Mental Health

It's perfectly normal not to feel well after a traumatic experience or be stressed about ongoing painful incidents and require help. You can seek support both online and over the phone in many languages.

• At ipso-care, you can seek advice from experienced counsellors online, anonymously and free of charge. The employees speak German, English, French, Turkish, Russian, Ukrainian, Somali, Italian, Farsi, Dari, Arabic, Tigrinya, Pashto and Burmese. The consultation is free.
• If you need urgent help, contact the telephone counselling service (Telefon-Seelsorge) on 0800 111 0 111. Alternatively, you can reach the "Muslim Counselling Telephone" (Muslimische Seelsorgetelefon) in Arabic, Turkish and Urdu on the telephone number 030 44 35 09 821. The Russian-speaking telephone counselling is available at +49 30 44 03 08 454. The employees of all three hotlines are reachable day and night, and their service is free. You can also contact a clinic with a psychiatric department. To search for a psychiatric emergency room nearby, visit psychenet.de.
• You can also find a mental health tips app at almhar.org. The app offers support for the most common mental health issues and gives you initial tips on dealing with the situation. The app is available in English, Arabic and Farsi.
• Refugee-trauma.help provides information on dealing with trauma in Arabic, German, English, Farsi, Spanish, Tigrinya and Ukrainian. You will learn what trauma is and how the body reacts to it. The website also provides tips and specific exercises which help you deal with trauma.
• So-called "self-help groups" are also helpful for many people. In a self-help group, you meet other people who have had similar experiences. Trained therapists lead these groups. On nakos.de, you can search (in German) for a self-help group in your area. There are also groups in other languages.

If you need someone to talk to, contact the staff of virtualsupporttalks.de for support. The volunteers speak German, English, Ukrainian and Russian and will listen to you. To reach them, you can contact them via email. The staff will then call you within 24 hours. The service is free.

You can also contact a telephone counselling service. You can reach the "Muslim Counselling Telephone" (Muslimische Seelsorgetelefon) day or night by calling 030 44 35 09 821. The employees speak Turkish, Arabic and Urdu. On the phone number 030 44 03 08 454, you can reach the employees of "Telefon Doweria" in Russian day and night. Their service is free. You may only have to pay some regular service fee for the phone call. Alternatively, you can reach the employees of a German-speaking telephone counselling service day or night by calling 0800 111 0 111 or at telefonseelsorge.de. The employees speak German. Their service and the phone call itself are free.

In principle, anyone can help by being present and listening. But it is more useful if you inform yourself beforehand.

• You will find a "Guide to Psychological First Aid" in German, English, Ukrainian and Russian at IOM. Among other things, you will find essential advice on dealing with traumatised people and tips on correct body language.
• At mhfa-ersthelfer.de, you will find 20 essential tips in German, English, Russian and Ukrainian for people looking after refugees. Even if you personally are/have been a refugee, this information can help you better deal with other affected refugees.
• On the Refugio München website, you will find information in German on how you can best help while taking sufficient care of yourself at the same time.
• At the "Nationwide Working Group for Psychosocial Centres for Refugees and Victims of Torture", you will find extensive practical guidelines in German on how to deal with a traumatised person.
• You can also participate in events organised by the project "Razom - United at Ipso". The webinars deal, among other things, with self-care and coping with trauma and its consequences. You can register for various webinars on ipsocontext.org. 

Trauma is an emotional or psychological injury. Just like our body, our psyche can suffer injuries from certain events. Typical events that can result in trauma are, for instance, violent crime, natural disasters, war, flight, torture, physical or psychological violence, sexualised violence, serious traffic accidents, threats of violence, the death of a loved one and serious illnesses.

These events could be very stressful for the persons affected and might cause them to feel overwhelmed, afraid and helpless. Sometimes, these reactions and feelings can last longer, resulting in restlessness, trouble sleeping, tremors, sweating, nausea, dizziness, shortness of breath, difficulty concentrating, feelings of guilt, depression, anger, fear, etc. Many people who have had troubling experiences cannot stop thinking about the experience. One other common result is that parts of the memory of the incident(s) are missing and/or specific details are remembered too clearly.

The undesirable symptoms often subside just a few hours or days after the traumatic event, particularly when the traumatic event lasted only for a short time and the person had the opportunity to process the traumatic experience properly.

When the person cannot cope with the traumatic experience and does not receive any outside support, trauma can lead to mental illnesses such as post-traumatic stress disorder, depression, addictions, anxiety disorders, etc. Only a specialist can reliably determine whether you have post-traumatic stress disorder, but there are some indications you should consider. You can take a short self-test in German at psychenet.de to find out more.

If you continue to suffer from the consequences long after the traumatic situation, it is best to seek treatment from a psychiatrist. Most forms of therapy can be carried out on an outpatient basis, i.e. the patients live at their home and visit the specialist's practice 1-2 times a week after making appointments. See the sections "What forms of therapy are available?" and "How can I find a suitable therapy offer?" below to learn more.

If a child has experienced a stressful situation and cannot process the experience, one or more of the following symptoms often appear weeks after the event:

• The child is afraid of being separated from their parents or staying alone.
• The child cries or trembles for no apparent reason.
• The child is often unresponsive.
• The child is not developing according to age.
• The child is terrified.
• The child avoids other children.
• The child often appears sad or depressed.
• The child is very skittish.
• The child is very restless.
• The child is often aggressive.

