It's not that they "don't realize they're ill" but rather that they "are not ill"

It's not that they "don't realize they're ill" but rather that they "are not ill"

In fiscal year 2024, part of the Mental Health and Welfare Act was revised.

The reality of psychiatric care in Japan, which is often ridiculed as outdated and violating human rights.

Japan is the only country that still has 329,000 psychiatric hospital beds, and the main reason for this is thought to be that psychiatric hospitals are run by private hospitals.

In psychiatric hospitals, a system of medical protective hospitalization remains, whereby a person can be forcibly admitted without the person's consent, with the consent of the family, on the grounds that they "have no awareness of their illness."

(The correct thing to say is that they are "not ill," not "have no awareness of their illness.")

[Why physical restraints do not disappear in Japan]

In the first place, this is because physical restraints are necessary to forcibly perform medical procedures on people who do not consent to hospitalization or treatment.

Medical care is meddling.

It can be said that Japan's values ​​are that "medical care is higher than the individual's self-determination and QOL."

"Once you are forced into a psychiatric hospital, you cannot leave until you die."

This is no joke. Drug addiction and confinement to closed wards are the main reasons why people lose their social skills and are unable to return to society.

Simply put, this is a "treatment failure," but I have to say that it is highly doubtful whether psychiatric care, which can only calm excited people, can be called a "treatment."

Factors that prolong hospitalization include hospitalizations abandoned by families and hospitalizations for medical protection.

The government has now begun measures to prolong hospitalizations for medical protection.

The hospitalization period has been set at six months.

However, with the consent of the family, it can be extended indefinitely.

Moreover, the extension requirement ⑧ is vicious, and the legal amendment is merely a formality that allows social hospitalization to be extended indefinitely. (I will attach it at the end of this article.)

The government cannot reduce the number of psychiatric hospitals, and has no intention of doing so.

Private psychiatric hospitals function as private substitutes for prisons, using medical expenses.

The perception that "psychiatrists should not be consulted, psychiatric drugs should not be taken, and it is a place that should not be approached" is spreading throughout society, and the number of patients admitted to private psychiatric hospitals is increasing.

<For details, please see the data below>

(Trends in the number of hospitalized patients with mental illnesses (breakdown by age group) https://www.fukushi.metro.tokyo.lg.jp/shinsho/jiritsushienkyougikai/dai7ki/4reiwa/seminar.files/kanagawa3.pdf)

As time goes on, psychiatric hospitals are transforming into elderly care facilities.

In 2017, 62% of the age ratio of patients admitted to psychiatric hospitals was 65 years old or older.

And now, there are many dementia patients who cannot afford to move into special nursing homes or senior housing.

Psychiatric treatment wards are being used to reduce the out-of-pocket expenses by using health insurance.

Is elderly care a medical job?

Is it really appropriate to continue spending medical expenses on people who need welfare services and will not be discharged from the hospital?

From this perspective, I think the end of psychiatric care in Japan is near.

Finally, I have attached the procedure for renewing medical protective hospitalization.

The necessity of hospitalization procedures

"7. Dementia state (deterioration of cognitive function, which is interfering with daily life in general)"

"8. Residual state of schizophrenia, etc. (difficulty in carrying out daily living activities, social judgment, and functioning due to disability)"

It will become more and more common, and people will start to criticize psychiatric care from all sides, saying "it's full of lies" and "it's just a nursing home."

（「病識がない」のではなく「病気ではない」問題だらけの日本の医療【２０２４年　医療保護入院の入院期間の更新について】2024年05月07日 |を転載）