The therapeutic environment of psychiatric hospitals in Japan: A comparison of medical welfare facilities for senile dementia

Abstract

With the dual purpose of protecting the human rights of mentally disordered persons and promoting their social rehabilitation, the newly revised Mental Health Law was enacted in July 1987. It has brought significant change in that it has shifted Japanese mental health care from a hospital-based to a community-based system. Consequently, the therapeutic environment in the psychiatric hospitals has been changing from a closed to an open one. Recently, the amenity of hospital environments has been discussed. Furthermore, in the revision of medical fees of April 1994 the government established the long-term care ward system, which is a good indication of the changing nature of psychiatric institutions in Japan. I will report on the current therapeutic environment in Japanese psychiatric hospitals, and will also compare it with the care environment in facilities for healthcare services for the aged (and/or senile dementia) and special nursing homes for the aged.