7.5 Mental health
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Health strategy for Children and Young people and Austrian Health Targets
Mental health forms an integral part of the Health strategy for Children and Young people(Kinder- und Jugendgesundheitsstrategie). Aim 5 aims to strengthen the life competence of children and young people, according to aim 11 early diagnosis and specific support for children and adolescent shall be improved and aim 15 sets out to improve care in selected fields (child and youth psychiatry, psychosomatics, neuro paediatrics and social paediatrics). Furthermore, National Health Target 9 stresses the promotion of psychosocial health in all population groups.
Austrian Structural Health Plan (Österreichischer Strukturplan Gesundheit, ÖSG)
In 2008, regulations concerning child and youth psychiatry have first been integrated into the Austrian Structural Health Plan(Österreichischer Strukturplan Gesundheit, ÖSG). They are a guideline for the implementation and expansion of the in-patient child and youth psychiatry regarding improvements in provision and an increase in the number of medical specialists in this area. The latter is a condition for the long-term planned improvement of the out-patient child and youth psychiatric care. However, the implementation state is still expandable in Austria and varies in the regions. Somatic disorders with a mental background as well as a row of mental clinical pictures among children and young people often don’t need psychiatric intervention, but are optimally treatable at specialised psychosomatic care units. Hence, the implementation and expansion of the psychosomatic care unit for children and young people are stipulated in the Austrian Structural Health Plan. The aim is to guarantee a multidiscipline care for all psychically suffering or strongly overburdened children and young people regardless of their social status by a nationwide care service free of charge. This provision includes specialised medical, psychological as well as psychotherapeutic and functional-therapeutical care. Due to the expansion of the regarding services, a positive development took place (according to the evaluation of provisions for the update of Child and Youth Health Strategy in 2016). In many federal states, the psychiatric and psychosomatic in-patient and day-clinic care for children and young people have been further developed. In parallel, the out-patient care has been further developed too.
National Mental Health Strategy (Nationale Strategie zur psychischen Gesundheit)
The Child and Youth Health Strategy is strongly supported by the National Mental Health Strategy (Nationale Strategie zur psychischen Gesundheit) and the 'package of measures until 2020' of the Main Association of Austrian Social Security Institutions by affirming the improvement and expansion of the mentioned service areas.
- Promoting mental health and emphasising its central importance: The topic of mental health must be prominently anchored in all policy areas. .
- Sustainable preventive measures: preventing mental illness and suicide
- Taking effective action against stigmatisation and discrimination of people with mental illnesses
- Providing fair and adequate funding
- Provide good primary care for people with mental illness: better inform people dealing with mental disorders about diagnosis and treatment options
- Promoting appropriate services for vulnerable stages of life: disseminating knowledge about mental illness and stress in general, especially among young people. Prevention must begin with the identification of children at risk.
- Providing effective care for people with severe mental illness through locally-based service: Structural and outcome quality, a solid legal framework as well as cross-sectoral coordination are needed
- The involvement of patients and relatives in planning and decision-making processes must be ensured. Strengthening human resources, offering attractive training and training conditions
- Generating reliable data on the mental health of the Austrian population and the psychosocial care landscape
- Evaluating effectiveness and gaining new insights
Austrian Suicide Prevention Plan (SUPRA)
Since the 1980s, a significant decline in suicide incidence in the general population has taken place (which slowed down considerably with the onset of the global economic crisis between 2008 and 2014). The numbers are still three times higher than road fatalities (Suizidprävention Sozialministerium). Among adolescents and young adults aged 15 to 24, suicide is the second most common cause of death (gesundheit.gv.at). 'Therefore, an increased awareness of the need for support in this phase of life is necessary. Tailor-made offers are needed, as the life and emotional worlds of adolescents differ significantly from those of adults', which is why Fonds Gesundes Österreich promotes suicide prevention projects that have been specially developed for children and adolescents.
In 2012, the former Federal Ministry of Labour, Social Affairs, Health and Consumer Protection implemented theco-ordination office for suicide prevention and presented the National Austrian Suicide Prevention Plan (SUPRA). The SUPRA-web portal has been launched in May 2017. For young people SUPRA aims to teach how to recognise and manage conflicts and how to deal with crises, depression and suicidal thoughts through education. Announcements and risk signals should be noticed and understood. Education systems, children's groups, youth clubs, associations, interest groups, etc. should help. Health and medical care facilities and social work should provide offers that have no threshold, are anonymous and immediately accessible. Special attention should be paid to risk factors in the environment in which children grow up as well as to signals indicating difficult family circumstances. Increased support should be provided for families at risk, with special attention to the problems of single parents and migrants.
Main measures for the improvement of child and adolescent psychiatric care
- Quick expansion of the child and adolescent psychiatric in-patient care structures in accordance with the ÖSG provisions (ongoing, in process of implementation).
- The decree of a lack field (Mangelfach) regulation until 2021 aims for an urgently necessary rise of the education capacity in this area (issued in 2015).
