[The amendment to Austria's medical training regulation permitting continued care by child and adolescent psychiatrists after reaching legal adulthood: a qualitative study on professional attitudes and clinical practice].

Abstract

Background: Adolescents with mental health conditions need stable care structures during their transition to adulthood. The traditionally mandated transfer from child and adolescent psychiatry to adult psychiatric care at the age of 18 does not satisfy this need. A new amendment to the medical training regulations (Ärztinnen/Ärzte-Ausbildungsordnung), effective May 15, 2024, now officially allows child and adolescent psychiatrists (CAPs) in Austria to continue treatment after their patients reach legal adulthood. This study is the first to analyze CAPs' assessments of the amendment and aims to document initial effects on care provision.

Methodology: Semi-structured interviews were conducted with 16 child and adolescent psychiatrists (CAPs) working in various settings. Data analysis was performed using Reflexive Thematic Analysis.

Results: The study shows that the amendment was introduced unexpectedly for many CAPs, with some private practitioners expressing frustration over the lack of preparation time. Despite this, the reform was largely welcomed and even considered overdue by some. However, given the high patient load, many CAPs still allocate their limited resources to minors, leaving the amendment's impact minimal. In the inpatient sector, persistent shortages of beds have also hindered any substantial changes.

Conclusions: While the amendment receives substantive approval from the interviewed CAPs, existing resource constraints in both inpatient and outpatient sectors prevent the realization of its potential. The improvements in psychiatric care for transition-age patients intended by the amendment will likely not materialize without capacity expansion.