PRO*ACTIVE is a project funded by the Innovation Fund of the German Federal Joint Committee (G-BA). It is led by the Department of Psychiatry, Social Psychiatry and Psychotherapy at Hannover Medical School (MHH) in cooperation with AOK Lower Saxony (AOKN).

The project establishes and evaluates a novel four-step care model designed to improve treatment for employed AOKN-insured individuals who are on long-term sick leave due to depression.

The approach combines early identification and proactive outreach by AOKN with timely specialized diagnostic assessment by the Department of Psychiatry, Social Psychiatry and Psychotherapy at MHH. Patients are then directly referred to specialized outpatient psychotherapy. This coordinated care pathway aims to improve health outcomes and the quality of care for individuals with depression while reducing prolonged periods of work incapacity.

At the core of PRO*ACTIVE is an innovative outpatient treatment approach embedded within existing healthcare structures. The intervention is a workplace-focused cognitive behavioral therapy (CBT) known as return-to-work CBT (RTW-CBT). This approach places the patient’s reintegration into working life at the center of the therapeutic process. In contrast to traditional psychotherapy—where return to work is often addressed only toward the end of treatment—therapists in RTW-CBT take an active supporting role throughout the entire reintegration process.

The therapy is delivered in specially certified outpatient practices. Its effectiveness compared with standard CBT (treatment as usual [TAU]) will be evaluated in a randomized controlled trial.

PRO*ACTIVE will be implemented from October 2025 to January 2029 in several regions in and around Hanover and is funded by the Innovation Fund with ≈ 4.2 million €. The effectiveness evaluation will be conducted by the Institute for Biometry at MHH, while process and health economic evaluations will be carried out by the Institute for Epidemiology, Social Medicine and Health Systems Research at MHH.

 

Project website: https://innovationsfonds.g-ba.de/projekte/pro-active.712

Study registration: https://www.drks.de/search/de/trial/DRKS00039266

E-Mail: proactive@mh-hannover.de

 

Project leaders: Dr. Ivo Heitland & Prof. Dr. Kahl
Deputy project leader: Dr. Britta Stapel
Secretariat: Theresa Rollenhagen

Project coordinator: Inka Napiwotzki

 

Project staff:

• Sebastian Bertele (second opinion procedure)
• Sarah Theysohn (second opinion procedure)
• Dr. Nicole Scharn (psychiatric treatment)
• Johanna Lisser (psychologic treatment)
• Stefanie Groba (psychologic treatment)
• Ellyn Saenger (manual development & second opinion procedure)
• Ioana Iliadis (manual development & psychologic treatment)
• Henna Geddert (manual development & RTW workshop)

ReHaTOP is a joint initiative of Hannover Medical School (MHH), the Jobcenter Region Hannover, and the Bildungswerk der Niedersächsischen Wirtschaft (BNW). The program supports individuals experiencing long-term unemployment who face additional challenges due to psychological distress or mental illness. Its goal is to strengthen social participation and open up new employment perspectives.

Long-term unemployment can trigger a cycle of social withdrawal, declining health, and increasing barriers to employment. ReHaTOP addresses these challenges through a holistic and interdisciplinary approach. On site, a multiprofessional team consisting of social workers, case managers, and psychologists works together with participants to develop individualized support and intervention plans.

MHH plays a central role in diagnostic assessment, medical and psychological support, and scientific evaluation. Physicians and psychotherapists from the Department of Psychiatry, Social Psychiatry and Psychotherapy provide medical-psychological consultations and offer psychological support in individual and group settings tailored to the specific needs of participants. These interventions aim to help participants better understand and manage psychological distress, thereby improving quality of life and motivation while enhancing employment opportunities.

The project is continuously evaluated to assess the effectiveness and efficiency of its different components and to further optimize the intervention strategies. In this way, ReHaTOP contributes both to the direct support of participants and to the advancement of knowledge in integrated care practice.

ReHaTOP is funded from 2022 - 2027 with a funding volume of ≈ 2.8 million €. Until the beginning of 2026, > 500 individuals have participated in the program. An extension of the project beyond 2026 is planned.

