Kadoya Mitsuo
Seishin Shinkeigaku Zasshi. 2003;105(7):884-7.
While the rest of the world has experienced or completed deinstitutionalization in the turn of the century, Japan has not come up with a clear plan to decrease mental hospital beds. There are 330,000 people in hospitals, and at least 1/3 of them for social reasons. Japanese hospital-centered policy has been enrooted on paternalism that hospitals are responsible for the care of the severely mentally ill. Enactment of Mental Health and Welfare Act in 1995 was epoque making because this law is provided an opportunity for people with psychiatric disabilities to live in the community with support services. With this act, Central government has introduced care guidelines how to coordinate services by care managers in each municipalities in 2002. It is important to address that this new treatment model be based on individual's need and support given to improve an individual's quality of life in the community.
当世界其他地区在世纪之交经历或完成了非机构化时，日本却没有出台明确的减少精神病院病床数量的计划。医院里有33万人，其中至少三分之一是出于社会原因住院的。日本以医院为中心的政策深深植根于家长式作风，即医院负责照顾重症精神病患者。1995年《精神健康与福利法》的颁布具有划时代意义，因为该法律为精神残疾者提供了在社区中获得支持服务生活的机会。根据这项法律，中央政府于2002年出台了护理指南，指导各市政当局的护理管理人员如何协调服务。必须指出的是，这种新的治疗模式应基于个人需求，并提供支持以提高个人在社区中的生活质量。
