Supporting children who have parents with mental disorders in Tyrol A mapping of existing Tyrolean support and societal structures Final report LBI-HTA Projektbericht Nr.: 113a ISSN: 1992-0488 ISSN-online: 1992-0496 Supporting children who have parents with mental disorders in Tyrol A mapping of existing Tyrolean support and societal structures Final report Vienna, October 2018 Projektteam Management: Dr. Ingrid Zechmeister-Koss, MA; Ludwig Boltzmann Institute for Health Technology Assessment, Vienna Authors: Dr. Ingrid Zechmeister-Koss, MA; Ludwig Boltzmann Institute for Health Technology Assessment, Vienna, Dr. Melinda Goodyear, PhD, MBSc; Monash University Melbourne Additional contribution External review: Mag. Getrud Gaugg, Abteilung Kinder- und Jugendhilfe, Amt der Tiroler Landesregierung; Dr. Karl Stieg, Psychiatriekoordination, Amt der Tiroler Landesregierung Internal review: Dr. Jean Paul, PhD, BASc, BSc (Hons) (Mental Health Research Programme/ Ludwig Boltzmann Gesellschaft/Vienna; Medical University of Innsbruck/Innsbruck; Austria), Diplom-Kffr. Annette Bauer, MSc (London School of Economics/London/UK), Univ. Prof. Dr. Hanna Christiansen, PhD (Philipps University/Marburg/Germany), Dr. Batool Fatima, Dr.PH, PMDCP, MA (Aga Khan University/Karachi/ Pakistan), Dr. Ingunn Olea Lund, PhD (The Norwegian Institute of Public Health/Oslo/Norway) This report is based on the project ‘The Village’ (http://village.lbg.ac.at) which is part of the Mental Health Research Programme of the Ludwig Boltzmann Gesellschaft GmbH, Vienna hosted by the Medical University of Innsbruck and funded by the Austrian Federal Ministry of Education, Science and Research Correspondence: Ingrid Zechmeister-Koss; [email protected] This report should be referenced as follows: Zechmeister-Koss, I., Goodyear, M. Supporting children who have mentally ill parents in Tyrol: A mapping of existing support structures and epidemiological dimensions. LBI-HTA Projektbericht Nr.: 113a; 2018. Wien: Ludwig Boltzmann Institut für Health Technology Assessment. Conflict of interest All authors declare no conflict of interest in sense of the ‘Uniform Requirements of Manuscripts Statement of Medical Journal Editors’ (www.icmje.org). Acknowledgement We would like to thank all the Tyrolean experts who provided a lot of valuable data and information on Tyrolean support systems and Rosanna Buchauer, Julia Kapferer and Anna-Elena Pinggera from the village team for their effort on visualising services on geographical maps. IMPRESSUM Media Owner and Publisher: Ludwig Boltzmann Gesellschaft GmbH Nußdorferstr. 64, 6 Stock, A-1090 Wien https://hta.lbg.ac.at/page/imprint Responsible for Content: Ludwig Boltzmann Institut für Health Technology Assessment (LBI-HTA) Garnisongasse 7/20, A-1090 Wien https://hta.lbg.ac.at/ Die HTA-Projektberichte erscheinen unregelmäßig und dienen der Veröffentlichung der Forschungsergebnisse des Ludwig Boltzmann Instituts für Health Technology Assessment. Die HTA-Projektberichte erscheinen in geringer Auflage im Druck und werden über den Dokumentenserver „http://eprints.hta.lbg.ac.at„ der Öffentlichkeit zur Verfügung gestellt. LBI-HTA Projektbericht Nr.: 113a ISSN: 1992-0488 ISSN-online: 1992-0496 © 2018 LBI-HTA – Alle Rechte vorbehalten Table of Content Summary ................................................................................................................................................................ 7 Zusammenfassung ............................................................................................................................................... 9 1 Background ......................................................................................................................................................... 11 2 Aim of report and research questions ............................................................................................................. 13 3 Method ................................................................................................................................................................. 15 4 Tyrolean geography ........................................................................................................................................... 17 5 Demographic characteristics in Tyrol ............................................................................................................ 19 5.1 Population ................................................................................................................................................... 19 5.2 Households and families ............................................................................................................................ 20 6 Socio-economic characteristics in Tyrol ......................................................................................................... 23 7 Overview on the Austrian welfare system ...................................................................................................... 25 8 Healthcare system .............................................................................................................................................. 29 8.1 Overview ...................................................................................................................................................... 29 8.1.1 Organisation and governance ................................................................................................................ 29 8.1.2 Financing ................................................................................................................................................. 30 8.1.3 Physical and human resources .............................................................................................................. 31 8.1.4 Provision of care ..................................................................................................................................... 31 8.2 Healthcare services in Tyrol ...................................................................................................................... 32 8.2.1 Public health service .............................................................................................................................. 32 8.2.2 Inpatient care for acute services ........................................................................................................... 33 8.2.3 Inpatient rehabilitation care ................................................................................................................. 34 8.2.4 Outpatient care ....................................................................................................................................... 34 8.2.5 Mobile services ........................................................................................................................................ 34 8.2.6 Additional services and projects ........................................................................................................... 34 8.2.7 Registered physicians and midwifes .................................................................................................... 35 9 Social care system ............................................................................................................................................... 37 9.1 Overview ...................................................................................................................................................... 37 9.1.1 Organisation and governance ................................................................................................................ 37 9.1.2 Financing ................................................................................................................................................. 37 9.2 Social services of potential relevance for COPMI and their families in Tyrol ...................................... 38 9.2.1 Services within the social affairs field .................................................................................................. 38 9.2.2 Services within the field of child and youth welfare .......................................................................... 39 9.2.3 Health promotion and early childhood interventions........................................................................ 42 9.2.4 Employment related services ................................................................................................................ 44 9.3 Cash benefits ............................................................................................................................................... 44 9.3.1 Family allowance (Familienbeihilfe) ................................................................................................... 46 9.3.2 Maternity allowance (Wochengeld) ..................................................................................................... 46 9.3.3 Family time bonus (Familienzeitbonus) ............................................................................................. 46 9.3.4 Child care allowance (Kinderbetreuungsgeld) ................................................................................... 47 9.3.5 Means-tested minimum income scheme (Bedarfsorientierte Mindestsicherung) ......................... 48 9.3.6 Specific cash benefits for families in Tyrol ......................................................................................... 50 LBI-HTA | 2018 3 Supporting