title: [How should be a psychiatric hospital to take in and utilize the psycho-social approaches in Japan? -- From the view point of psychiatry, medical model, medical system and economical management system].
abstract: The author developed argument that a cause of the present condition of our country, in which psycho-social approaches have not fully spread though its clinical efficacy has been well recognized, is in the medical institution side. Because, our psychiatric reforms over 17 years, that reduced the average duration of hospitalization from about 2156 days to 61 days, has attained by deployment of various psycho-social approaches based on "therapeutic community model" and "psychodynamic team treatment". Furthermore, it has done by the affinity, continuity and complementarities of "psychodynamic team treatment" and psychosocial approaches with following special features. That is, since psycho-social approaches is 1. techniques to acquire the social life skill and to prevent re-hospitalization, 2. the group psychotherapy by facilitating the patient's mutual help capability, 3. based on "acceptance of the disease" by "noticing the diagnosis". Even if the therapeutic orientation or assumption of the psychiatric hospital does not comprehend above all of 1-3, it is important whether it is in the same direction or not. In other words, it is the issue of the medical-economical-management system, medical model and also the kind of psychiatry that is the source of them. Our hospital is for short term hospitalization and in focus on the outpatient treatment with "psychodynamic team treatment" based on "therapeutic community model". That is why our hospital has a potential advantage to take in and utilize the psycho-social approaches. On the other hand, there is the same reason why it is difficult for the traditional psychiatric hospital for long term hospitalization with higher hierarchical "physical medicine model" based on the descriptive psychiatry. The further problem is that both psychiatric hospital staff and psycho-social therapists do not realize it. The most important issue for us is having the recognition and exploring the method not to adapt to a psychiatric hospital but to improve and spread psycho-social approaches to psychiatric hospital.
authors.affiliation: Regal Cooperation of Medical Services Communauté Vent et Arc. Nozoe Hospital.
authors.forename: Kohei
authors.initials: K
authors.lastname: Horikawa
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Horikawa
mesh_terms: D004469:Economics, Hospital; D006778:Hospitals, Psychiatric / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D007564:Japan; D001523:Mental Disorders / Q000534:rehabilitation*; D011613:Psychotherapy / Q000379:methods*