with 1,713,979 children and adolescents in Austria in 2012 younger
than 19, there is a population of 299,946 persons requiring treatment.
Of this number, 9.7% of all children and adolescents, i.e. 166,256
children and adolescents are impacted by a psychiatric disorder in a
more narrow sense and are thus definitely in need of treatment.
For this relatively large group of children and adolescents in need of
psychiatric treatment, however, the treatment availability by specialists
for child and adolescent psychiatry is widely lacking. The figures
provided by the Austrian Medical Chamber and the Federal Ministry of
Health differ slightly, but one can assume that currently only slightly
more than half of the approximately 350 specialists who are needed
to ensure adequate care are actually available.
Insufficient treatment
availability
The reason for this serious gap in care lies primarily in the fact that the
statutory basis for independent specialist training in the specific field of
child and adolescent psychiatry was only created in 2007. The delayed
establishment of a corresponding professional profile has had the
result that many of the currently registered specialists acquired their
title during the transition period between the time when child and
adolescent psychiatry was only a supplementary field to when it was
established as a special field and only a small number is actually
practicing in the core area of child and adolescent psychiatry. The
number and age structure of specialists makes it practically
impossible to identify the number of psychiatrists in Austria that will be
effective as far as care is concerned anytime soon. Additionally, the
training capacity for specialist training was at times not utilised
accordingly because operators of hospitals set other priorities and
permanent positions were reclassified for other specialties.
In the course of efforts by the Laender to expand inpatient bed
capacity in the area of child and adolescent psychiatry, due to these
factors, there are problems in filling the necessary specialist positions,
which will inevitably continue to come up in the future (see NPM Report
2013, pp. 41 et seq.).
Visits by the commissions have shown that in hospitals with psychiatric
wards for children and adolescents it is often impossible to man night
and weekend shifts with specialists for child and adolescent
psychiatry. Due to the lack of specialists, the commissions have found
that children and adolescents are housed and treated in adult
psychiatric wards, which according to the CPT is a violation of
preventive human rights and professional standards. In a current
fundamental decision in 2014, the Supreme Court emphasised the
“separation rule” for adolescents in psychiatric medical facilities. Thus
the Supreme Court put the protection of personality rights of minors in
psychiatric institutions and facilities into concrete terms for the first
time; as a result, spatial separation of adolescents and adult patients
is mandatory.
47
Rule requiring
separation of adults
and adolescents is
violated
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