Notes

The medical care system in Germany is large and complex, and comprises three main areas:

1. Outpatient medical care provided by doctors in local clinics. In the context of youth cooperation, (child and youth) psychiatrists, paediatricians and gynaecologists play an important role. Other healthcare professionals in this context include therapists and non-statutory midwifery practices.
2. Inpatient care in hospitals, especially children's hospitals, socio-paediatric centres and labour wards with diverse healthcare professionals (doctors, nurses, midwives, therapists).
3. Public healthcare, here in particular the public health service including local health authorities.

Many different healthcare fields intersect with child and youth services for a wide variety of reasons:

• Starting with the area where youth services meets child and youth psychiatry. Many young people in a variety of child and youth services settings (e.g., residential care) need psychiatric care. Conflict often arises between the systems where each tries to pass on responsibility for "difficult" young people to the respective other. A further major point of intersection with child and youth psychiatry relates to the responsibility of child and youth services for integration support for children and adolescents with/at risk of psychological disability (Article 35a of Book 8 of the Social Code [SGB VIII]), which is subject to corresponding psychiatric evaluations.
• Moreover, there is a clear need to cooperate with the field of adult psychiatry, since many adults with mental health issues are also parents of children. Whilst adult psychiatry in the context of work with relatives (including children) is dependent on youth services programmes, vice versa, youth services is dependent on the support of the adult psychiatry field for evaluations of the impact of parental illness on children and, where necessary, to help structure an adequate parenting environment. Moreover, a not insubstantial number of young persons that have attained full age are under adult psychiatric care and are either supported by or should be in the care of youth services.
• Another important area for youth services is working with paediatric doctors to diagnose the effects of abuse, since they provide the knowledge required to assess whether and how danger to children/adolescents can be averted.
• Lastly, it should be noted that at the turn of the millennium a broad-based concept for early intervention services was introduced in extensive dialogue between youth services and the health authorities, which has since been formalised in the Federal Child Protection Act (Bundeskinderschutzgesetz/BKiSchG). The Act prescribes reciprocal duties of cooperation applicable to both action systems (and other actors) with respect to under-3s. The National Centre for Early Prevention was established to govern and moderate this programme. It is part of the Federal Centre for Health Education in cooperation with the German Youth Institute.

• Denner, Silvia (ed.) (2008): Soziale Arbeit mit psychisch kranken Kindern und Jugendlichen. Stuttgart.
• Kölch, Michael/Ziegenhain, Ute/Fegert, Jörg (eds.) (2014): Kinder psychisch kranker Eltern - Herausforderungen für eine interdisziplinäre Kooperation in Betreuung und Versorgung. Weinheim and Basel.
• Mall Volker/Friedmann, Anna (eds.) (2016): Frühe Hilfen in der Pädiatrie. Heidelberg.