Hospitals and psychiatric institutions and adolescent psychiatric care in Carinthia could not be approved due to objections from the Medical Chamber. Local care is of key importance However, relevant approval is urgently needed in order to guarantee local child and adolescent psychiatry care in multidisciplinary facilities. In this context, the Austrian Public Health Insurance Office pointed out that a pilot project had been initiated in collaboration with the Carinthian Regional Association for Psychotherapy. It is intended for children and adolescents up to the age of 18, started in April 2018 and is limited to three years. The care programme is due to be rolled out across the Land during this time. Integrative concepts for addiction are required “Adolescents with complex psychiatric diseases” and resultant addiction do not receive adequate care. Their treatment should be specifically addressed in the psychiatry concept. The separation of substance use disorders and psychiatric illness is now outdated. A total of 90% of the persons with substance use disorders have an underlying psychiatric illness. The psychiatry coordinator of the Land should be fully involved. The NPM therefore advocates the implementation of integrative concepts for comprehensive care. Generally speaking, an increase in the number of beds for minors suffering from psychiatric diseases is required. It does not suffice to set up more psychosomatic beds because psychosomatic diagnoses are not an integral component of psychiatry and there is no “psychosomatics” discipline in Austria. X Effective incentives (financial reward, attractive working conditions and working hours, career opportunities, further education programmes amongst others) must be created in order to win specialists in child and adolescent psychiatry for positions in clinics of the Vienna Health Association. X Parallel to this, (non-hospitalised) care settings must be created, which address the psychiatric symptoms as well as the developmental and behavioural disorders of the target group. X In order to ensure adequate transitional psychiatry, a detailed plan of the structural and organisational principles is necessary, which also defines the required staffing and personnel development programmes. 2.2.5 New buildings and conversions necessary 55 Therapeutic design of hospital areas Creating modern spatial structures is a key factor in preventing agitation and aggression and contributes to avoiding measures that restrict freedom. The necessity of new buildings and conversions is not contested by the operators, but their implementation is delayed. Projects are insufficiently budgeted and are not monitored with the required priority.