Tagawa Seiji
Seishin Shinkeigaku Zasshi. 2016;118(9):666-672.
About half of inpatients in psychiatric hospitals in Japan are over 65 years old. Most of them are long-term inpatients with schizophrenia. The number of beds in psychiatric hospitals will probably decrease in 10-15 years. Local shift means that those long-term inpatients leave hospital and spend their lives more fully and more comfortably. Most of them are over 65 years old. However, the motivation of the government and mental hospitals to promote this local shift seems to be low. Most men- tal hospitals in Japan are private, and so such a shift may be against their interests. The gov- ernment wants to decrease the number of beds in mental hospitals due to international criti- cism and for financial reasons. But I'm afraid some may think that in 10-15 years, regardless of whether local shift goes good or bad, many long-term inpatients eventually die and beds at mental hospitals will subsequently decrease. So local shift is a 'time limited problem'. However, if many long-term inpatients leave mental hospitals, they will use mental clinics or other community-based mental health care. Also, cooperation with other agencies will be very important. If such community support fails, a revolving door phenomenon will develop.
日本精神病医院约半数住院患者年龄在65岁以上。他们大多是患有精神分裂症的长期住院患者。未来10至15年，精神病医院的床位数量可能会减少。就地安置意味着那些长期住院患者出院后能更充实、舒适地生活。他们大多超过65岁。然而，政府和精神病院推动这种就地安置的积极性似乎不高。日本大多数精神病院是私立的，所以这样的转变可能不符合它们的利益。出于国际批评和财政原因，政府希望减少精神病院的床位数量。但恐怕有人会认为，10至15年后，无论就地安置进展如何，许多长期住院患者最终会死亡，精神病院的床位随后也会减少。所以就地安置是个“有时间限制的问题”。然而，如果许多长期住院患者离开精神病院，他们将使用精神科诊所或其他社区心理健康服务。此外，与其他机构的合作将非常重要。如果这种社区支持失败，就会出现“旋转门”现象。
