title: How can a change in the operating system of the mental health review board promote the discharge of long-term hospitalized psychiatric patients? A case study of Seoul city.
abstract: BACKGROUND
  One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers' awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak.
  
  
  METHODS
  The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies.
  
  
  CONCLUSIONS
  Any policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers' acceptance and so on.
  
  
  CONCLUSIONS
  Despite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies' recommendations are essential.
authors.affiliation: Seoul Mental Health Center, Seoul, Republic of Korea ; Yongin Mental Hospital, Yongin, Republic of Korea ; Seoul Mental Health Center/Yongin Mental Hospital, 6 Bongeunsa-ro 21gil, Gangnam-gu, Seoul 135-545, Republic of Korea.
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Seoul Mental Health Center, Seoul, Republic of Korea.
authors.forename: Hee-Young
authors.initials: HY
authors.lastname: Lim
authors.affiliation: Suji-Yonsei Psychiatric Clinic, Yongin, Republic of Korea.
authors.forename: Youngki
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Yongin Mental Hospital, Yongin, Republic of Korea.
authors.forename: Yong-Suk
authors.initials: YS
authors.lastname: Lee
keywords: Discharge order rate; Length of hospital stay; Mental Health Review Board
references.citation: Int J Ment Health Syst. 2014 Jan 17;8(1):4
references.pmid: 24433522