title: [Private facilities for the mentally disturbed in the Tohoku region, Japan].
abstract: OBJECTIVE
  The modernization of mental health services in Japan began in 1868 during the Meiji Restoration (restoration of imperial government from Shogun era). However, mental institutions in Japan were inadequate until the end of World War II in 1945. The Tohoku region, comprised of 6 prefectures located in northeastern Japan, experienced a delay in modernization, struggled economically, and also showed a delay in the development of mental institutions. To supplement the insufficient number of mental institutions, the Tohoku region had private institutions for the mentally disturbed. This report presents an overview of the mental and private institutions for the mentally disturbed in the Tohoku region between 1868 and 1945.
  
  
  METHODS
  We investigated mental and private institutions for mentally disturbed persons in the Tohoku region between 1868 and 1945 based on a review of the literature: Shuzo Kure: Current conditions of facilities with mental patients in Japan (1907). Shuzo Kure, Goro Kashida: Actual situation and statistical observation of home custody for mental patients (1918). Osamu Kan: Survey on mentally disturbed persons similar to mentally ill persons, and on mental illness in Japan (1937). Ministry of Health and Welfare: Report on Psychiatric Institutions (1940).
  
  
  RESULTS
  The establishment of both mental and educational institutions for clinical psychiatry was delayed by 30 years in Tohoku compared to the central part of Japan (Kyoto and Tokyo). Private institutions for the mentally disturbed were also uncommon, but the treatment of mental illness in the Tohoku region between 1968 and 1945 was mainly performed at Joge Hot Spring, Miyagi Prefecture, which was also a private institution for the mentally disturbed. (1)Miyagi Prefecture: A hotel was completed in 1864 at Joge Hot Spring, and, by 1891, many mental patients were staying at the hotel. The treatment involved bathing in the hot spring with a temperature close to the body temperature for a long period of time. Mental patients gathered from multiple prefectures in the Tohoku region. The hotel became increasingly less popular from around 1960 and closed around 2005. Tohoku Jikei-In was a private institution established in 1899 for persons who fell ill during a journey with no-one to help. It began to take in mental patients in 1905, and, at its prime, contained 18 to 19 patients. From around 1934 to around 1943, Jisho Nishikata built an institution for mental patients within Nichiren Shu Butsugenji Temple, which is a Buddhist temple. (2) Yamagata Prefecture: The Buddhist temple Kangetsuzan Myohoji Temple contained mental patients. (3) Fukushima Prefecture: In 1927, Ryokan Oe established Ryozenan at the top of Ryozen Mountain to treat mental patients by reciting sutra and prayer. The facility was closed down when abusive treatment of mental patients was revealed in 1936. There are no records regarding private institutions for mental patients in Akita, Aomori, or Iwate Prefectures.
  
  
  CONCLUSIONS
  The establishment of mental institutions in Tohoku Prefecture was delayed and the number of beds for patients was insufficient between 1868 and 1945. Private institutions played a large role in housing mental patients. Even today, the number of mental institutions in the Tohoku region is small.
authors.affiliation: Asahiyama Hospital.
authors.forename: Hitosi
authors.initials: H
authors.lastname: Kondou
mesh_terms: D001512:Bedding and Linens / Q000600:supply & distribution; D049673:History, 20th Century; D006778:Hospitals, Psychiatric / Q000266:history*; D006801:Humans; D007564:Japan; D008605:Mental Health Services / Q000266:history*; D011570:Psychiatry / Q000266:history*; D047789:World War II