicide are added. In that case what counts is not the "right" route through the system but the fastest: a phone call – the emergency number in case of acute danger to yourself, otherwise one of the free hotlines.
Step by step
- Recognise warning signsPersistent hopelessness, suicidal thoughts, complete social withdrawal, neglect of eating, sleep or personal hygiene are alarm signals – in yourself as well as in others.
- In acute danger: emergency number 112If there is a concrete danger to life and limb (e.g. acute suicidal intent), call the emergency number 112 or go to the nearest emergency department. This applies at any time, including at night and at weekends.
- Otherwise: call TelefonSeelsorge or a crisis serviceFor all other acute emotional crises, the TelefonSeelsorge (0800 111 0 111 / 0800 111 0 222) and regional crisis services can be reached around the clock, free of charge and anonymously.
- Use the on-call medical serviceFor urgent but not life-threatening concerns outside consultation hours, the on-call medical service (Ärztlicher Bereitschaftsdienst) can be reached on 116117.
- Arrange follow-up careAfter an acute crisis it is worth making an appointment soon with a GP practice or a psychotherapist to plan further support, rather than leaving it at the one phone call.
Deadlines
- In case of acute suicidality, do not wait for a therapy place or a call back – call the emergency number 112 immediately or go to the nearest emergency department.
- TelefonSeelsorge and similar hotlines offer emotional support but are not an ambulance service and do not replace emergency medical care.
- "It will pass" is not a safe assessment when hopelessness or suicidal thoughts persist for weeks – when in doubt, better to seek help once too early than too late.
- Relatives who notice warning signs in others should raise the subject directly; according to the available evidence this does not increase the risk, but often increases the chance that those affected seek help.
In depth · legal basis, figures and practice – for advisers and professionals
Link between loneliness and mental illness
Persistent loneliness is not a distinct clinical condition, but research regards it as a risk factor for depression, anxiety disorders and a less favourable course of existing mental illnesses (Buecker & Neuber 2024, narrative review). The transitions between distressing loneliness and a depressive episode needing treatment are fluid; a professional consultation helps with assessment.
Emergency care
Under § 76 Abs. 1 Satz 2 SGB V, in emergencies insured persons may use any doctor and hospital even outside consultation hours. For psychiatric emergencies, the emergency departments or outpatient institute clinics of psychiatric hospitals are also responsible, as well as – organised differently depending on the federal state – socio-psychiatric crisis services (e.g. the nationwide Krisendienst Bayern). According to the available information, there is no nationally uniform crisis service structure identical in all Länder; the specific availability locally should therefore be asked about locally.
Distinguishing the hotlines
The TelefonSeelsorge is church-sponsored, ecumenical in orientation and intended for all age groups; it does not replace acute treatment but refers callers on where needed. 116117 (appointment service centre / on-call medical service) is intended for urgent, non-life-threatening medical concerns, not for a mere need to talk.
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