 

Project website: https://rehatop.de

E-Mail: rehatop@mh-hannover.de

Project video for Niedersächsischer Gesundheitspreis: https://www.youtube.com/watch?v=TJQUzN7M2X8&themeRefresh=1

Project video for MSD Gesundheitspreis: https://www.youtube.com/watch?v=3_hzk1N9PDo

 

Project leader: Dr. Ivo Heitland
Deputy project leader: Prof. Dr. Kai G. Kahl
Secretariat: Lars Loop

Project coordination:

• Dr. Laura Beier (medical lead)
• Nina Ristel (psychological lead)

 

Project staff:

• Anne Kleine Büning (psychological psychotherapist)
• Chiara Jacobi (psychological psychotherapist)
• Johanna Lisser (psychological psychotherapist)
• Marianna Pielniok (psychological psychotherapist)
• Jacques Lafon (psychological psychotherapist in training)
• Anne Magnusson (psychological psychotherapist in training)
• Lennart Schroeter (psychological psychotherapist in training)

The project Psychosocial Coaching is a collaboration between Hannover Medical School (MHH) and the Jobcenter Region Hannover. It is designed for individuals receiving citizen’s income (Bürgergeld) whose employment prospects are limited due to mental illness or persistent psychological distress.

Participants are referred to the project by Jobcenter staff when psychological barriers are suspected to hinder (re)entry into employment. Participation is voluntary.

The program is based on the psychological and scientific expertise of MHH. Qualified psychological psychotherapists provide structured diagnostic assessments and counseling directly at participating Jobcenter facilities across five sessions. The Department of Psychiatry, Social Psychiatry and Psychotherapy currently supports 14 locations with 16 psychotherapists in advanced training.

The aim of the program is to identify psychological distress at an early stage, provide professional diagnostic assessment, and recommend appropriate treatment and support options. Participants receive clear feedback regarding their psychological situation and guidance on further steps to facilitate both health stabilization and integration into the labor market.

In addition, MHH supports the project through training and professional supervision for Jobcenter staff. These training sessions provide knowledge on mental disorders, communication strategies, and effective approaches for working with psychologically distressed clients.

The project Psychosocial Coaching is funded from 2022 - 2028 with a funding volume of ≈ 6.9 million €. Since its launch, > 1.600 individuals have been supported through the program. An extension of the project funding until 2034 is planned. The project is continuously evaluated by MHH.

 

Project website: https://psychosoziales-coaching-hannover.de

E-Mail: psychosoziales-coaching@mh-hannover.de

 

Project leader: Dr. Ivo Heitland
Deputy project leader: Prof. Dr. Kai G. Kahl
Secretariat: Lars Loop

 

Project coordination:

• Sarah Theyson (psychological lead)
• Beste Bedir (psychological lead)
• Thorsten Folsche (medical lead)
• Niklas Siminski (scientific lead)
• Ioana Iliadis (network coordination)
• Patrick Pesch (network coordination)

 

Project staff:

• Klara Bokelmann (psychological psychotherapist in training)
• Jan von der Brelie (psychological psychotherapist in training)
• Pauline Eifler (psychological psychotherapist in training)
• Marie Fischer (psychological psychotherapist in training)
• Paula Hase (psychological psychotherapist in training)
• Anna-Sophia Heidrich (psychological psychotherapist in training)
• Cornelia Keller (psychological psychotherapist in training)
• Justus Klinke (psychological psychotherapist in training)
• Caroline Knapp (psychological psychotherapist in training)
• Johanna Mause (psychological psychotherapist in training)
• Dirk Münke (psychological psychotherapist in training)
• Selina Niehus (psychological psychotherapist in training)
• Rosa-Marin Perez (psychological psychotherapist in training)
• Sarah Rehpennig (psychological psychotherapist in training)
• Jelena Simic (psychological psychotherapist in training)
• Luisa Vosse (psychological psychotherapist in training)

About Psychocardiology

Psychocardiology is a medical field focused on the interaction between cardiovascular diseases and mental health. Depression and anxiety are common in both acute and chronic heart conditions, while cardiovascular diseases contribute significantly to premature mortality in patients with severe mental disorders.

 

Research

Our team has been investigating the bidirectional relationship between heart disease and mental health for many years. We have documented an increased prevalence of mental disorders in heart patients, including adults with congenital heart defects (ACHD) and women with postpartum cardiomyopathy (PPCM). Studies also show that improvements in depressive symptoms are associated with better cardiac performance.

