Problems in the Discharge Support of the Long-Term Hospitalized Patients in Psychiatry Department in Japan

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By March 30, 2017 No Comments

Authors: Kiichiro Shinoda and Hiromi Kuwata, JAPAN

Year: 2016

Event: 2016 TheMHS Conference

Subject: Book of Proceedings 2016, conference papers, proceedings papers

Type of resource: Conference Presentations and Papers

ISBN: 978-0-9945702-1-5

Abstract: Paper from TheMHS Conference 2016 Book of Proceedings: People. Authenticity Starts in the Heart. The Conference was held in Auckland, New Zealand 23 - 26 August 2016.

There was approximately a 350,000 psychiatric bed capacity in Japan. The number of hospitalized patients at the psychiatric department was approximately 320,000 at 2008, which was larger than that found in foreign countries (Ministry of Health, Labour and Welfare) 1). Because the prolongation of the length of stay would reduce the independence l of patients and affect life after discharge, rapid discharge, sickbed reduction, and life support reinforcement have been pushed forward in foreign countries 2). The trend of deinstitutionalization and decrease in hospital bed capacity have been promoted in the United States, Italy, Australia, and Norway from 1960s through 1970s (Ministry of Health, Labour and Welfare, 2010). In Italy where mental hospitals were absent and in the United States, an area support system was already established to some extent that promoted deinstitutionalization. On the other hand, in Japan, there is a history of isolating psychiatric patients. Therefore prolongation of the hospitalization of psychiatric patients has been promoted. In Japan, prolongation of hospitalization is often associated with social hospitalization. The Ministry of Health, Labour and Welfare reported that among approximately 73,000 patients 70% are hospitalized more than one year. For such present conditions, enhancement of social support system was planned such as various focused supports or enactment of a disability independence support (it was revised to a disability total support law in 2013) based on the vision of "hospitalization care to the local life". The discharge of patients has not been promoted for a long time. About the discharge of the long-term inpatient, there was the preceding reports described in a viewpoint of the nursing intervention or about psychology of the patient side. No study which clarified problems in the discharge support of patients was found. Therefore, I interviewed patients hospitalized in psychiatry department for a long time and investigated the problems in discharge support.

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