Patrick is always annoying because he can’t control his anger. He cannot cope with change and sometimes reacts extremely to it. The 20-year-old has a diagnosed developmental disorder and an intellectual disability.
He is currently staying at the district hospital for mental illnesses in Lohr. However, his treatment there will soon be completed. It is unclear where he can live afterwards. At the end of August he had to leave his youth group home because, at 20, he was too old for that. Acute psychiatry is an interim solution, but also an emergency solution. Because Patrick doesn’t know where to go.
Mother cannot physically or mentally cope with the care
It is impossible to move back in with his mother Sabine and stepfather. She has been fighting for her son for years – today she feels powerless: “I feel terribly sorry for him. You can’t control it properly yourself. It’s made so difficult for you. But you have to keep going somehow.”
Despite months of searching, there was no place for the 20-year-old in a residential group for adults. The supply is scarce and there is a lack of staff. Especially in intensive care, which Patrick would need. The care ratio there has to be high – because of the aggressive behavior of the young adults.
Clearly no known need
The Upper Bavaria district is responsible for Patrick. Because his mother Sabine, who is also his legal guardian, lives in Munich. When asked, the district explained that they had sent the mother a list of suitable facilities and asked her to call them and point out the urgency of finding a place for Patrick. In the Upper Bavaria district there are 130 places in intensive care facilities for adults.
However, it is not known how great the need is: data on waiting lists is not available. When asked, the Bavarian Ministry of Social Affairs cannot provide any figures: the group of those affected is “not definable and very heterogeneous”. The need for places – and therefore staff – is obviously not known.
A lack of care places puts a strain on acute hospitals
The lack of care places is also reflected in the psychiatric clinic in Lohr am Main: There are currently three other people living in Patrick’s ward alone whose treatment has actually been completed, who should go, but cannot get a place in a connecting facility.
A massive problem, says medical director Professor Dominikus Bönsch: “We have a backlog of up to 20 people waiting for such places. Our front runner has been waiting for a suitable place for seven years. This is unimaginable and inhumane. But it will work out will get even worse,” he fears.
Supply gap due to staff shortage
Beate Otte-Frank from the “Experience, Work and Learn” association, which is part of the Protestant youth welfare service, criticizes the lack of political interest. Those affected like Patrick are not isolated cases, but they also do not represent a group so large that there is pressure to act. The psychologist looked after Patrick during his time in a residential group for young people in Würzburg. She is certain that the current situation can only be changed with more staff.
When asked, the Upper Bavaria district explains that it is constantly trying to create additional offers. But: “Many interested service providers are unfortunately withdrawing their offers or putting their plans on hold because they cannot guarantee care for the people affected due to the current shortage of skilled workers and personnel. We regret this very much.” At the same time, the district emphasizes that it is not responsible for recruiting personnel. Nevertheless, he continues to point out the problem at the state level.
Psychiatry director: “Soon there will be more of a gap than a system”
Patrick has the right to be supported in his desire for a self-determined life. This also includes his needs when it comes to living. This is set out in the Federal Participation Act. The Bavarian Ministry of Social Affairs admits that it is currently a challenge to ensure this given the staff shortage. At the same time, the ministry sees the districts as responsible here.
It turns out that there are many different responsibilities, including between the social and health ministries, while at the same time the need is growing. Because the number and complexity of mental illnesses is increasing, reports Professor Dominikus Bönsch from the Lohr am Main district hospital. The result could be that more and more people slip through the gaps in the system, he warns. The director of psychiatry sees the reason for this primarily in the rigid bureaucracy: “Everyone is only responsible for a certain area. But the fact that there is a lot of mixing and that cases never fit into just one drawer is not taken into account.”
Homeless assistance as a last option
Patrick could therefore not be the first to be released from a psychiatric hospital into homelessness, confirms Michael Thiergärtner from the homeless service in Würzburg. This happens again and again. Because there are not enough spontaneous places in the existing help system. “It is often the case that emergency housing assistance is the last net that is still tight.” Here people get a roof over their heads – at least for one night.
The now 20-year-old has been passed from institution to institution his whole life. New situations are particularly difficult for him to endure. This is tragic for those affected like him. But it also has consequences for society, says Beate Otte-Frank from the “Experience, Work and Learn” association in Würzburg. Because if people like Patrick end up homeless, that could also become a security problem.
Consequences for society
“Such a person becomes conspicuous when homeless. People will feel threatened. They can become criminal and violent, towards themselves and others,” says psychologist Beate Otte-Frank. In the end, people like Patrick would eventually be locked away and kept in custody. “But these are not solutions. This is a moral question: whether we are prepared to set out on a journey for these people too.”
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