Furthermore, we have identified increased cardiovascular risk in patients with mental disorders such as depression, borderline personality disorder, and bipolar disorder. Using routine data from over one million people in collaboration with AOK Niedersachsen, we confirmed elevated risks of heart attack, stroke, and mortality associated with depression. Future analyses will explore whether treatment of depressive disorders can reduce cardiovascular risk.

 

Psychocardiology Outpatient Clinic

The Psychocardiology Outpatient Clinic is a service by the Department of Psychiatry, Social Psychiatry, and Psychotherapy in cooperation with the Department of Cardiology and Angiology aimed at patients of the cardiology outpatient clinics.

Our clinic provides a supportive environment for patients to discuss psychosocial challenges and daily stressors, focusing on both coping with illness and effective stress management. Comprehensive assessments include personal interviews and questionnaires to understand the multifaceted impact of heart disease on daily life.

For patients needing both physical and emotional support, we offer specialized psychocardiological psychotherapy tailored to the needs of people with heart conditions.

The psychocardiology outpatient clinic is being continuously evaluated within the framework of an ongoing scientific registry study, which investigates various aspects of the interaction between mental health and cardiovascular disease with a focus on the demand and efficacy of the provided treatment.

 

Project website: https://mhh-kardiologie.de/ambulanzen-sprechstunden/psychokardiologische-ambulanz/

E-Mail: psychokardiologische-ambulanz@mh-hannover.de

 

Project leader: Prof. Dr. Kai G. Kahl
Scientific leader: Dr. Britta Stapel
Deputy scientific leader: Dr. Ivo Heitland

 

Project staff:

• Cornelia Keller (psychological psychotherapist in training)
• Lucas Langer (psychological psychotherapist in training)
• Selina Niehus (psychological psychotherapist in training)
• Inken Schulte (medical doctoral candidate)

 

Publications:

• Märtens C*, Stapel B*, Heitland I*, Zeidler J, Bauersachs J, Stahmeyer JT, Kahl KG. Depression severity and major cardiovascular events: Findings from German insurance claims data. Journal of Psychosomatic Research. 2026;204:112579. DOI
• Sliwa K, Viljoen C, Hoevelmann J, Rakisheva A, Ali Farhan H, Damasceno A, Jessen N, Jovanova S, Mbakwem A, Simpson M, Jackson AM, Petrie MC, van der Meer P, Van Craenenbroeck E, Kahl KG, Tschope C, Sinagra G, Seferovic P, Bayes-Genis A, Bauersachs J. Access to medical care globally for patients with peripartum cardiomyopathy: a clinical consensus statement of the Heart Failure Association of the ESC. Eur J Heart Fail. 2026. DOI
• Stapel B, Winter L, Heitland I, Löffler F, Bauersachs J, Westhoff-Bleck M, Kahl KG. Impact of congenital heart disease on personality disorders in adulthood. Eur J Prev Cardiol. 2024;31(11):1324-32. DOI
• Fillies B*, Stapel B*, Lemke LH, Loffler F, Bauersachs J, Kahl KG, Westhoff-Bleck M. Remission from depression is associated with improved quality of life and preserved exercise capacity in adults with congenital heart disease. Front Cardiovasc Med. 2024;11:1418342. DOI
• Kahl KG, Stapel B, Heitland I. A lonely heart is a broken heart: it is time for a biopsychosocial cardiovascular disease model. Eur Heart J. 2023;44(28):2592-4. DOI
• Pfeffer TJ, Herrmann J, Berliner D, König T, Winter L, Ricke-Hoch M, Ponimaskin E, Schuchardt S, Thum T, Hilfiker-Kleiner D, Bauersachs J, Kahl KG. Assessment of major mental disorders in a German peripartum cardiomyopathy cohort. ESC Heart Fail. 2020. 10. DOI
• Westhoff-Bleck M, Briest J, Fraccarollo D, Hilfiker-Kleiner D, Winter L, Maske U, Busch MA, Bleich S, Bauersachs J, Kahl KG. Mental disorders in adults with congenital heart disease: Unmet needs and impact on quality of life. J Affect Disord. 2016;204:180-6. DOI

Digital Interventions to Improve Mental Health in Psychocardiology (DigiStrucMed)

Mental health challenges, particularly anxiety and depressive symptoms, are common among patients with cardiac diseases and often have a significant impact on their quality of life. Access to specialized psychotherapists is frequently limited, waiting times are long, and most therapies are not specifically tailored to the needs of patients with cardiac conditions.

