Peter Fischer1,2, Sören Hanak3, Beate Wally3, Martin Aigner4,5. 1. Department für Psychiatrie, Forschungsgesellschaft Donaustadt, Langobardenstraße 122, 1220, Wien, Österreich. p.fischer@wienkav.at. 2. Arbeitsgruppe Psychiatrie im Allgemeinkrankenhaus, Österreichische Gesellschaft für Psychiatrie und Psychotherapie, Wien, Österreich. p.fischer@wienkav.at. 3. Department für Psychiatrie, Forschungsgesellschaft Donaustadt, Langobardenstraße 122, 1220, Wien, Österreich. 4. Arbeitsgruppe Psychiatrie im Allgemeinkrankenhaus, Österreichische Gesellschaft für Psychiatrie und Psychotherapie, Wien, Österreich. 5. Abteilung für Erwachsenenpsychiatrie, Universitätsklinikum Tulln, Tulln an der Donau, Niederösterreich, Österreich.
Abstract
BACKGROUND: Clinical psychiatry changed dramatically in the past 30 years. Clinical challenges are very different from those in old mental hospitals. Psychotherapy and sociotherapy are effective but very time-consuming parts of treatments of nearly every psychiatric disorder. Planning of staff resources based on the German "Psychiatrie Personalverordnung" does not match with modern quality requirements. As a result, the standards of evidence-based treatment cannot be offered to severely mentally ill inpatients. METHODS: We carried out a buttom-up calculation of medical staffing for the concrete patients considering diagnosis, and length of stay of the psychiatric department of the Danube hospital in Vienna 2013 and 2014. This is an 80 bed unit responsible for an area of 250,000 inhabitants, providing about 1100 admissions each year. RESULTS: The calculated yearly sum of working hours for medical doctors in the particular department was 39,527. When considering a net working-time of 80%, the actual number of medical staff should be at least doubled to allow psychiatric treatment according to current guidelines. CONCLUSIONS: Severely ill psychiatric patients seem to be undertreated because of low staffing of psychiatric departments.
BACKGROUND: Clinical psychiatry changed dramatically in the past 30 years. Clinical challenges are very different from those in old mental hospitals. Psychotherapy and sociotherapy are effective but very time-consuming parts of treatments of nearly every psychiatric disorder. Planning of staff resources based on the German "Psychiatrie Personalverordnung" does not match with modern quality requirements. As a result, the standards of evidence-based treatment cannot be offered to severely mentally ill inpatients. METHODS: We carried out a buttom-up calculation of medical staffing for the concrete patients considering diagnosis, and length of stay of the psychiatric department of the Danube hospital in Vienna 2013 and 2014. This is an 80 bed unit responsible for an area of 250,000 inhabitants, providing about 1100 admissions each year. RESULTS: The calculated yearly sum of working hours for medical doctors in the particular department was 39,527. When considering a net working-time of 80%, the actual number of medical staff should be at least doubled to allow psychiatric treatment according to current guidelines. CONCLUSIONS: Severely ill psychiatricpatients seem to be undertreated because of low staffing of psychiatric departments.
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