(Vienna, 26 January 2026) As part of the WWTF-funded STREAMLINE project, the scientific team led by Judit Simon, Professor of Health Economics at MedUni Vienna, has conducted the first comprehensive analysis of the provision, utilisation and costs of mental health services in Vienna. The results reveal structural imbalances in the provision of care, regional differences in utilisation and a lack of transparency regarding the actual costs of individual services.
In the first step of the project, which was launched in 2023, all available services for people with mental health conditions in Vienna were systematically surveyed and analysed. A total of 368 organisations and around 6,900 individual service providers were identified, including psychotherapists, psychologists and psychiatrists. The majority of services are outpatient services involving direct contact, i.e. treatment without hospitalisation. Specialised services for specific age groups or clearly defined target groups are comparatively rare. "It is also striking that individual service providers are heavily concentrated in inner-city districts, while peripheral districts are significantly less well served," reports principal investigator Judit Simon, head of the Department of Health Economics at the Center for Public Health at MedUni Vienna. In the case of specialists in psychiatry, elective doctors predominate, whose services must initially be paid for privately, which can make access even more difficult.
Significant regional differences in supply and use
Based on Austria-wide administrative data, the study also examined how the use of mental health services developed between 2018 and 2023. "This reveals significant regional differences that cannot be explained solely by age or population structure," says co-principal investigator Michael Berger (Department of Health Economics, Center for Public Health, MedUni Vienna). While the prescription of so-called psychotropic drugs – medicines that act on the central nervous system and influence the psyche – declined slightly among adults, it increased among children and adolescents during the same period.
The analyses also reveal that utilisation depends heavily on the services available in the district of residence. A higher density of registered psychiatrists is associated with shorter hospital stays, but also with more medication-based treatment. In Vienna, there is a disparity between areas with higher treatment needs and the actual distribution of service providers, especially in the outer districts.
Empirical basis for planning and managing care
In addition, reference costs for selected services in the field of mental illness were calculated for the first time. Reference costs describe the average actual costs of a service based on the personnel, infrastructure and other resources used, and thus differ from mere tariff or reimbursement rates. A total of 20 such reference costs were determined for services in the health, social and justice sectors, as well as for informal support services. "Our results show that existing tariffs do not always reflect the actual costs of service provision," points out co-principal investigator Susanne Mayer (Department of Health Economics, Center for Public Health, MedUni Vienna). At the same time, it became clear that missing or difficult-to-access cost data complicates health policy planning.
"Overall, our analyses show that reliable, harmonised and publicly accessible information on services, usage and costs is a key prerequisite for needs-based planning and management of mental health care. The STREAMLINE results provide a new empirical basis for this and highlight where existing structures make access to services difficult or are regionally unbalanced," says Judit Simon, summarising the significance of the analyses, which was conducted in collaboration with the Austrian Institute for Health Technology Assessment (AIHTA), the Austrian National Public Health Institute (GÖG) and the University of Loyola.