Current status of general hospital psychiatry in Japan.
The current status of general hospital psychiatry was overviewed to clarify the progress and the stagnation. To facilitate well-organized community psychiatric care, general hospital psychiatry should play a central role in psychiatry. The policy makers of the Japanese mental health system should place a special emphasis on general hospital psychiatric beds to further process of shifting from a hospital based to a community based psychiatry system. It is also necessary that general hospital psychiatry should become more aggressively involved in community psychiatry, e.g. emergency psychiatry. Consultation-liaison (C-L) psychiatry has been quickly developed and become one of the main psychiatric fields. For further development, a multidisciplinary team approach with co-medical staffs is necessary to supply efficient and effective care to medically ill patients. A proactive model of C-L care rather than a doctors' needs model should also be considered. Well designed research evaluating the efficiency and effectiveness of C-L activities in medical settings needs to be done to increase funding to general hospital psychiatry. This research evidence would also lead to a more fully integrated general hospital psychiatry into the practice of medicine and catch up with the ongoing medical reform in Japan.
Kishi
Yasuhiro
Y
Department of Psychiatry, University of Minnesota, USA.
Hosaka
Takashi
T
Kurosawa
Hisashi
H
D003156:Community Mental Health Services; D003362:Cost-Benefit Analysis; D004632:Emergency Medical Services; D006769:Hospitals, General; D006801:Humans; D033183:Interdisciplinary Communication; D007564:Japan; D008505:Medical Staff, Hospital; D010348:Patient Care Team; D011567:Psychiatric Department, Hospital / Q000191:economics / Q000639:trends; D012017:Referral and Consultation / Q000191:economics