[The Local Shift of Long-term Inpatients and Bed Reduction as Viewed by a Mental Health Clinic].

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.