Need for mental healthcare in Germany – results from the European Health Interview Survey 2025

Background

Mental disorders constitute a major and growing public health burden. Needs-based mental healthcare requires up-to-date evidence. Two key indicators are “perceived need for care” as a predictor of help-seeking and “unmet need”, indicating access gaps and inequities. Both were assessed in the European Health Interview Survey (EHIS) wave 4 (2025). We present results for adults in Germany.

Methods

Descriptive analyses of German EHIS 4 (2025) data (n = 32,075 ≥ 18 years) were conducted. Weighted proportions and 95% confidence intervals were estimated for 1) perceived need for mental healthcare in the past 12 months, 2) mental healthcare use when needed and 3) nine main reasons for unmet need. Results were stratified by gender, age group and level of formal education.

Results

Overall, 16.6% (95% CI 15.9-17.4) of adults reported perceived need for mental healthcare in the past 12 months. Higher proportions were observed in women, among 18- to 29-year-olds and those with medium education. Unmet need, defined as at least one episode of no mental healthcare use despite perceived need, affected 8.7% (8.1-9.3) in total. Of those with perceived need, 52.7% (50.3-55.2) reported unmet need. Proportions decreased with age, with no gender differences or educational gradient. Most frequent reasons for unmet need were waiting lists or missing referral letters (46.7%, 43.4-50.1), lack of time (9.7%, 7.8-12.0) and financial barriers (8.8%, 6.9-11.2).

Conclusions

A substantial share of the population reports need for mental healthcare. Pronounced differences by gender and age may reflect varying morbidity and mental health literacy. More than half of those who perceived need experienced at least one episode of unmet need. To ensure comprehensive mental healthcare, efforts should focus on young people and improving access and availability. Evidence on individuals who do not seek professional help despite perceived need would complement these findings.

Key messages

• Recent survey data show a widespread need for mental healthcare in Germany: 16.6% reported perceived need and 8.7% had at least one episode of unmet need, affecting more than half of those with need.

• Measures should focus on young adults, as perceived and unmet need decreased with age. Reducing waiting times and referral barriers could improve comprehensive mental healthcare.