Tohyama T, Yamashita N
Department of Hygiene, Nara Medical University.
Nihon Koshu Eisei Zasshi. 1993 Nov;40(11):1062-8.
Compared to other advanced countries, the field of mental health in Japan is characterized by a large hospitalized to general population ratio and a long mean hospitalization period. This is in large part attributable to the lack of appropriate housing as well as occupational recreational centers after discharge. At the same time the education of psychiatric medical staff has focused on the hospital environment, with little attention devoted to training at centers of community mental health. This hospital-dominant approach has been difficult to shed, and has persisted since the WHO report of Dr. Clark in 1968. Paralleling the introduction of the certified doctor system, at the Japanese Society of Psychiatry and Neurology recently, the manner of postgraduate training for psychiatrists and attempts to reform it were debated. In the midst of this debate, a consensus has emerged that study of community mental health is one of the minimum requirements to become a full-fledged psychiatrist. However, no adequate community mental health training programs have been established at any institution. At Nara Medical University hospitals, considerable weight has been placed on community mental health training, with such a training program designed and put into practice. In the present report, this training program is introduced and interim results reported, and the problems associated with community mental health training are discussed.
与其他发达国家相比，日本心理健康领域的特点是住院人数与总人口的比例较高，平均住院时间较长。这在很大程度上归因于出院后缺乏合适的住房以及职业娱乐中心。与此同时，精神科医务人员的教育侧重于医院环境，很少关注社区心理健康中心的培训。这种以医院为主导的方式很难摆脱，自1968年克拉克博士的世界卫生组织报告以来一直持续。随着认证医生制度的引入，最近在日本精神神经学会，对精神科医生的研究生培训方式及其改革尝试进行了辩论。在这场辩论中，已达成共识，即社区心理健康研究是成为一名合格精神科医生的最低要求之一。然而，任何机构都尚未建立足够的社区心理健康培训项目。在奈良医科大学医院，社区心理健康培训受到了相当重视，设计并实施了这样一个培训项目。在本报告中，介绍了该培训项目并报告了中期结果，同时讨论了与社区心理健康培训相关的问题。
