BACKGROUND:There is no doubt that mental health care should be geared toward evidence, cost-effectiveness, and need. Health care data that allow comparisons of demand and real needs are scarce. This is especially true for outpatient care. METHOD:The aim of this study was to assess and analyze data from health insurance plans and social welfare. RESULTS:The costs of mental health care in Germany amount to 13 mio per year and 100,000 population. Health insurance schemes account for two thirds of total costs and social welfare for one third. The distribution of expenses seems not to be based on need analyses. Especially the chronically mentally ill are disadvantaged. CONCLUSIONS:The redistribution of expenses from inpatient to outpatient care including integrated health care approaches would result in more cost-effective mental health care.