Evaluation of Everyday Living Areas for Deinstitutionalized Community-Living People with Mental Illness

Abstract

Deinstitutionalization of psychiatric care has been associated with increased homelessness, crime, and suicide, partly owing to insufficient, adequate, and accessible community resources. Therefore, appropriate resource placement is a key deinstitutionalization issue. The study’s aim was to identify residential group homes for people with mental illness in Kochi Prefecture, Japan, and the social resources necessary for social reintegration using a geographic information system (GIS). Everyday living areas (ELAs), as defined by the Japanese Community-Based Integrated Care System for People with Mental Illness (CICSM), were assessed using ELA location simulations. We used GIS to determine the spatial distribution of group homes, visiting nursing stations, psychiatric hospitals, daycare centers, and employment support offices. Following the CICSM definition of ELAs, we identified areas that people with mental illness could reach within 30 min on foot/by bicycle and counted the number of social resources in them. The ELA location simulation results suggest that policymakers should avoid uniform distribution of ELAs according to the CICSM definition. Establishing ELAs in suburban areas requires careful consideration of the available community resources, number of people with mental illness, existing support systems, and feasibility of the location.

History of Japanese psychopathology: Portraits of the second‐generation psychopathologists (Takeo Doi, Yomishi Kasahara, Hiroshi Yasunaga, Tadao Miyamoto, Bin Kimura, and Hisao Nakai) and their relationship to psychiatric reform movement in Japan

“…As noted herein, these objections spilled over into the field of psychiatry, triggering the psychiatric reform movement. Although Nakai criticized the medical faculty's system, he did not participate in the subsequent series of psychiatric reform movements because he believed that “if we examine patients with regret, even patients who could be cured might not be cured.” 62 In other words, Nakai believed that if he considered psychiatry in a negative light, he might hinder treatment.…”