Consortium PSYCHIATRICUMConsortium PSYCHIATRICUMConsortium PSYCHIATRICUM2712-76722713-2919Eco-Vector19910.17816/CP199SPECIAL ARTICLEСПЕЦИАЛЬНАЯ СТАТЬЯReview ArticleRecent Developments in Community-Based Mental Health Care in Japan: A Narrative ReviewПоследние достижения амбулаторной психиатрической помощи в Японии: нарративный обзорhttps://orcid.org/0000-0002-1730-409XIwataniJunИватаниДзюн
Japan

MD, PhD, Visiting associate professor, Department of Psychiatry

jun.iwatani.rd@gmail.comItoJunichiroИтоДзюнъитиро
Japan

MD, PhD, Director

junichiro11@gmail.comTaguchiYukikoТагучиЮкико
Japan

MA, Staff psychologist, Department of Neuropsychiatry

yukiko.taguchi.mt@east.ntt.co.jphttps://orcid.org/0000-0001-7434-3100AkiyamaTsuyoshiАкиямаЦуёси
Japan

MD, PhD, Director, Department of Quality Improvement

akiyama@east.ntt.co.jpTokyo Medical UniversityТокийский медицинский университетMental-health Clinic Si Può FareКлиника психического здоровья Си По ФэйрNTT Medical Center TokyoМедицинский центр NTT16122022281220223463743006202205122022Copyright ©; 2022, Eco-VectorCopyright ©; 2022, Эко-Вектор2022Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by/4.0https://consortium-psy.com/jour/article/view/199

BACKGROUND: Since the 1950s, mental health care in Japan has been hospital-centered. A set of legislative initiatives were undertaken in 1995, emphasizing the importance of community-based mental health care. However, despite these attempts to develop a community-based mental health care system, the rate of inpatient-based treatment has remained high and the shift from hospital-centered care to community-based has still not fully materialized.

AIM: This study aims to conduct a review of the available literature on the development of community-based mental health care in Japan between 2010 and 2020.

METHODS: We conducted a standardized literature search in the electronic database Igaku Chuo Zasshi, aiming to identify original studies published between 2010 and 2020 that explored community mental health care in Japan. The included studies’ outcomes were categorized as performance surveys, service user reports, service provider reports, and educational activities. A descriptive-analytical method was implemented in the current review.

RESULTS: A total of 25 studies were examined. Six studies reported surveys assessing the performance of community-based mental health care on the assertive community treatment (ACT), compulsory treatment, home-visit nursing care, physical complications, and a welfare medicine collaboration on a remote islands. Four studies investigated the perspectives of service users or their families on home-visit nursing care, social participation, community program, and legislative revision. Ten studies focused on social withdrawal, service providers perspectives on local population needs, supporting skills, care programs, and the professional growth of psychiatric social workers. Five studies focused on educational approaches for future healthcare professionals and efforts to improve mental health literacy among adolescents.

CONCLUSION: This paper provided the first comprehensive review of Japan’s community-based mental health care. Between 2010 and 2020, community mental health care in Japan evolved in many directions, with the understanding that various needs should be met. Home-visit nursing care and ACT can be considered as the most thoroughly investigated and better developed. Research that adopt rigorous methodologies such as randomized controlled trials is required if the goal is to achieve solid conclusions.

ВВЕДЕНИЕ: С 1950-х годов психиатрическая помощь в Японии была главным образом сосредоточена в стационарах. В 1995 г. в законодательство был внесен ряд изменений, которые подчеркнули важность амбулаторной психиатрической помощи. Однако, несмотря на попытки развития системы амбулаторной психиатрической помощи, уровень стационарного лечения остается высоким, а переход от больничного лечения к амбулаторному так и не осуществился в полной мере.

ЦЕЛЬ: Целью данного исследования является обзор доступной литературы, посвященной развитию амбулаторной психиатрической помощи в Японии в период с 2010 по 2020 гг.

МЕТОДЫ: Мы провели стандартизированный литературный поиск в электронной базе данных Igaku Chuo Zasshi с целью найти оригинальные исследования об амбулаторной психиатрической помощи в Японии, опубликованные в период с 2010 по 2020 гг. Результаты выбранных исследований были классифицированы как опросы эффективности, отчеты пользователей услуг, отчеты поставщиков услуг и образовательные мероприятия. В настоящем обзоре использован описательно-аналитический метод.

РЕЗУЛЬТАТЫ: Всего включено 25 исследований. В шести исследованиях сообщалось об опросах, оценивающих эффективность амбулаторной психиатрической помощи в проведении ассертивной амбулаторной терапии, принудительного лечения, сестринского ухода на дому, соматических осложнений и социально-медицинском сотрудничестве на отдаленных островах. В четырех исследованиях изучали представления потребителей услуг или их семей о сестринском уходе на дому, социализацию, общественные программы и изменения в законодательстве. Десять исследований были посвящены социальному отчуждению, представлениям поставщиков услуг о потребностях населения, навыкам обслуживания, программам ухода и профессиональному росту психиатрических социальных работников. Пять исследований были посвящены подходам к обучению будущих медицинских работников и мерам по повышению грамотности подростков в вопросах психического здоровья.

ЗАКЛЮЧЕНИЕ: В данной статье представлен первый всеобъемлющий обзор амбулаторной психиатрической помощи в Японии. В период с 2010 по 2020 гг. в Японии наблюдалось развитие амбулаторной психиатрической помощи во многих областях благодаря растущему пониманию необходимости удовлетворения существующей потребности. Наиболее изученными и разработанными видами помощи можно считать сестринский уход на дому и ассертивную амбулаторную терапию (AАT). Исследования, в которых используется строгая методология, такая как рандомизированные контролируемые испытания, необходимы, если целью является получение надежных выводов.

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