Hospitals and psychiatric institutions Due to the small organisational units, holiday and sick leave taken by the specialists in child and adolescent psychiatry cannot be covered in the outpatient clinic itself. Permanent positions in public health insurance scheme required Establishing the out-patient clinics can thus only be a first step towards achieving adequate child and adolescent psychiatric care in the area of officebased doctors in Styria. From the NPM’s point of view, the creation of permanent positions in the public health insurance scheme in the area of child and adolescent psychiatry to supplement the out-patient clinics is imperative. This dual system would also meet the requirements of Section 135 of the General Social Insurance Act (Allgemeines Sozialversicherungsgesetz) that grants the insured the right to choose their doctor. Evaluation intended The office of the regional government of Styria reacted to this criticism and promised to evaluate the out-patient care model of “psychosocial counselling with integrated out-patient clinics” throughout Styria. If required, adjustment should be made to the current structural planning in order to increase the effectiveness of care. XX  Demand in the out-patient area of child and adolescent psychiatry cannot be covered by the existing institutions and current staffing levels. The medical staff shall thus be increased in these institutions in order to ensure nationwide treatment programmes. Furthermore, permanent positions in the public health insurance scheme for child and adolescent psychiatry have to be created. 2.2.10 Requirements of effective transitional psychiatry The transition from youth to adulthood is a difficult developmental challenge for every person. Adolescence and young adulthood are a particularly critical phase for the development and chronification of mental disorders. The transition from adolescence-centred to adult-oriented care between the ages of 16 and 24 is thus an enormous challenge. Interdisciplinary cooperation required From the developmental psychopathological perspective, specific in-patient and in-patient programmes on an interdisciplinary basis that support the transition would be expedient. It is pivotal that such medical treatment programmes take unstable maturing phases into consideration. They should combine core elements of competences for adolescent psychiatric treatment with core elements of competences for adult psychiatric treatment in a framework suitable for young people. The relevant staffing is also important to this end. Key contents of these integrated offers are parental work, psycho-education of the affected young persons and their relatives (partners and parents), the inclusion of developmental issues 61

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