Four speakers including a psychiatrist, a pharmacist, and psychiatric social workers presented their experience and opinion about community mental health. It was very exciting meeting.
There are many patients suffering mental disorders in Japan. It is estimated that there are 1 million schizophrenic patients, of which a fifth are hospitalized.
Japan is infamous that long-term inpatient care is frequently adopted to psychiatric patients. The majority of inpatients has been in the hospital for more than ten years. This fact is criticized from the view of community mental health.
Actually, acute psychiatric treatment is not bad in Japan. Most of the patients who were forced to be hospitalized can be discharged within some months. But a few patients fail to return to the community. In addition, many inpatients have no home, no family, no friends in the community.
How can we move them out from the hospital?
A speaker emphasized that maximum level of support was necessary to aid their discharge in complicated patients. The supporters visit the home of the patient twice or even three times in a day. Every meal is delivered to the home. If the patient disappeared, the workers in the hospital, officials in the local health center, and the police are collaborated to search him. After several months of the early life in the community, most patients, even with extremely severe psychotic symptoms, become less vulnerable. And they will be able to live without maximized support.
A group home owner told that psychiatrists tend to overestimate psychotic symptoms of the patients. Some patients can get along with others even they are suffering from serious hallucination and delusion. Instead, violent patients easily fail to live in a group home. However, psychiatrists working in the hospital often reject to hospitalize aggressive patients. It is irrational, according to him.
Nowadays, psychiatric medication is so developed that many patients can recover from the seriously ill mental state. On the other hand, the power to accept them as a member of the community is still developing in Japan. We have to share the risk of the patients. A speaker showed an example in which a patient with schizophrenia became an owner of a group home. He had managed the accommodation for seven years. Unfortunately, the group home had to be closed, finally. Nonetheless, this fact suggests patients with mental disorders can become not only the receiver but also a provider of community care.
Listening to the presentations, I was encouraged very much. Now, I have to reconsider the contents of my current work, to improve the performance regarding supporting the patients.
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