Depression is a widespread disease: it is estimated that more than five million people are affected in Germany alone. And in the wake of the coronavirus pandemic, the climate crisis and the war in Ukraine, these figures have continued to rise. However, mental health care has been struggling for a long time: you usually have to wait months for psychotherapy and it doesn't offer the right treatment for everyone. In order to change this, Dr Andreas Heißel, together with scientists from a consortium of health insurance companies and research institutions, has investigated to what extent
this gap in care can be closed with the help of sports therapy. The advantage: sports therapy and health sports are available quickly and at a low threshold. There is a very well-developed network of health sports clubs, physiotherapy practices and rehab centres throughout Germany, where appointments can also be made at short notice. "With sports therapy, we could reach untreated people in particular who are not open to psychotherapy or have to wait a long time."
What was missing until now was evidence of a tried and tested sports therapy programme. Heißel and Co. therefore launched a study on "Sports/Exercise Therapy for Depression", STEP.De for short: almost 400 patients received either sports or psychotherapy to treat symptoms of mild to moderate depression. Importantly, the sports therapy group was also accompanied by psychotherapists. They confirmed the diagnosis at the beginning, checked in every four weeks and decided in a final discussion with the patients how to proceed and whether subsequent psychotherapy was necessary or not. In between was the group-based sports therapy, 32 sessions over four months, framed by an individual sports test and a final consultation with a psychologically trained sports therapist. During this time, the researchers regularly surveyed the participants with regard to the symptoms of depression, as well as their ability to work and health-related quality of life.
The result was very clear, as Andreas Heißel summarises: "Both therapies proved to be highly effective - and on a par, even six months later. What surprised us was that of those who completed sports therapy, only around 20 per cent went on to start psychotherapy." Conversely, 80 per cent of patients did not require further treatment after the four months of sports therapy, while psychotherapy continued in most cases. This finding is particularly interesting for health insurance companies: After all, it means around a thousand euros lower treatment costs for STEP per person over a period of ten months.
"Our study proves it: Sports therapy is an effective treatment method for mild to moderate symptoms of depression," says the researcher. It should not replace psychotherapy, but rather complement it, he emphasises: "Sports therapy expands the treatment portfolio - and can be a door opener. The 20 per cent of patients who still need psychotherapy after sports therapy are then ready for it."
Now "only" someone was needed to put the STEP programme developed in the study into practice. But how? "Everyone waved goodbye - not their job," says the researcher. "So in the end, out of necessity, we tackled it ourselves." With the support of Potsdam Transfer, the university institution for knowledge and technology transfer, Andreas Heißel founded the Centre for Emotional Health Germany (ZEGD) in June 2023. "Our goal is always to help researchers as efficiently as possible," says start-up coach Ole Korn. "To achieve this, we customised our support to Andreas Heißel's individual needs. This ranged from advice on the business model and support with a business plan for further funding to clarifying legal and tax issues. Pitch training was also included."
The new company is intended to bring together the healthcare stakeholders required for sports therapy. "Actually, everyone benefits: the health insurance companies save money, the sports centres earn more with the therapy courses than with rehabilitation sports and the therapists gain new expertise in dealing with depression patients. Doctors and psychotherapists, on the other hand, can offer patients for whom they have not yet been able to find therapy places and, if necessary, bridge the waiting time until psychotherapy. Above all, however, those affected can find help at short notice," says Heißel.
The eight-strong ZEGD team is now working on expanding the network and making sports therapy more widely available. Thanks to the so-called selective contract, three health insurance companies have already included STEP therapy in their portfolio and cover the costs. On the other hand, the centre cooperates with seven sports centres in Berlin, where trained therapists offer STEP courses. Above all, however, Andreas Heißel and his team have "thought big" from the outset in order to scale up the care model quickly. To this end, they have now digitalised STEP sports therapy. This means that not only therapists can now complete the training and obtain certification from anywhere. Patients can also use the therapy, even if there is not yet a sports centre offering it in their area.
This article was published in the university magazine Portal Transfer 2024.