Hospitals and psychiatric institutions This opinion coincides with the results of the above quoted work on the basis of the data from the Austrian Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy. As of 31 December 2019, there were 96 authorised trainee positions for the discipline of child and adolescent psychiatry in all of Austria. Because of the lack of medical specialists who are required for training, 25 out of 125 positions nationwide could not be filled recently. As it will continue to be very difficult to fill these positions in the foreseeable future, there will be no relevant growth in trainee places (see Fliedl/Ecker/Karwautz, 2020, 185). Push specialised subject training The regulation for rare subjects in its current form is, in the opinion of the authors, not adequate for achieving full care in the area of child and adolescent psychiatry. Until 31 May 2021, the instruction and supervision of the interns by two medical specialists is considered sufficient for approving the first four trainee positions in the specialised area of child and adolescent psychiatry. For every other trainee position, however, an additional fulltime medical specialist is necessary (or several parttime medical specialists equivalent to one FTE), see Section 37 (1) Regulation on Education and Training for Medical Practitioners 2015 (Ärztinnen-/Ärzte-Ausbildungsordnung), Federal Law Gazette II 147/2015. In order to achieve an improvement in child and adolescent psychiatric care, training in the specialised subject shall be promoted throughout Austria (see Fliedl/Ecker/Karwautz, 2020, 187). Call for special care programmes From the NPM’s point of view, for effective child and adolescent psychiatric care, additional programmes outside of hospitals must be created, which meet the needs of the target group, some of whom display strong psychiatric symptoms and associated developmental and behavioural disorders. In this way, the imminent effects of inadequate care (such as self-harm and harm to others, hospitalisation, the breakup of relationships, lack of perspective and hopelessness etc.) can be reduced. Increase mobile programmes In the view of the Austrian Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, mobile programmes (so-called home treatment models) should be included in the performance-based hospital financing. There are examples for such programmes in Germany and Switzerland (see Fliedl/Ecker/Karwautz, 2020, 187). Create incentives for filling vacancies The NPM strongly recommends providing the conditions required to make it possible to operate the bed wards in Floridsdorf Hospital and avoid admissions freeze in the existing locations. Effective incentives shall be created in order to interest applicants in medical specialist positions at clinics of the Vienna Health Association. Hietzing Hospital transitional psychiatry In its Report 2019 (pp. 61 et seq.), the NPM already pointed out the necessity of expanding in-patient transitional psychiatry programmes for adolescents in the transformational phase into adulthood. To this end, intensive interdisciplinary cooperation between specialists in child and adolescent psychiatry, adult psychiatry and therapeutic and nursing staff is required. 53