[A Survey and Suggestions Regarding Prefectures' Mental Disorder Medical Care Plans].

Abstract

The Psychiatric Care and Mental Health and Welfare System Committee surveyed the contents of mental disorder medical care plans established by the 47 prefectures in Japan. Based on the "opinions of the Japanese Society of Psychiatry and Neurology Board of Directors following the official recognition of mental disorders as important diseases under the Medical Service Law's medical care plan" (September 28, 2011), investigations were conducted focusing on three aspects : locations of medical care plan discussions, public awareness of medical care information, and target values. Medical care plans of the 47 prefectures were collected. A ques- tionnaire regarding the mental disorder care plan decision process was sent to each prefecture, and answers were received from -those in charge of each jurisdiction. Among the 45 prefec- tures that responded, the mental disorder care planning groups held an average of 3 meetings. The largest number of meetings held was 7 (in 3 prefectures), and 2 meetings or fewer were held in 15 prefectures. No meeting was held in 7 prefectures. Locations in which the promotion of regional medical care cooperation regarding mental disorders was discussed were recorded by less than half of the medical care plans. The names of the medical facilities that were recorded in many of the medical care plans included various functions, such as "facilities for emergency psychiatric care" and "dementia medical centers." However, medical care functions specific to various mental disorders and medical facility names including these functions were only recorded in approximately half of the medical care plans. Regarding target values for promoting medical care plans, the vast majority of prefectures recorded that the "average in- patient discharge rates occurred in under 1 year."A relatively large number of prefectures also recorded "suicide mortality rates". and the "number of dementia medical centers" ; however, there were hardly any records concerning "rates of in-patient hospitalization for medical care and protection lasting more than 1 year." Moreover, there were few records regarding the "number of patients (per 100,000 of population) hospitalized for medical care and protection each year" and the "percentage of patients receiving care in protective room isolation." While prefectural medical care plan contents are varied, definite improvements of psychiatric care through medical care planning are finally underway. Mental disorder medical care plans based on the Medical Service Law operate together with related documents such as the guideline based on the Mental Health and Welfare Act, Article 41 ; disability welfare plans based on the Comprehensive Support for Persons with Disabilities Act ; and long-term care plans based on the Long-term Care Insurance Act. Further implementation and assessment, and continued revision based on this assessment, are needed with regard to these related plans and guidelines.