A Historical Study of Involuntary Psychiatric Hospitalization Based on Family Consent: Consent Hospitalization under the Mental Hygiene Act

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K02233
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 08020:Social welfare-related
• Research Institution: Ritsumeikan University
• Principal Investigator: GOTO Motoyuki 立命館大学, 先端総合学術研究科, 講師 (70722396)
• Co-Investigator(Kenkyū-buntansha): 黒木 俊秀 九州大学, 人間環境学研究院, 教授 (60215093) ; 本村 啓介 独立行政法人国立病院機構さいがた医療センター(臨床研究部), 臨床研究部, 精神科診療部長 (60432944) ; 久保田 明子 広島大学, 原爆放射線医科学研究所, 助教 (40767589)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 肥前療養所 / 開放医療（開放管理） / 自由入院 / 閉鎖病棟 / 精神衛生法 / 同意入院

Outline of Final Research Achievements

The covid-19 placed restrictions on the facilities to be surveyed, and the National Hizen Sanatorium (now the National Hizen Psychiatric Center) was revised in the course of historical research.
As a result of analyzing the primary data stored at the center, it was found that not only was open patient treatment conducted in the late 1950s under Director Masao Ito, but that free admission was emphasized as a form of hospitalization, and that the impact of this continued even 20 years after Ito's retirement. The reforms by Ito were not only implemented after his resignation, but also after his retirement. It is not uncommon to conclude that the reforms made by Ito failed due to the re-increase of closed wards after his retirement, but it was found that Ito had left a significant impact even after his retirement in the sense that the high number of free admissions, which stood out from the national average, continued.

Free Research Field

歴史社会学

Academic Significance and Societal Importance of the Research Achievements

精神科医療の入院先が閉鎖病棟であるか否かは、自己決定を重視する現代的患者像にとって重要な論点である。本研究では、1950年代後半に戦後初の大規模な開放的患者処遇を行った国立肥前療養所について研究を行った。その結果、肥前療養所では開放処遇のみならず、自由入院も多くなっており、かつ自由入院の多さは改革終了後も長く続いた。このことから、精神科医療機関の開放的処遇及び自由（任意）入院の増加にとって、責任者による改革の意思決定が重要であることが示唆された。しかし肥前の改革は上からの「開放化」であり、当時の病院や医療改革が、患者不在を自明視する中で行われてきたことも明らかになった。