Hospitals and psychiatric institutions 2.2.9 Deficits in out-patient child and adolescent psychiatric care in Styria Implementation of the Regional Health Care Structure Plan for Styria should guarantee out-patient child and adolescent specialist care in out-patient clinics. This is designed to meet the public health goal of providing out-patient care for children and adolescents – regardless of the type of illness – for as long as possible. The NPM observed, however, that the psychosocial counselling centres for children and adolescents are not yet operated as out-patient clinics. As a consequence, the specialists in child and adolescent psychiatry employed there cannot write prescriptions. Establishment of outpatient clinics delayed This breeds conflict when the attending general practitioners do not follow the recommendations of the specialists in the institutions. There are differences of opinion with regard to medication especially after the diagnosis of untreated ADHD. The lack of authority to write prescriptions on the part of the specialists in child and adolescent psychiatry also has a negative effect insofar as the families of the patients can get the impression that the specialists in child and adolescent psychiatry in the psychosocial counselling centres have less competence that the general practitioners. This is the case in particular when the general practitioners do not follow the prescription recommended by the experts. The result is a negative transmission of symptomatology, which further complicates the therapy. The office of the regional government of Styria assured the NPM that upon completion of the approval procedures the psychosocial counselling centres for children and adolescents would be set up as out-patient clinics and be given the authority to write prescriptions. This process was delayed, however, because the Regional Administrative Court of Styria overruled the resolution of the regional government of Styria in April 2019 on formal grounds. This resolution had stipulated the need for socio-psychiatric out-patient clinics for children and adolescents. But even after approval and taking into operation of the sociopsychiatric out-patient clinics for children and adolescents, the existing need in the area of office-based doctors will still not be covered by far. A total of just five fulltime positions for specialists in child and adolescent psychiatry are planned for out-patient clinics in Styria. With the exception of Graz, only five specialist positions are planned as fulltime positions (0.25 to 0.5 FTE), making the opening times of the out-patient clinics just four to eight hours per week. It is therefore to be expected that the existing waiting times of several months for treatment cannot be reduced and that the bottlenecks in the provision of care will remain. Insufficient treatment capacity 60