Where and how to get mental health support
Managing your mental health, seeking help when you think you need it, what help is available, and what will be reimbursed by the CNS and what is free are questions that often come up on social media groups in Luxembourg.
This article guides you through each of these questions, with links and telephone numbers in addition to information on the types of therapy supported by the Luxembourg government.
Mental health a growing issue
A report from STATEC and TNS Ilres found that a third of Luxembourg residents experienced a decline in their mental health during the early pandemic lockdown.
More recently, research carried out by the University of Luxembourg and Paris School of Economics from March to July 2021 found that 13% of respondents from Luxembourg reported moderate anxiety, 8% severe to moderately severe anxiety, and 21% had moderate to severe depressive symptoms.
Overwhelmingly the figures were higher for younger people, and about 37% of those aged 18-44 years admitted their mental health had worsened.
When should I see a professional?
The pandemic in itself has caused much stress, anxiety and depression for many people. If this is a passing phase, then you probably don’t need to seek help. However if feelings persist or worsen over the days and weeks, you probably need professional help. The government website covid-psy.lu says you should seek help if:
- You lack energy and have difficulty functioning normally
- You have negative thoughts you can no longer control
- You have lost a lot of weight and have no appetite
- You have difficulty sleeping, wake up frequently, and have nightmares often
- You worry about anything and everything so much it paralyzes you
- You have panic or anxiety attacks including palpitations, shortness of breath, numbness, nausea, or pressure in your chest
- You are finding it difficult to cope with the death of a parent or loved one
- You notice an increase in anger and aggression either towards yourself or someone close
- You think death is a better option than life
- It is difficult for you to stop thinking about a painful event that has happened to you and invades your daily life
- You notice a marked increase in consumption of alcohol, medication or drugs to relax you or help you cope.
If you think you have depression you can do a self-test here which will help you decide if you want to or should seek further help. If you are worried about suicidal thoughts you should take this self-test. You can find out more about panic, social anxiety and phobias here.
How much will it cost?
In Luxembourg treatments offered or prescribed by doctors (either your GP or a psychiatrist) are covered by the CNS. Psychotherapies and visits to a psychologist in a hospital are supported by the CNS but some services provided in private practice are not covered.
Although Luxembourg’s psychotherapy law was voted in July 2015, as yet changes to reimbursement have not been made, although a new legal framework for psychotherapeutic treatments was created early last year, in agreement with FAPSYLUX (the psychotherapist association) after three years of discussions. Not all psychotherapists can register with the CNS, in part due to language requirements.
Medications such as anti-depressants are reimbursed at 80% of cost, and consultations with a psychiatrist or psychotherapy from a psychiatrist are reimbursed, but therapy carried out by a psychologist will not be reimbursed.
Many of the 37% of people aged 18-44 who cited worsening mental health in a STATEC survey, gave income worries and unemployment as a main cause, so paying for private support is probably not possible for many people. There are free consultations provided by a number of non-profit organisations (see below for more details and contact telephone numbers).
First, we explain the difference between a psychologist, psychiatrist and psychotherapist and outline what costs you can recoup from the CNS.
Who should you talk to?
It is sometimes worth consulting your family doctor first for advice. Some mental health symptoms have physical origins such as a hormone imbalance which can be further investigated by test analysis and treated by a specialist or with therapy, diet and medication. Your doctor can also advise on whether it is better for you to see a psychologist, psychotherapist or a psychiatrist.
Psychologists are professionals in psychology and behavioural functioning. Clinical psychologists specialise in mental health disorders. Most have completed a university course or even have doctorates and undergo regular training to practice, but they are not usually doctors in the medical sense.
Psychologists can help you to improve or maintain your mental health by giving you capabilities to manage certain feelings or situations, or by helping you to socially integrate if that is required. You should seek their support if you have doubts in your skills or your life, difficulties dealing with problems, or you suffer from stress. Psychologists will listen, provide support and advice, which could be short-term or long-term, and consultations can last between 30 to 90 minutes.
Most English-speaking psychologists are in private practice rather than part of the national health fund (CNS), and they are in short supply, often with waiting lists. You will not be able to claim reimbursement from the CNS, although if you have private medical cover, you may get something back.
