Manpower requirements for medical doctors in psychiatric departments of community hospitals-bottom-up calculation for the psychiatric department of Donauspital in Vienna

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. 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. 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. Severely ill psychiatric patients seem to be undertreated because of low staffing of psychiatric departments.