Against this background, our research group, within the DigiStrucMed funding program of the Else-Körner-Förderstiftung and in cooperation with the Institute for Information Systems at Leibniz University Hannover, develops and evaluates digital interventions that translate evidence-based psychotherapeutic approaches into app-based formats. These interventions have been refined and assessed over five funding periods. Accompanying evaluations have demonstrated, among other outcomes, a significant reduction in anxiety symptoms.

 

The objectives of the individual subprojects were:

• WebApp-based prevention and therapy of adjustment disorder after life-threatening cardiac events – the “AD-support” study
• Clinical evaluation with a WebApp-based therapy of mental disorders after life-threatening cardiac events
• Is blended treatment with a WebApp-based therapy of mental disorders after life-threatening cardiac events more effective compared to non-blended treatment?
• Implementation of an AI-supported mental health app in psychocardiology
• Exploring Client-Centered and Clinical psychotherapy Programs Using the LeA+ Digital Therapist in Psychocardiology

 

Overall, the projects on digital interventions to improve mental health in psychocardiology were supported by the Else-Körner-Förderstiftung with ≈ 100 thousand € across five funding periods.

 

Project leaders: Prof. Dr. Kai G. Kahl & Dr. Ivo Heitland
Deputy project leader: Dr. Britta Stapel

 

Current project staff:

• Jonas Barfknecht (research assistant informatics)
• Ekaterina Petrova (medical doctoral candidate)
• Islam Rizk (medical doctoral candidate)

 

Publications:

• Larionov K, Petrova E, Demirbuga N, Werth O, Breitner MH, Gebhardt P, Caldarone F, Duncker D, Westhoff-Bleck M, Sensenhauser A, Maxrath N, Marschollek M, Kahl KG, Heitland I. Improving mental well-being in psychocardiology-a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients. Front Psychiatry. 2023;14:1138475. DOI
• Gebhardt P, Caldarone F, Westhoff-Bleck M, Olsson KM, Hoeper MM, Park DH, Stapel B, Breitner MH, Werth O, Heitland I, Kahl KG. Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events. Front Psychiatry. 2022;13:812807. DOI

 

Akzept*D: Do Patients with Depression and Their Care Providers Accept Online Health Services? – A Study on Acceptance and Critical Success Factors

Within the framework of the Akzept*D study, our research group investigates factors that determine the use and acceptance of online health services, such as internet-based cognitive behavioral therapy programs (iCBT), for the treatment of depression. Both patient perspectives and those of treating physicians and psychotherapists are taken into account.

The project was funded by the Volkswagen Foundation from 2021 - 2024 with a grant of approximately ≈ 500 thousand €. The consortium is led by the Department of Psychiatry, Social Psychiatry, and Psychotherapy at MHH, with project management carried out by the Institute for Health Economics/CHERH at Leibniz University Hannover. Other partners include the Institute for Information Systems at Leibniz University Hannover, Ostfalia University of Applied Sciences, and AOK Niedersachsen.

Collaboration among the participating institutions enables a systematic investigation of success factors for iCBT, with the overarching goal of sustainably improving the acceptance and effectiveness of digital therapies.

 

Project leader: Prof. Dr. Kai G. Kahl

 

Project partners:

• Prof. Dr. Annika Herr, Leibniz University Hannover (LUH), Center for Health Economics Research Hannover (CHERH)
• Prof. Dr. Michael Breitner, Leibniz University Hannover (LUH), Center for Health Economics Research Hannover (CHERH)
• Dr. Oliver Werth, Leibniz University Hannover (LUH)
• PD Dr. Jan Zeidler, Leibniz University Hannover (LUH), Center for Health Economics Research Hannover (CHERH)
• Prof. Dr. Daniela Eidt-Koch, Ostfalia, University of Applied Science

 

Publications:

