A Community Mental Health Support System for People with Mental Illness in Japan

Over 40 years has passed since primary supports for people with mental illness in developed countries shifted from institutions to communities. The level of treatments for mental illness in Japan is not considered immature; however, despite the general shift from institutional care to community care, Japan has the highest number of psychiatric beds in the world. One characteristic of the Japanese mental health system is that community supports have developed while the main treatment focus continued to be on inpatient care. This article explores various qualities of a Japanese community mental health system in historical context, as contrasted with the international standard set by the World Health Organization, and the impact of cultural aspects in the field. In addition, a case of a person with schizophrenia illustrates an initial intervention in Japanese communities and hospitals. The findings suggest that noninstitutional characteristics of the mental health system, including enthusiasm in clinical settings, flexible social structures, and sensitivity in interpersonal relationships, play important roles in the community support system in Japan. Because a great number of Japanese empirical studies related to community mental health are not published in English, many practices, which have proven to be beneficial to the field, remain unrecognized by the international community of mental health providers. The next challenge is to introduce the skills and systems that are worthwhile from Japan to the international community.