In November 2010, a report on implementation of the Medical Treatment and Supervision Act was submitted to the Diet, as provided for in the law. However, the report did not sufficiently describe conditions surrounding actual applications of the law, and subsequently the legal affairs committee of the Japanese Society of Neurology and Psychiatry carried out a survey regarding several items not covered in the report. Survey targets were 28 hospitals treating inpatients under the Medical Treatment and Supervision Act (Part 1), and the Ministry of Health, Labour and Welfare (Part 2). Part 1 comprised three items: 1) rulings to dismiss petitions for discharge; 2) rulings to dismiss petitions for continued hospitalization; and 3) rehospitalization under the Medical Treatment and Supervision Act. Survey results showed that, of 16 rulings against petitions for discharge, only two were considered reasonable by the hospitalizing institution. This offers an excellent opportunity to examine the remaining cases in detail and highlight problems related to the law, such as the issue of social hospitalization and questions regarding differences in diagnosis and risk assessment.
Of 17 cases of rehospitalization under the Medical Treatment and Supervision Act, eight cases were deemed to involve some mistakes or deficiencies in treatment during the initial hospitalization. It is important to examine details of treatment during initial hospitalization, and treatment and support provided after initial discharge, in these cases, as well.
The survey sent to the Ministry of Health, Labour and Welfare consisted of 17 items, but responses were received for only three items: 1) checks and collections of reports; 2) the detailed contents of requests in 79 cases where improvements in treatment were requested; and 3) the details of 19 cases where patients were transferred to other medical facilities from hospitals covered by this law. However, the present survey by itself does not reveal the full details of even the three items for which responses were received, highlighting the importance of increased disclosure of actual applications of this law in the future.
<Authors' abstract>
Actual Applications of the Medical Treatment and Supervision Act: A Survey of Hospitals and the Ministry of Health, Labour and Welfare
1 Mental Health and Welfare Center, Okayama City
2 Chiseikai Kanasugi Clinic
3 Tama Chuou Hospital
4 Japanese Red Cross Kitami Hospital
5 Kofu Hospital of Hyogo Prefecture
6 Department of Psychiatry, Kyoto University Hospital
7 National Hospital Organization Sendai Medical Center
8 Shakujii Cocolo-no Clinic
9 Social Welfare Foundation Sakuragaoka Memorial Hospital
10 Tengai Mental Clinic
11 Department of Psychopathology, Faculty of Medicine, Gifu University
12 Graduate School of Environmental and Life Science, Okayama University
13 Tama Aoba Hospital
14 Okayama Psychiatric Medical Center
15 Kumamoto Mental Health Hospital
16 Chiba Psychiatric Medical Center
17 Hamadera Hospital
18 Hoshino Clinic
19 Kashiwazaki Kousei Hospital
20 Psychiatry International University of Health and Welfare Hospital
21 Mino Clinic
22 Department of Psychiatry, Toyooka Hospital
23 Hizen Psychiatric Center
2 Chiseikai Kanasugi Clinic
3 Tama Chuou Hospital
4 Japanese Red Cross Kitami Hospital
5 Kofu Hospital of Hyogo Prefecture
6 Department of Psychiatry, Kyoto University Hospital
7 National Hospital Organization Sendai Medical Center
8 Shakujii Cocolo-no Clinic
9 Social Welfare Foundation Sakuragaoka Memorial Hospital
10 Tengai Mental Clinic
11 Department of Psychopathology, Faculty of Medicine, Gifu University
12 Graduate School of Environmental and Life Science, Okayama University
13 Tama Aoba Hospital
14 Okayama Psychiatric Medical Center
15 Kumamoto Mental Health Hospital
16 Chiba Psychiatric Medical Center
17 Hamadera Hospital
18 Hoshino Clinic
19 Kashiwazaki Kousei Hospital
20 Psychiatry International University of Health and Welfare Hospital
21 Mino Clinic
22 Department of Psychiatry, Toyooka Hospital
23 Hizen Psychiatric Center
Psychiatria et Neurologia Japonica
116: 458-474, 2014
Accepted in revised form: 1 March 2014.
Accepted in revised form: 1 March 2014.
＜Keywords：Medical Treatment and Supervision Act, Diet report, actual conditions, rehospitalization, ruling of dismissal＞