• Werth O, Jankowski I, Muller NS, Schulte F, Warnemunde-Jagau P, Breitner MH, Herr A, Kahl KG. Success by design: A holistic analysis of design principles for depression apps. Digit Health. 2025;11:20552076251336276. DOI
• Martens C, Stapel B, Heitland I, Zeidler J, Kahl KG, Stahmeyer JT. [Differences in the utilization of specific healthcare services among persons with a diagnosis of depression - which impact has the socioeconomic status?]. Psychiatr Prax. 2025;52(8):416-23. DOI
• Stahmeyer JT, Zeidler J, Schutte S, Warnemunde-Jagau P, Eidt-Koch D, Schulte F, Breitner MH, Jankowski I, Herr A, Kahl KG. [Level of knowledge and intention to use digital health services among people with depression: a survey]. Gesundheitswesen. 2025. DOI
• Stahmeyer JT, Martens C, Eidt-Koch D, Kahl KG, Zeidler J, Eberhard S. The State of Care for Persons With a Diagnosis of Depression. Dtsch Arztebl Int. 2022;119(26):458-65. DOI

 

Ricky in Action: Social Robotics in Care

Since early 2024, the social robot “Ricky” (Navel by Navel Robotics) has been deployed at the Johanniter Senior Residence in Hannover-Ricklingen as part of a research project supervised by our working group. Ricky engages residents in structured, dialogue-based interactions, asks questions, stimulates memories, and facilitates activating conversations. The goal is to explore new ways to support psychosocial care and to relieve the workload of nursing staff.

Against the backdrop of increasing shortages of care personnel and higher risks of social isolation and loneliness in older age, the use of assistive technologies is becoming increasingly relevant.

Through a combination of quantitative assessments (e.g., cognition, mood, sleep, and quality of life) and qualitative interviews with staff, the study examines the effects, acceptance, and practical feasibility of using Ricky.

Early results indicate that implementation is feasible and well received. Initial findings suggest activating effects for residents as well as practical support in daily care routines. This represents a promising step toward innovative, human-centered care.

 

Project leader: Prof. Dr. Kai G. Kahl

Project staff: Bela Bogedain (Doktorandin)

 

The HUMAN-LS project (Health Equality, Migration and Diversity) investigates health inequalities in Lower Saxony, with a particular focus on people with migration-related characteristics. These include factors such as year of immigration, country of birth, nationality, and German language proficiency.

This approach enables a more nuanced understanding of migration and allows for the targeted analysis of specific determinants. The project aims to identify differences in access to healthcare, the use of healthcare services, and the quality of care. Based on these findings, evidence-based recommendations will be developed to support a more equitable healthcare system for this group of people.

The overall project is led by Prof. Dr. Christian Krauth (Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School) and is conducted in collaboration with Leibniz University Hannover. Within this framework, our research group investigates questions related to mental health care in several subprojects. The investigation of these research questions are funded over the project period from 2025 – 2029 with ≈ 500 thousand € by the State of Lower Saxony and the Volkswagen Foundation through the zukunft.niedersachsen funding programme.

One study examines whether outpatient psychotherapists make different decisions when accepting new patients depending on characteristics such as nationality or religiosity. Using an experimental design, the study assesses whether these characteristics influence the likelihood of obtaining a therapy appointment.

In a second study investigate the role of cultural broaching, meaning the active addressing of cultural backgrounds by therapists during treatment. It explores how this affects patients’ trust and their confidence in the therapeutic process, and whether it can foster more positive expectations towards therapy.

A third subproject aims to investigate the use of coercive measures in psychiatric acute wards. Based on qualitative interviews with patients and clinicians, the study analyzes decision-making processes as well as experiences and perceptions of these measures, with particular attention to migration-related factors.

 

Project website: https://www.mhh.de/institut-fuer-epidemiologie/forschung/forschungsschwerpunkt-gesundheitsoekonomie-und-gesundheitspolitik

 

Project leaders: Prof. Dr. Kai G. Kahl & Dr. Ivo Heitland

 

Project staff:

• Chiara Jacobi (doctoral candidate)
• Ellyn Saenger (doctoral candidate)
• Tamar Unger (doctoral candidate)

The study “Collaborative Outcomes Study on Health and Functioning during Infection Times” (COH-FIT) was initiated during the COVID-19 pandemic to investigate the short- and long-term effects of the pandemic on physical and mental well-being in the general population. The project involved more than 200 researchers from over 40 countries. The international consortium is led by Prof. Dr. Christoph Correll (Charité Berlin) and Dr. Marco Solmi (University of Padua, Italy).

