[Mental health care in Austria: history--developments--perspectives].
The reform of psychiatric services in Austria started during the second half of the seventies of the 20th century. During the early phase the reform focussed on dehospitalization and principles of community psychiatry. About 60% of psychiatric hospital beds were closed and the size of psychiatric hospitals was reduced. One of the psychiatric hospitals was closed and psychiatric departments were opened as part of district general hospitals. During this time the number of psychiatric hospital admissions increased markedly and a large proportion of mentally ill are treated as inpatients in non-psychiatric wards. Only about a fifth of self-employed psychiatrists working in their own office have a contract with health insurances. In Austria, the number of psychotherapists is much higher than the number of psychiatrist. A variety of different types of community services provide social and vocational rehabilitation, focussing on consultation, housing, daily structure and employment. Psychiatric services are nowadays fragmented into a number of sub-disciplines such as psychosomatics or child and adolescent psychiatry. This fragmentation and the missing coordination of psychiatric services hamper the enhancements of psychiatric care. This complicates the development of integrated services, i.e. the structured and planned cooperation of the different types of services. Since there are no binding rules for the organisation and planning in entire Austria, financing and organisation of services is fragmented. For establishing an integrated health care, coordination and cooperation between providers, sponsors of health care as well as policy makers are essential.
Meise
Ullrich
U
Klinik für Allgemeine Psychiatrie und Sozialpsychiatrie, Department für Psychiatrie und Psychotherapie, Medizinische Universität Innsbruck. ullrich.meise@i-med.ac.at
Wancata
Johannes
J
Hinterhuber
Hartmann
H
D001317:Austria; D003156:Community Mental Health Services / Q000639:trends*; D003631:Day Care, Medical / Q000639:trends; D003688:Deinstitutionalization / Q000639:trends*; D005544:Forecasting; D018166:Health Care Reform / Q000639:trends*; D006285:Health Planning / Q000639:trends; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation; D010348:Patient Care Team / Q000639:trends; D011057:Politics; D011570:Psychiatry / Q000639:trends*; D011788:Quality of Life