Children and young adults up to the age of 27 years can get psychological help from ONE (Office National de l’Enfance). You can find out more about its psychological and psychotherapeutic partners on its website.
Psychiatrists are doctors and can also specialise in child mental health disorders. Most are also psychotherapists. They can diagnose you taking into account biological, psychological, relationship and environmental aspects, and exclude any physical illness that is causing psychological symptoms. They can prescribe additional tests and drug treatments or the therapeutic care required.
Consultation can be as short as 15 minutes or as long as an hour and a half, and the frequency of the visit will depend on the type of treatment you receive. The rates for a psychiatrist consultation are set by the CNS and reimbursed 88% for adults and 100% for children.
Psychologists or doctors (mostly psychiatrists) have been trained in psychotherapy methods (see below for what these are). They will give you a psychotherapeutic diagnosis and provide care for mental health disorders, behavioural disorders, distress and traumatic events. The aim is to make lasting changes to your emotional management, adapt behaviours, relax thoughts and improve your social relations or state of health. This may be supplemented by medication.
Currently psychotherapy is not covered by the CNS but it is planned to be. If you see a private psychotherapist that is not a registered doctor you are unlikely to get reimbursed. If you see one who is registered as a doctor you will get reimbursed 88% as an adult and 100% as a child.
Psychotherapy methods recognised in Luxembourg:
Cognitive Behavioural Therapy or CBT is based on the interactions between thoughts, emotions, behaviours and their consequences. You will set one or more goals with your psychotherapist and cover how to reach them. CBT is particularly successful for dealing with generalised anxiety, obsessive-compulsive disorder and the mental side of eating disorders.
Systemic and family therapies are preferred if a person’s difficulties or symptoms are the result of interactions with the family, and therapy may include family members, to uncover the difficulties and find solutions.
The psychodynamic approach is based on the work of psychoanalysts and aims to bring back to the conscious level conflicts or traumas repressed into the unconscious to understand and reduce suffering or disorders.
Humanist therapies look at the positive vision of human beings and help to mobilise psychological growth to develop a person’s potential.
Where can I find a psychologist, psychiatrist or psychotherapist?
You can look for psychologists and psychotherapists on the Luxembourg Psychological Society directory, filtering by language, location or problem/required therapy.
Most of the main hospitals have psychiatric units or clinics for outpatient and inpatient treatment, plus the central hospital for neuro-psychiatry in Ettelbruck has outpatient appointments for psychiatric and psychotherapy for adults and children.
The University of Luxembourg has a mental wellbeing counselling service for students and employees.
If you cannot get an appointment with a professional you can book a teleconsultation via e-Consult on e-Sante.
D’Ligue (LLHM or the Luxembourg League of Mental Hygiene) has consulting services for people with mental health issues carried out by a team of psychologists, psychotherapists, psychiatrists and social workers, open to the public from Monday to Friday 8.00 to 17.00 at 11 rue du Fort Bourbon. Consultations are free and you can set up an appointment by calling 49 30 29.
Ligue Medico Sociale offers psychological consultations and help with eating disorders at its centres in the city, Dudelange, Ettelbruck, Echternach, Clervaux, Wiltz, Dudelange, Esch-sur-Alzette and Redange. You must make an appointment first and can do so by phoning 22 01 22.
Réseau Psy is a non-profit organisation that works with the Ministry of Health and CNS. You can get a consultation, support and medical treatment at their centre OppenDir at Esch-sur-Alzette, on 54 16 16, or at Grevenmacher, on 75 93 21.
In the north, Liewen Doubaussen offers psychiatric and psychological support at its centre in Ettelbruck, on 26 81 51 1.
Stressberodung (cooperation between the Chamber of Employees and the LLHM) provides a free service with up to five consultations which is confidential. Consultations are by appointment only from 8.00 to 14.00, either by phoning 27 494 222 or emailing firstname.lastname@example.org
The portal for information on medical health lists a number of additional organisations that provide support to couples, families, and children.
You can contact the psychological hotline on 247 65533 seven days a week from 7.00 to 23.00 and receive assistance (multilingual) by a qualified team member. There are also numerous other helplines listed in our article Feeling Alone.