Psychiatric hospitals are seeing an increase in dementia patients
（認知症が増え、統合失調症の入院患者が減少している理由2024年07月09日 より引用）
The Ministry of Health, Labor and Welfare's medical system reform includes a reduction in psychiatric hospital beds.
<The 8th Medical Reform 2024~ https://www.mhlw.go.jp/content/10800000/001041839.pdf>
In fiscal year 2020, the total number of dementia (Alzheimer's type, vascular) patients was 6% of the 273,000 psychiatric hospital inpatients.
And the number of schizophrenia patients has been decreasing year by year, and compared to fiscal year 2008, the hospitalization rate has decreased from 18.5% to 14.1%.
What does this show?
Traditionally, psychiatric hospitals were run in an "isolation and detention" style, giving the disease an unclear name like schizophrenia, managing people who were independent in their daily lives, and making a profit.
However, from now on, it will change into a nursing care and welfare business that targets elderly people with dementia.
Psychiatric hospitals are taking on the needs of an aging society.
Schizophrenia and dementia are illnesses that can be diagnosed as long as the doctor says that the patient is "unable to live with his/her family."
The definition is vague, and there are no standardized diagnostic criteria.
If the patient refuses, the hospital can forcibly hospitalize the patient with the family's consent, saying that the patient "does not recognize his/her illness."
This is not a human rights issue that occurs in psychiatric hospitals.
Even in general hospitals, if the patient refuses tube feeding or intravenous feeding, the hospital will calmly restrain the patient with the family's consent.
The current state of Japanese medicine is that "unconstitutional violations using medical care as a shield" are being carried out without hesitation.
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Let's get back to the main topic.
Why has the ratio of hospitalized patients changed? I would like to consider this question.
Reason 1: "The number of disease names has increased, and the number of mental clinics and psychosomatic medicine departments has increased."
→In order to keep outpatients, there is no need to give them a name like schizophrenia, which has a strong negative image and is also meaningless
→Pleasant-sounding names like anxiety disorder and depression, which anyone can get, have become widespread
→Clinics have lowered the level of labeling in order to maintain the number of patients
→In order to run the clinic, there is a trend toward not admitting patients.
*Only complainers and troublesome, persistent patients are admitted to hospital.
②Inpatient medical fees have become "super emergency, more acute"
People with schizophrenia are basically only long-term hospitalized patients and repeat patients, so they do not qualify for the super emergency system.
Due to institutionalization, their ability to live in society is extremely low, and even if they are discharged from the hospital, there is a high possibility that they will become homeless or commit suicide.
→Sedate elderly people with dementia and rotate them between senior care facilities and senior housing
→High medical fees and generous nursing standards (10:1) staffing
If the diagnosis is schizophrenia, the barrier to returning to society at the time of discharge will be high.
This is the same as the discrimination against AIDS patients in the past, where people were afraid to come into contact with AIDS patients, and the recent discrimination against people infected with COVID-19.
(For more information, please watch the video)
"Learn about HIV and AIDS - Protect yourself and protect your loved ones"
"I don't want to stay in this town anymore" - COVID-19 discrimination by infected people
So, if they simply give the diagnosis "schizophrenia", it will be difficult to return to society and encourage discharge, so they change the name of the disease they diagnose, which is a trick.
The most common diagnosis these days is "depression", and depending on how the doctor's opinion is written, you can get a disability pension of the second grade.
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For the above reasons, the era in which hospitals can operate with chronic illnesses over the long term is coming to an end.
And when you are actually hospitalized in a psychiatric hospital for a long time, you are addicted to psychotropic drugs and isolated in a closed space, which gradually reduces your social skills and starts to show "symptoms the same as schizophrenia".
In my opinion, "institutionalization = schizophrenia."
In other words, schizophrenia is a medically present disease.
Conversely, there are countless people who go about their daily lives despite having hallucinations and delusions.
They don't receive any treatment.
There is no definition of mental illness.
If you had to diagnose it, you would call it "stress-related transient confusion" or "fatigue-related confusion."
And I think it should be treated by a neurologist.
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Why do we become confused by daily stress?
It's because we don't manage not only our physical bodies, but also our spiritual bodies.
Humans have a physical body and an invisible "spiritual body."
Therefore, if you don't know about the "spiritual body," "your spiritual body will become increasingly unhealthy."
And that impacts even the physical body, the body and brain functions (mental functions). (More details are written on the Rapt blog)
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