The prevalence of mental illness in Austria is comparable to that of other Western countries. However, depression and suicide are slightly more prevalent. Half of patients with mental disorders do not receive medical or psychological treatment. In some areas, mental disorders are particularly underrecognised and undertreated. These include medically ill patients with psychiatric comorbidity, patients with somatic symptom disorders, elderly patients with mental health problems, and refugees with health problems. The history of psychosomatic medicine in Austria started with the ‘Studies on Hysteria’ of Breuer and Freud in 1895. This history was dramatically interrupted when the National Socialists seized power and almost all psychoanalysts were persecuted, forced to leave the country, or murdered. Psychoanalytic counselling centres were closed. After the Second World War, the development of psychosomatic outpatient clinics and counselling centres only slowly began again. In the 1970s, psychosomatic consultation liaison (C-L) services were set up in university hospitals and a few outpatient and inpatient psychosomatic treatment centres were established. Training curricula for doctors emerged in the 1980s. Diploma courses in psychosocial medicine, psychosomatic medicine, and psychotherapeutic medicine were established. These courses build on each other. In 2018, a specialisation in psychosomatic medicine was created. All doctors can acquire this specialisation in an 18-month training. Initial studies of the effects of these training courses show an improvement in participants’ skills in recognising and treating psychosomatic disorders. C-L services are now available in all major hospitals. Outpatient and inpatient psychosomatic care have also been improved.