The social security system for the psychologically ill

Structure of the social system

Social law provides a range of support for psychologically sick and disabled persons, whereby it is expressly emphasized that the  special needs of this group of persons are to be catered for accordingly (§ 27 Sect. 1 SGB V, § 10 Sect. 3 SGB IX) (Social Security Statute Book).

The legal social structure with its formal regulations, respective ordinances and guidelines and recommendations is, however, so complex that only few have an overview about the entire system.

Consultancy and information concerning legal claims is a task for the respective service provider (health fund, pension insurance, employment agency, social office, integration office, etc.).

For consultancy and support of disabled persons or persons threatened by disability and their confidants (which includes relatives) concerning services for rehabilitation and respective participation, rehabilitation service providers have been obliged toset up common service centers. According to “door signs“, this process appears tobe progressing swiftly (often with the pension insurance funds), but locally the “service centers“ of the respective rehabilitation service providers still exist (health fund, pension insurance, employment agency, social and youth support agencies).

Some social services and benefits to which a psychologically ill person has a fundamental right depend on the availability of such services on a local basis. This applies, for example, for facilities for rehabilitation, of which there are relatively few on a national level.

With regard to the issue of regional availability of facilities and services, please contact the social psychiatric services, which are available almost everywhere,and which normally provide a goodoverviewof the regional support available. In addition, most regions have a psychiatric coordinator who has a professional overview of thesituation. Sometimes you can find “psychosocial address books“ or “guides“. (Also refer to "The Care System") 

Elements of the social security system

The most important elements of social security in the case of psychological illness or disability are the following: 

For illness: Services of treatment include 

• Medical attendance including psychotherapy and dental treatment
• Medicinal drugs
• Therapist cures whichinclude i.a. ergotherapy which can be prescribed for specific therapy of disordersof thepsychosocialandsocio-emotional functions due to illness
• Home care which includes special services of psychiatric care at home
• Sociotherapy
• Hospital treatment
• Services for medical rehabilitation  as well as stress tests and occupational therapy.

In cases of (imminent) disability. Services for rehabilitation and participation include 

• Services for medical rehabilitation
• Services for participation in working life (professional rehabilitation)
• Benefits to ensuresubsistence, and other supplementary benefits
• Services for participation in community life, including support in gaining practical knowledge and skills required and suitable to enable disabled people to take part in community life where possible, support in self-determined living in care homes and support in participating in community and cultural life

Support and compensations (especially the disabled person’s pass)  

Support in case of need for care (in accordance with the Care Insurance law)

Securing subsistencedepending on the personal situation before and during sickness or disablement is covered by a range of services and benefits, which include

• Continued pay (employer)
• Sick pay (health fund)
• Subsistence pay (pension insurance or employment agency)
• Pension due to reduced earning capacity (pension insurance)
• Basic subsistence for senior citizens and in case of incapacity to work (districts and cities)
• Unemployment pay I - ALG I (employment agency)
• Unemployment pay II - ALG II (normally the employment agency)
• Subsistence support in accordance with SGB XII (formerly: federal social support act); this benefit is subordinate to all other benefits, also to any benefits for subsistence for relatives (also refer to Maintenance obligations of relatives)