In a fundamental decision in September 2014, the Supreme Court confirmed this opinion and set out that even attaching a four-point restraint serves to make medical or nursing measures possible and therefore, any restraint that precedes these measures is part of psychiatric health and nursing care. Therefore, private security companies are neither entitled nor authorised to participate in attaching restraints, even on the orders of the attending nursing staff. If this occurs nevertheless, the coercive measures are inadmissible and result in consequences for the operators of the medical facilities under liability law, because the operators are responsible for the conduct of the security staff of private companies. In October 2014, the Supreme Court stated in a judgement that activities requiring close proximity to the body, such as holding on to them to prevent them from leaving a ward, may not be carried out by security staff. These decisions confirm misgivings that the NPM already set out in 2013. Confirmation by the Supreme Court Therefore the NPM strongly advocates that private security companies no longer be utilised for care measures in psychiatric medical facilities. Patient advocates under the Hospitalisation of Mentally Ill Persons Act and representatives of residents under the Nursing and Residential Homes Residence Act will have to increasingly pay attention to this issue. Operators of hospitals unresponsive As the affected hospital operators showed little willingness to undertake structural changes prior to these court decisions, the NPM will again approach the Laender in question. It must always be noted that the absence of participation by private security companies in care measures may not result in increased use of measures that restrict freedom. Therefore, organisational arrangements and personnel schedule planning are required, which can optimise and boost resources. Persons working in psychiatric institutions and facilities must find conditions that enable them to carry out their responsibilities in conformance with human rights without risking their own safety.  �� Inclusion and participation of private security staff in patient care is inadmissible and may not occur. Concomitant arrangements are necessary to maintain patients’ personal rights and to enable measures to ensure staff safety. 2.2.2.4 Child and adolescent psychiatry in Austria – shortage in the training of specialists In the report on “Outpatient Psychosocial Care of Children and Adolescents” by the national research and planning institute for health care Gesundheit Österreich GmbH reference is made to the result of epidemiological studies on child and adolescent psychiatry, setting forth that an average prevalence rate of children and adolescents needing psychiatric care of 17.5% can be assumed. This means that 46 High number of children and adolescents needing treatment