Mental Health of Germans Continues to Deteriorate

Representative survey data from a long-term study by the RKI paint a bleak picture

Mental stress and illnesses such as depressive disorders and anxiety disorders have been increasing significantly for several years. Currently, about 27.8 percent of adults in Germany, or about 17.8 million people, suffer from a mental illness (DGPPN January 2023). The impact of the Corona pandemic has further exacerbated this issue: globally, the number of depression cases increased by about 25 percent in the first year of the COVID-19 pandemic, equating to nearly 280 million sufferers worldwide(1).

As part of the “Mental Health Surveillance” (MHS), which is being established as part of a research project of the Robert Koch Institute (RKI), the study has found a downward trend in three indicators of mental health among adult Germans since its launch in spring 2019: Anxiety disorders, depressive disorders, and a positive assessment of mental status.

Collective risk factors increasingly burden the population

Women and the younger age groups (18 to 29 and 30 to 44 years) seem to be most affected by the current deterioration in their mental health. But the author:s led by Lena Walther observe negative trends in all gender and age categories since the study began in 2019.

From April 2019 to June 2022, there were significant declines in three domains of mental health among the adult population of Germany. A previous study(2) based these findings on survey data collected monthly. During the respective spring/summer comparison period, the estimated proportion of the population that scored above the threshold on a brief screening for depressive disorders increased from 11 percent in 2019 and 9 percent in 2020 to 13 percent in 2021 and finally to 17 percent in 2022.

The proportion of those who screened above the set level for anxiety disorders also increased between 2021 and 2022 (from 7 to 11 percent). Additionally, subjective ratings of mental health (SRMH, “self-rated mental health”) worsened: while 44 percent of the population rated their mental health as very good or excellent in 2021, this percentage dropped to 40 percent in 2022.

The analyses are based on representative telephone surveys from the “Gesundheit in Deutschland aktuell”(3) study. This study has been implemented with a largely constant concept since 2019. The survey includes data from a total of 47,098 adults, which corresponds to an average of about 3,120 respondents per month. These individuals were interviewed between mid-February 2022 (the starting point of data collection for 2022) and mid-May 2023.

Corona pandemic, war, inflation, and climate change are major stressors for people

In this regard, the author:s attribute the significant deterioration to ongoing collective stressors: in addition to several years of a state of emergency due to the Corona pandemic, the war in Ukraine, economic fluctuations and inflation, and the increase in climate change impacts also influence the situation.

It therefore seems urgent to take stronger measures to preserve and strengthen the mental health of society, according to the authors. This becomes all the more relevant when one considers that, in addition to the years of the pandemic, there have been other ongoing community stresses, such as the war in Ukraine, economic changes, and the intensifying climate crisis.

In light of these trends, medicine, health care, and policy face significant challenges in the structure of care and the urgent task of expanding therapeutic services.

Essential for a health-centered future: technology-based therapeutic approaches

In order to meet the growing demands of medicine, science and numerous institutions are calling more and more emphatically for an expansion of therapeutic offerings for patients:and for a long-overdue change of era in psychiatry and neurology: The increased use of non-invasive brain stimulation methods, which are above all more easily accessible to those affected, could help to significantly improve the care of patients.

As early as July 2023, the “Center for Responsible Research and Innovation (CeRRi)” of the Fraunhofer Institute for Industrial Engineering IAO, in cooperation with the University Hospital of Göttingen and international partners, drew up guidelines for the development and implementation of “Non-Invasive Brain Stimulation (NIBS)”. Their “Recommendations for Non-Invasive Brain Stimulation in the European Union” were published in a “White Paper” – read more at: Non-Invasive Brain Stimulation procedures: Increasingly Essential for Healthcare.


(1) World Health Organization (2022). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. Available at

(2) Mauz E, Walther L, Junker S, et al: Time trends in mental health indicators in Germany’s adult population before and during the COVID-19 pandemic. Front Pub Health 2023; 11: 1065938 CrossRef MEDLINE PubMed Central

(3) Walther L, Junker S, Thom J, Hölling H, Mauz E: High-frequency surveillance of mental health indicators in the adult population of Germany: trends from 2022 to 2023. Dtsch Arztebl Int 2023; 120: online first. DOI: 10.3238/arztebl.m2023.0180