Hospitals and psychiatric institutions XX  The non-hospitalised care of patients following in-patient psychiatric treatment must be ensured nationwide in order to avoid non-indicated stays in hospital. XX  Attention shall be paid to setting up after-care facilities for patients with special needs which have sufficient staff to provide the individual care of these persons. 2.2.8 Continuing inappropriate placement of the chronically mentally ill The NPM already criticised the placement of chronically mentally ill persons in Styrian nursing homes in the past (see most recently NPM Report 2017, p. 38 et seq.). Placement in nursing homes and medical facilities The demarcation of competencies regarding the psychosocial care system in Styria continues to be unclear. The Styrian Disability Act (Steiermärkische Behindertengesetz) guarantees chronically mentally ill persons the right to full in-patient, partial in-patient, out-patient and mobile support under certain conditions; Section 4 (4) of the same law allows those affected to even choose between the available facilities and services. However, pursuant to the Styrian Social Welfare Act (Steiermärkische Sozialhilfegesetz), the groups of persons mentioned above may also be placed in nursing homes and medical facilities. An additional incentive for admitting persons with psychiatric diagnoses to nursing homes and medical facilities was recently created with the regulation on Social Welfare Act services and remuneration that came into effect in October 2018. The regulation stipulates the payment of a so-called “psychiatry supplement” for the admission of the group of persons mentioned above to such institutions and facilities. This is considerably more than the care supplement applied in the otherwise customary standard cost model. In addition, the “psychiatry supplement” was increased by 7% in 2018. Private nursing homes and medical facilities operate on a profit-oriented basis and want to ensure the capacity utilisation of their operations. Persons for whom a “psychiatry supplement” is paid are thus often admitted for unlimited periods of time. More importantly, this is possible because there are still not enough other alternatives available for the care of persons with disabilities in Styria. The failure to expand local, small-scale care structures – which has been requested for a long time – as well as misguided management (for example, through the “psychiatry supplement” mentioned above) mean that a large number of young chronically mentally ill persons in Styria continue to be hospitalised in private nursing homes and medical facilities. 58