Hospitals and psychiatric institutions Current municipal health care planning includes 15 new beds at the Neurological Rehabilitation Centre Rosenhügel, which should be ready for occupancy in the first six months of 2018. Furthermore, an additional ward with 24 inpatient and six day-care places is being set up at Vienna North Hospital. Additional positions have already been created in the nursing, psychological and administrative areas in both the Neurological Rehabilitation Centre Rosenhügel and Vienna General Hospital. The number of admissions to adult psychiatry decreased to 163 in 2016. Rapid implementation of intended projects urgently required Current developments in the field of child and adolescent psychiatry demonstrate that appropriate measures have been taken to finally rectify the many years of shortcomings. Existing care services are also being expanded in Tyrol and Vorarlberg. However, it must be carefully observed, if the planning objectives are actually met. In any way, the planning horizon in Styria and the expansion in the inpatient area (up to 2025) have to be reconsidered, and the existing inpatient capacity must be increased at a faster rate. These structural changes are urgently necessary to stop the current practice of caring for children and adolescents in adult psychiatry in as far as possible. Increase in number of training places to cover demand Furthermore, the efforts being made to heighten awareness for child and adolescent psychiatry in the area of medical specialist training must be stepped up considerably. This is necessary to meet the growing demand emanating from the required expansion of treatments in the outpatient and inpatient area. Shortage of contracted office-based medical specialists In the view of the NPM, medical specialists for child and adolescent psychiatry who have contracts with a public health insurance office should be increasingly integrated in this care structure. The aim is to facilitate local care and to promote the de-stigmatisation of the psychiatric treatment of children and adolescents in the interest of the patients. As a rule, the opening of outpatient child and adolescent psychiatric facilities is commendable, but the range of services – as in other medical fields – should be supplemented by contracted office-based doctors who can be consulted at the expense of social public health insurance. The nationwide stepping up of public health insurance fund contracts should help ensure the prevention, early diagnosis and timely treatment of children and adolescents in particular in order to avoid as far as possible the further deterioration and progression of an acute mental disorder into a chronic condition. A differentiated system in which the services both in the inpatient and day-care area, as well as the outpatient and office-based area are fully networked would make it possible that the living conditions of the affected children and adolescents and their parents can be considered in a flexible way. It would also enable them to choose between care in an outpatient facility and at an office-based doctor’s surgery at least in the medium term. 54

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