| Budget Amount *help |
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 2003: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 2002: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 2001: ¥800,000 (Direct Cost: ¥800,000)
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| Research Abstract |
1.In North America, the advocacy system for the hospitalization of mental patients is well established, and the responsibility of the government with regard to the system is clear. Health services are independently monitored by advocacy organizations in the public and private sectors. The families of patients are regarded as important stakeholders, and various community support systems are key factors in advocacy for both patients and their families. By comparison, in Japan, mental hospitals are privately established and managed ; therefore government is not deeply involved in advocacy for hospitalized mental patients. In addition, the community support system is not sufficiently established to prioritize patients' wishes to be discharged over the wishes of their families. We found the assurance of sufficient health service resources with multiple alternatives to be indispensable for the accomplishment of advocacy for patients. 2.In the United States and Europe, the provision of treatment for patients when they are discharged and start living in their communities is a major task. Some states and counties have regulations obliging patients living in communities to receive treatment. The effect of these regulations on advocacy for patients remains to be examined. 3.In the United States, a social "Recovery" model insisting that patients should not merely be passive recipients of treatment, has been part of the mental health service policies of counties and states since 1990, and, resulted in the establishment of programs for promoting active involvement of patients in their treatment. Although there have been active social movements on the part of mental health service consumers, the public and private sectors are competing for social resources after the introduction of the managed care system. The influence of market competition in the field of medical and welfare services on advocacy for consumers should be specifically analyzed.
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