[What kinds of skills are needed to develop the outreach services in the context of community-based mental health?].

Outreach services in the context of a policy, "from hospital based to community based", are intended to know more about community living situation of patients, and provide supports so that they can bring their life back as citizens. Therefore, these outreach services are completely different from traditional monitoring based outreach services. These supports require skills which are different from those in psychiatric hospitals. Those differences would be visible in terms of skills because staff will be exposed to "life" of patients. Furthermore, those differences in skills would come up from necessity of facing negative feeling of people who receive outreach services often have toward medical care and support. Based on this standpoint, the author proposed tentative plan which divided necessary skills for outreach into five phases from the viewpoint of the training as follows: Level 1: Shifting perspectives from illness management to community living based, Level 2: Knowing their living situations and strengths. Building trusting relationship as staying present to the person. Level 3: Staying on top of skills in strength model, case management, and psychoeducation. Level 4: Being able to work in a team setting smoothly. Level 5: Even if the paternalism is necessary in the particular situation, staff needs to be able to face that situation without escaping. In addition, the author called the attitude of psychiatric facilities toward community psychiatry as "regionalization" and divided "regionalization" into six stages while showing necessary skills for each stage.