To further develop community psychiatry in Japan, there first needs to be an ability to generate an appreciation about mental health among the general public and to obtain the support of society. Second, strong networks need to be established among public health centers, welfare bureaus, and consultation offices for children, and crisis intervention needs to be provided. Third, a good working relationship must be developed with public health nurses, who regularly visit homes where there are potential health problems, and they must be helped to remedy those problems. Fourth, and most important, psychiatric hospitals should not isolate themselves from the rest of society. Psychiatric hospitals must be open, so that residents in the community will feel comfortable about admission to one.
While public education and public understanding about mental illness are fostered, the country also needs to develop a variety of facilities: day-care and night-care services, supported dormitories, other halfway houses, sheltered workshops for vocational opportunities, and other appropriate programs. With a variety of facilities and services, people with mental disabilities will be able to try, according to their ability, to adapt to a new environment and eventually participate in society as independent individuals. However, psychiatric hospitals should continue to offer prompt medical intervention, if necessary, so as not to arouse unnecessary misgivings in the community.
Given their far-reaching value, rehabilitation services of the mentally ill should not be at the sole expense of psychiatric hospitals. Today, Japan needs a community psychiatry system suitable for its culture and its social needs. Japan also needs a policy that does not impose a financial burden on those willing to undertake community psychiatry. Without registration for financial support to cover almost-inevitable deficits incurred by rehabilitation services for former patients, and with the social stigma still remaining in this society, hospitals have been forced to withdraw from rehabilitation services in some cases.
The Mental Health Law provides that the national, prefectural, and local governments shall endeavor to enable mentally disordered persons to adapt themselves to social life by expanding and improving the facilities needed for medical care, social rehabilitation, and other welfare purposes and education. But there is still no remarkable change to be found in the social rehabilitation of mentally disordered persons. Requests need to be made for more subsidies and legal support to promote the rehabilitation and community care of mentally ill people in Japan.
Asai K., Takahashi T., & Tsung-yi L. ( 1991). The mental hospital as a base for community mental health in Asian cultures. Tokyo: Keimei Publishing.
Ministry of Health and Welfare. ( 1988a). The mental health law. Tokyo: Koken Shuppan.