[Wishes and realities: regional structures of cooperation and coordination of medical and psychosocial services for children and adolescents].

Health impairments adolescents are faced today, are mainly diseases with obvious relations to psychological and social circumstances (e.g.: allergies, chronic and psycho-physical diseases). The change of quality in the range of prevalent diseases sets limits to the classical curative medicine, in that pure medical treatment fails if it is not supported by psycho-social counselling and care. This underlines the need for enforced cooperation between health- and psycho-social care professionals. Therefore the following questions were of interest in our studies: What is the actual amount of cooperation between medical and psycho-social caregivers? Which regional and professional circumstances support willingness and abilities for cooperation? To answer these questions, practitioners in medicine, psychology and social-work in eight selected regions in West- and East-Germany were asked to answer a comprehensive questionnaire, which was offered to the complete number of relevant professional groups in the selected regions. The particular items concerning cooperation show that physicians practice an intensive cooperation among their own professional group but do rarely cooperate with psycho-social care professionals. In the same way psychologists and social-workers do rarely cooperate with physicians. The main barrier between these professional groups seems to be the structural separation between the medical and the psycho-social care-system in Germany. The use of any form of psychotherapy enforces the willingness to cooperate in both systems. The development of structures of cooperation depends on the existence of a good working "Psychosoziale Arbeitsgemeinschaft" (PSAG). In conclusion this legal organization offers a good starting point for an extension of interdisciplinary cooperation in the field of health-care and health-promotion for children and adolescents.