Between March 2020 and June 2022, more than 150,000 participants from 49 countries were surveyed anonymously online across three data collection waves. This makes COH-FIT one of the largest international studies examining the health consequences of the COVID-19 pandemic.

Within the international COH-FIT consortium, our research group at Hannover Medical School focuses particularly on the impact of the pandemic on psychological distress and access to medical and psychological care among individuals with cardiovascular diseases.

The project is planned to continue beyond the pandemic. In light of increasing global crises and geopolitical conflicts, a new international survey wave titled COH-FIT Global Crises (COH-FIT-GC) is currently being prepared. The aim is to investigate how various global crises affect mental health and functional well-being worldwide. Within this project, the Department of Psychiatry, Social Psychiatry and Psychotherapy at Hannover Medical School will be responsible for data collection and analysis in Germany. COH-FIT-GC is currently in the planning phase.

 

Project website: https://www.mhh.de/kliniken-und-spezialzentren/klinik-fuer-psychiatrie-sozialpsychiatrie-und-psychotherapie/blog/ankuendigung-2

E-Mail: kahl.kai@mh-hannover.de

 

Project leader: Prof. Dr. Kai G. Kahl
Scientific leader: Dr. Britta Stapel

 

Project staff: Ioana Iliadis (doctoral candidate)

 

Publications:

• Solmi M, …, Kahl KG, …, Correll CU. Global and risk-group stratified well-being and mental health during the COVID-19 pandemic in adults: Results from the international COH-FIT Study. Psychiatry Res. 2024;342:115972. DOI
• Solmi M, …, Kahl KG, …, Correll CU. The collaborative outcomes study on health and functioning during infection times in adults (COH-FIT-Adults): Design and methods of an international online survey targeting physical and mental health effects of the COVID-19 pandemic. J Affect Disord. 2022;299:393-407. DOI
• Kahl KG, Correll CU. Management of Patients With Severe Mental Illness During the Coronavirus Disease 2019 Pandemic. JAMA Psychiatry. 2020;77(9):977-8. DOI

• Cardiology and Angiology (Prof. Dr. Johann Bauersachs, PD Dr. Mechthild Westhoff-Bleck, Prof. Dr. David Duncker)
• Pneumology and Infectology (Prof. Dr. Marius Höper, Prof. Dr. Karen Olsson)
• Clinical Department for Rehabilitation and Sports Medicine (Prof. Dr. Uwe Tegtbur)
• Department of Clinical Psychology and Sexual Medicine (Prof. Dr. Tillmann Krüger)
• Institute of Epidemiology, Social Medicine and Public Health Research (Prof. Dr. Christian Krauth)
• Institute of Biometry (Prof. Dr. Armin Koch, Dr. Yvonne Ziert)

• Central Institute for Mental Health, Mannheim (Prof. Dr. Michael Deuschle)
• University Hospital Schleswig-Holstein, Campus Lübeck (Prof. Dr. Phillip Klein)
• Charité Universitätsmedizin Berlin (Prof. Dr. Christian Otte, Prof. Dr. Christoph Correll, Prof. Dr. Philipp Sterzer)
• University of Greifswald (Prof. Dr. Eva-Lotta Brakemeier)
• LMU Klinikum München (Prof. Dr. Frank Padberg)
• University Hospital Tübingen (Prof. Dr. Thomas Ethofer)
• Leibniz University Hannover (Institut für Gesundheitsökonomie, PD. Dr. Jan Zeidler)
• Leibniz University Hannover (Institut für Wirtschaftsinformatik, Prof. Dr. Michael H. Breitner)
• Ostfalia, University of Applied Science, Wolfsburg (Prof. Dr. Daniela Eidt-Koch)
• AOK Niedersachsen
• Jobcenter Region Hannover
• Volkswagen (PD. Dr. Lotta Winter)

• Australian Centre for Heart Health, Melbourne, Australia (Prof. Dr. Alun C. Jackson, Dr. Marlies E. Alvarenga)
• Australian National University, Canberra, Australia (Prof. Dr. Don Byrne)