- Expansion of the capacities for the basic care by resident medical specialists and guaranteeing the multidiscipline full care together with resident therapists with child specific education (ongoing, in process of implementation).
- Interlinking and cooperation of all involved services and structures like
- Health promotion, prevention, crises management, addiction treatment, rehabilitation, facilities for treatment of children and adolescent with complicated disorders and facilities for child and youth welfare (recommended in 2011, in process of implementation).
Main measures for the improvement of psychosomatic care
- Quick and nationwide expansion of psychosomatic care structures in accordance with the ÖSG provisions (in process of implementation).
Other measures of aim 15 of the Austrian Child and Youth Health Strategy
- Mental health strategy by the Main Association of Austrian Social Security Institutions: The action area 7 focuses on a low-threshold, nationwide basic care in psychiatry, psychotherapy and in functional therapy (in process of implementation).
- Project: regulation collection for ergotherapy, speech therapy and physiotherapy for children and adolescent (in process of development).
The SUPRA-web portalhas been launched provides a collection of 24 hour helplines, emergency institutions and information folders for suicide prevention.
feel-ok is a network consisting of numerous institutions in Switzerland, Austria and Germany. It provides an internet-based intervention programme for adolescents. In Austria it is coordinated by Styria vitalis and largely financed by public funds. The platform bundles the expertise of the network in a coherent and youth-friendly way. It offers information on numerous health and socially relevant topics in the form of texts, games and tests as well as services. Free documents for the classroom enable teachers to use feelok with little effort. Its aims encompass
- Development of appropriate self-esteem and self-confidence
- Promotion of a responsible approach to sexuality
- Prevention of violence, eating disorders and suicidal tendencies
- Prevention of alcohol problems as well as tobacco and cannabis use
- Promotion of healthy nutrition, physical activity, and ahealthy body weight
- Promotion of healthy ways of dealing with stress
- Support in choosing a profession as well as in case of professional difficulties
- Handbook eating disorders: help for relatives, teachers and pedagogic professionals (Handbuch Essstörungen: Hilfe für Angehörige, Lehrkräfte und pädagogische Fachkräfte bei Essstörungen) (Federal State of Carinthia)
- Web platform for people with eating disorders and their relatives (Onlineplattform für Personen mit Essstörungen und deren Angehörige)
- Workshops for girls and young women to prevent eating disorders by the Women, Parents, Girls health centre FEM (Workshop, FEM-Frauen, Eltern, Mädchen Gesundheitszentrum, Vienna)
- Workshops for multipliers, City of Vienna (Workshops für MultiplikatorInnen der Stadt Wien)
- Eating disorder hotline (City of Vienna)
The website www.bittelebe.at ('please live') was developed for adolescents and young adults who are worried that a friend might harm themselves. Its central statement is that most people who attempt suicide do not want to die, but can rather no longer continue living in the way and form they have been. Because of this, talking and help can save lives. The website contains tips for conversation and behaviour ('Talking about it, but how?') and clears up common prejudices in videos.
Free anonymous help on the subject of suicide is offered around the clock by 'Telephone counselling' (Telefonseelsorge) under the number 142 (without area code) and 'Rat auf Draht' under 147 (without area code). Rat auf Draht is specifically targeted and promoted towards children and young people and has been offering them an important contact point for problems, questions and in crisis situations since 1987. Apart from them, (grand)parents, other relatives, teachers and all caregivers can turn to the experts for help with questions about parenting. A team, consisting of psychologists, clinical/health psychologists, life and social counsellors, social pedagogues and lawyers, receives around 100,000 counselling requests per year. On average, up to 250 counselling sessions are conducted daily.
Platform ‘Behind the Curtain’ (Hinter der Fassade) against family violence
The website informs young people about violence at home, about their rights and about support services. Its workshops are aimed at teachers who would like to address the topic in the classroom. It provides a contact point that is confidentially and free of charge.
Helping migrants in dealing with traumata
The association AFYA offers traumatised refugees effective and evidence-based support. The programme ‘Strengthening Strengths - Overcoming Trauma’ („Kräfte stärken – Trauma bewältigen“) helps participants to recognise, understand and control their stress reactions. The training focuses on the symptoms of post-traumatic stress disorder, i.e. overexcitement and tension, avoidance and intrusion. Participants learn social-emotional skills to deal with these symptoms. They practice recognising and managing the increase in their stress level early on, they reflect on their leisure activities and sleeping habits, they learn ways to deal with worry, fear and anger and to control recurrent images (flashbacks). The trainings are conducted by native-speaking trainers. The project is funded by the Federal Ministry for Europe, Integration and Foreign Affairs, the Federal Ministry of Labour, Social Affairs, Health and Consumer Protection, Gesundheit Österrreich GmbH and Fonds Gesundes Österreich.
Mindbase by the City/Province of Vienna
The digital platform and app offers tested and effective programmes to support people in promoting their mental health. All offers are free of charge.