Mino Y, Ohara H
Department of Public Health, Kochi Medical School.
Nihon Koshu Eisei Zasshi. 1991 Oct;38(10):774-82.
Psychiatric care in Japan has received criticism not only within Japan but from other parts of the world. By contrast, the services for mentally ill in England is considered to be superior and is therefore presented briefly to benefit the development of better community psychiatric care in Japan. The history of psychiatric services in England is described briefly. After World War II, deinstitutionalization has been occurring and the in-patient rate per 100,000 population which was 354 in 1954 and has decreased to 120 in 1990. Despite a decrease in the in-patient rate, the admission rate per 100,000 population has been increasing gradually during this period. Deinstitutionalization process and the development of community care services are summarized. Among these are alternative services such as primary care, day care and residential services in the community which are considered to be important elements. Problems associated with deinstitutionalization process are also discussed. In developing community care services in Japan, lessons can be learned from the success and failures of England's attempt over the last 30-years to build a better, more community-based system.
日本的精神科护理不仅在日本国内,而且在世界其他地区都受到了批评。相比之下,英国为精神疾病患者提供的服务被认为更为优越,因此在此简要介绍,以促进日本发展更好的社区精神科护理。本文简要描述了英国精神科服务的历史。第二次世界大战后,去机构化一直在进行,每10万人口的住院率在1954年为354,到1990年已降至120。尽管住院率有所下降,但在此期间,每10万人口的入院率一直在逐渐上升。总结了去机构化过程和社区护理服务的发展情况。其中包括诸如初级护理、日间护理和社区寄宿服务等替代服务,这些被认为是重要的组成部分。还讨论了与去机构化过程相关的问题。在日本发展社区护理服务时,可以从英国过去30年建立更好的、更基于社区的系统的成功与失败中吸取经验教训。