National Preventive Mechanism
among others suffers from the permanent high stress levels of the personnel.
Adolescents are often placed in adult wards.
This grossly inadequate care is exacerbated by the absence of contracted
medical specialists for child and adolescent psychiatry in Styria. There is
only an outpatient range of services for minors without deductible in the
day-care clinics in Graz Süd-West/Standort Süd Regional Hospital and in
Hochsteiermark/Leoben Regional Hospital. Massive adverse effects can
thus arise for children, because they cannot receive competent professional
treatment quickly and are only admitted to inpatient care when a severe
mental illness occurs. Prevention, early detection and treatment of children
and adolescents in particular is of key importance in order to avoid mental
illnesses from further deteriorating or becoming chronic.
The use of psychotropic medication is often used in child and adolescent
psychiatry, although many of these medications were not approved for minors
meaning that there is no standardised product-related risk information
from the manufacturers. The principle “Children are not small adults, and
adolescents are not big children” applies without restrictions. Therefore, the
peculiarities of the child and adolescent organism must be considered both
for understanding psycho-pathological symptoms typical for the relevant
age and level of development, and for the use of psychotropic medication.
There were thus increased requirements for doctors in the field of the “offlabel use“ of psychotropic medication both in terms of acquiring information
prior to medication-based therapies and in terms of informing the patients.
In some child and adolescent psychiatry wards, information about possible
risks and side effects, therapeutic alternatives and risks related to the dosage
form is provided on off-label forms in individual cases. The patient is also
informed that the medication is not approved for the relevant indication and
the written consent of the treated person or their legal guardian is sought.
According to the observations made by the commissions, the lack of pertinent
professional child and adolescent psychiatry expertise in other wards means
that there are often no off-label forms, and psychotropic medication that is
not approved for minors is also prescribed for off-label use without special
professional explanation or documentation or without the express consent of
the patient or legal guardian.
An increase in bed capacity as quickly as possible is thus in the interest of the
children and adolescents requiring treatment. The outpatient and day-care
clinics should be strengthened by way of regionalisation.
The efforts of the NPM have at least brought about the commitment to set up
a chair of child and adolescent psychiatry at the University Clinic Graz for
the first time. However, it is still not clear how much resources will be made
available to the allocated clinical ward.
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