The Act on Mental Health and Welfare for the Mentally Disabled was partially amended during the 183rd ordinary session of the Diet, on June 13, 2013. The revision abolished the system of guardianship that had long imposed conflicting roles on families of people with mental disorders. Various issues and concerns remain, however, including the requirement that consent for hospitalization be provided by a family member.
Many people who need involuntary hospitalization find themselves in situations where it is difficult to continue living in the community. At the time of hospital admission, along with a medical examination, it is necessary to assess the patient's support system in the community and ascertain whether "hospitalization for medical care and protection" is, in fact, the only option. When hospitalization for medical care and protection is determined to be unavoidable, treatment and planning focused on early discharge and the patient's return to life in the community should be initiated immediately after hospitalization.
Actual patient outcomes clearly indicate that early discharge is often the result when medical institutions collaborate and network with multidisciplinary teams and community support workers immediately after hospitalization. It is hoped that the amended law will have a practical impact that will result in similar outcomes throughout the nation in the future. At the same time, it is crucial to expand staffing in medical institutions, foster a culture of team treatment, and promote the creation of better community mental health systems that include housing, social resources, and family support.
<Author's abstract>
Advocacy and Early Discharge under the New System of Hospitalization for Medical Care and Protection
Japanese Association of Psychiatric Social Workers
Psychiatria et Neurologia Japonica
116: 302-308, 2014
<Keywords:early discharge support, culture of team treatment, community mental health system, closing inter-municipality gaps>