At the National Child and Adolescent Psychiatry Service of the Robert Schuman Hospital in Kirchberg, adolescents aged 13 to 18 receive treatment. The facility currently offers 30 inpatient beds.
Last week, following a knife attack in Limpertsberg in which one girl injured another, the public prosecutor’s office renewed its warning that Luxembourg lacks sufficient capacity in youth psychiatry, both inpatient and outpatient. The Minister of Health and Social Security Martine Deprez has also responded to the concerns raised by the public prosecutor.
In an interview with RTL, child and adolescent psychiatrist Dr Gerhard Ristow explained that demand for these services closely follows the rhythm of the school year.
He noted that activity tends to calm during and just before school holidays, but increases sharply once classes resume and academic pressure builds. At certain times, the service reaches its limits, he said. Young people who do not require urgent inpatient care, such as those suffering from anxiety disorders, may then be placed on waiting lists.
Between 2020 and 2025, the number of inpatients in child and adolescent psychiatry rose from 362 to 457, an increase of 26%. Dr Ristow stated that the number of inpatient beds is now being expanded, with capacity expected to grow from 30 to 45 beds in the near future. In terms of inpatient psychiatric care, Luxembourg would then be relatively well equipped, he said.
However, Dr Ristow stressed that the real shortfall in the country lies elsewhere, in the lack of secure closed facilities. He said that at the Closed Unit for Juveniles (UNISEC), the unit for young offenders, there are currently just 12 places available, with plans to increase this to 30 by 2030.
Beyond psychiatric treatment, Dr Ristow argued that the country also needs secure pedagogical structures for adolescents who repeatedly run away. He described these as young people who may not necessarily have a psychiatric disorder but who exhibit problematic behaviour by repeatedly running away from educational supervision, a challenge faced by many residential care homes. Luxembourg currently has no such dedicated facilities, he said.
He also identified a third group in need of closed structures: young people who pose a risk to themselves. According to Dr Ristow, separate facilities should be created for these three distinct groups. Many such cases are primarily psychosocial rather than psychiatric, yet they are often referred to child and adolescent psychiatry, where they occupy beds that should be reserved for clinical patients, he said.
Dr Ristow further questioned whether the National Child Psychiatry Service at the Paediatric Clinic in the Hospital Centre of Luxembourg (CHL), which currently has between eight and ten inpatient beds, can meet demand. Based on his previous experience in Germany, he considers this number far too low.
Before 2009, in Mannheim, a city of around 500,000 inhabitants, there were 24 inpatient beds in child psychiatry, he said. A shortage of places, Dr Ristow warned, can lead to problems being left untreated, an issue that Luxembourg is already facing.
Asked whether the freezing of medical tariffs this year could make it harder to attract child and adolescent psychiatrists to Luxembourg, Dr Ristow said he personally still finds working in the country very appealing. Last week, Dr Serge Allard, President of the Luxembourg Paediatric Society, had suggested that such measures would hardly help attract more psychiatrists.
Dr Ristow highlighted that Luxembourg’s model, which consists of allowing doctors to work independently within a hospital setting, does not exist in the same way in Germany. He also considers the financial conditions attractive. When he worked as a junior doctor in Germany in 2009, he earned €4,500 per month, he said.
Dr Ristow acknowledged, however, that income remains one of the few strong incentives Luxembourg can offer to attract colleagues from abroad. Some doctors are reluctant to move abroad altogether, while for others, quality of life and leisure opportunities are decisive factors, he said. Perhaps Luxembourg could further improve its attractiveness in that regard, he added with a smile.