The most crucial step you should take is to make your child feel secure at present. You need to provide your child with a manageable and structured daily routine. Rituals help. Furthermore, you and other family members or close friends should spend time with the child as much as possible. Avoid situations that put additional stress on the child.

Please note: The child needs professional help if they show many of the above symptoms over an extended period. You can learn more in the section "How can I find a suitable therapy offer?".

There are a variety of therapy methods available for people suffering from trauma. What all these types of therapy have in common is that those affected have to deal with the traumatic experiences to process them properly. In the case of post-traumatic stress disorder, usually, one of the following therapy methods is used:

• PE therapy (Prolonged Exposure Therapy): In PE therapy, those affected think back to the traumatic event during the therapy session. You are reliving the trauma. The therapy session is recorded on tape, and the people concerned are asked to listen to this tape at home every day. This treatment is designated to reduce emotional reactions and psychological symptoms.
• Cognitive Behavioural Therapy (CBT): CBT is primarily about working on so-called "misconceptions". Many affected people blame themselves for what they have experienced or are ashamed of it. In CBT, those affected write down what they have experienced. Cognitive Behavioural Therapy's objective is to correct the affected individual's self-assessment of what they have experienced.
• EMDR Therapy (Eye Movement Desensitization and Reprocessing): In EMDR therapy, the person being treated recalls distressing experiences whilst doing bilateral stimulation, such as side-to-side eye movement or physical stimulation, such as tapping either side of the body. EMDR Therapy helps in processing the experience.
• NET therapy (Narrative Exposure Therapy): In NET therapy, the affected person tells their entire life story, with the traumata experienced being discussed in extensive detail. By doing so, the traumatic events should be better classified and processed.
• BEPP (Brief Eclectic Psychotherapy for PTSD): BEPP is a multi-faceted therapy that combines different elements. Those affected deal with what they have experienced with the help of conversations, writing tasks, etc.

In addition, creative approaches such as art therapy, music therapy, movement therapy, ergotherapy or relaxation techniques (e.g., yoga) are often included.

In addition to these and other forms of therapy, doctors can also prescribe medication such as antidepressants, etc.
Furthermore, those affected receive support in everyday life during the therapy, e.g. with professional integration or problems in the family.

There are many different therapists and forms of therapy. It is best to talk to your general practitioner first. There you can ask for support in finding the proper treatment and therapist.

On psych-info.de, you can search for therapists for adults, teens and children nearby in your language. You can also set various filters, e.g., the type of therapy or whether it should be private or covered by health insurance. The search engine only works in German. If you can't find any results in your federal state there, you can search for your federal state on bptk.de. As soon as you click on your federal state, you will be forwarded to a page where you can continue by clicking "Therapeutensuche".

You can also seek help (in German) from the staff of psychotherapiesuche.de by calling 030 2 09 16 63 30. You only have to tell them where you live and what you expect from therapy. They will help you find the right therapy offers in your area and language. Their service is free.

For most, it is more comfortable to go through therapy in their mother tongue. If you cannot find therapists in your language, you can also use the help of interpreters. The Social Welfare Office or Jobcenter can cover the costs for the interpreters if you cannot afford it. To get financial aid, you need to submit an application. Seek advice from a counselling centre for more information. You can find counselling and support from the Refugee Council or Pro Asyl. Visit fluechtlingsrat.de to search for Refugee Council in your area. You can reach Pro Asyl by emailing beratung@proasyl.de in English or German. You can also search for a counselling centre in your area on proasyl.de or our search engine on the Local Search page.

The answer depends on whether you are already a member of a health insurance company or not:

• I am a regular member of a health insurance company: In principle, health insurance companies usually cover therapy costs. However, if you are a member of statutory health insurance, you must ensure that your therapist has what is known as "health insurance approval" ("Kassenzulassung"). To start therapy, a doctor or psychotherapist must first make a so-called "suspected diagnosis" ("Verdachtsdiagnose"). This diagnosis should be sent to your health insurance company, which will either confirm or reject your request for therapy. It is best to talk to your family doctor directly first.
• I am not covered by a health insurance company: If you are not a member of a health insurance company, for instance, because your asylum procedure is still ongoing, you can apply to the Social Welfare Office for cost coverage. Ask social workers in your accommodation centre or a counselling centre for help. You can also seek counselling and support from the Refugee Council or Pro Asyl. Visit fluechtlingsrat.de to find the Refugee Council in your federal state. You can reach Pro Asyl by emailing beratung@proasyl.de in English or German. You can also search for a counselling centre in your area on proasyl.de or our search engine on the Local Search page.

However, many applications to the Social Welfare Office are immediately rejected because the authorities are reluctant to pay for therapies for people with an uncertain residence status. If your application is not rejected immediately, an assessment and evaluation will be carried out by doctors commissioned by the Social Welfare Office. These experts decide whether the Social Welfare Office should cover the costs of your therapy.

If the Social Welfare Office rejects your application: There are free therapy places at special treatment centres for refugees whose therapy is not covered by the Social Welfare Office. But it is pretty challenging to find a place in one of these treatment centres because there are not enough of them. You can find the addresses of these treatment centres on the website of the nationwide working group of psychosocial centres for refugees and victims of torture ("Bundesweiten Arbeitsgemeinschaft der psychosozialen Zentren für Flüchtlinge und Folteropfer"). The website is available in German and English. You must inquire directly at the specific centres to see in which language they provide service and whether there are any vacancies.