[Treatment of psychiatric patients with serious physical co-morbidity: administrative model in Tokyo].
In Japan, treatment of physical co-morbidity among psychiatric patients has been difficult in many aspects. Conflicts frequently arise when referrals are made from mental hospitals to general hospitals for many reasons, such as prejudice, lack of psychiatrists, and lack of psychiatric beds in general hospitals. Tokyo Metropolitan District, with over 12 million people in population, has suffered this problem, consequently leading to an establishment of a government-involved referral system in 1981. The government mediates between mental hospitals and designated treatment centers so that smooth transfers are made. After two decades of operation, the number of transferred patients via the system is on the increase. While this system still has many problems to be solved, it may become a model administrative system for other governments to apply and provide hints for effective treatment of med/psych cases.
Department of Psychiatry, Tachikawa Hospital.
Jun
J
Shigemura
Soichiro
S
Nomura
Hideki
H
Uemura
D015897:Comorbidity; D006769:Hospitals, General / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D010360:Patient Transfer / Q000458:organization & administration; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000458:organization & administration; D014041:Tokyo / Q000453:epidemiology