Hospitals and psychiatric institutions 2012 to 2019), the lowest bed indices are in Styria and Vienna (Fliedl/Ecker/ Karwautz, Kinder- und jugendpsychiatrische Versorgung 2019 in Österreich – Stufen der Versorgung, Ist-Stand und Ausblick, in: neuropsychiatrie, 2020, 181). In Vienna only about half of the in-patient and day-care treatment places planned in the Regional Health Care Structure Plan 2020 are currently available. Besides, there is a regular reduction in the in-patient treatment resources in the child and adolescent psychiatry departments due to freezes in the number of beds made available. Precarious care situation in Vienna Ten medical specialists stopped working in the child and adolescent psychiatry departments of Floridsdorf Hospital and Hietzing Hospital between November 2018 and September 2020. In contrast, there are approximately 346,000 minors living in Vienna today, more than a fifth of whom display symptoms of psychiatric illness, according to current studies (see Wagner et al., Mental health problems in Austrian adolescents: a nationwide, two-stage epidemiological study applying DSM-5 criteria, European Child & Adolescent Psychiatry 26, 1483–1499, 2017). In the opinion of the NPM, the decision to release the University Clinic for Child and Adolescent Psychiatry of Vienna General Hospital from the responsibility of the regional care network goes hand in hand with the risk of a deterioration of the quality of care. The NPM holds the view that this should only have been allowed after the care capacity for child and adolescent psychiatry in the in-patient and day-care area that is planned in the Regional Health Care Structure Plan for Vienna 2020 and the Health Care Plan for Psychiatry and Psychosomatics Vienna (Psychiatrischer und Psychosomatischer Versorgungsplan Wien – PPV 2030) has been successfully provided. Vienna General Hospital left the care network too soon A concentration of acute and crisis stays in the Department of Child and Adolescent Psychiatry of Hietzing Hospital is to be feared as a consequence, as this hospital has to take on responsibility for the full care of minor patients from all over Vienna. This can have a negative impact on the quality of local treatment and carries the risk that more medical specialists will leave the department because of the increased workload. The limited bed capacity for regional care also increases the risk that minor patients will be admitted to departments of adult psychiatry. Fear of rise in acute and crisis hospital stays The existing child and adolescent psychiatry departments in Vienna are not fully operational because there are not enough child and adolescent psychiatry specialists. In spite of the relevant job advertisements, it has not been possible to fill many of the medical specialist positions in the child and adolescent psychiatry departments at Hietzing Hospital and Floridsdorf Hospital. The reasons for this communicated to the commission included the growing competition from alternative job offers, the lack of financial incentives in a position offered by the Vienna Health Association, the stressful work situation as well as the low number of trainee positions and trained medical specialists. Lack of medical specialists 52

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