Presentation Information
[SY-1-02]The Current State of Psychiatric Care and ACT Practice in Japan
*Mariko Watanabe (Chihaya ACT Clinic(Japan))
Keywords:
Community-based care,Assertive Community Treatment,System building,Recovery-oriented approach
Over the past two decades, community-based care for individuals with mental illness has gradually gained recognition in Japan. This presentation introduces our Assertive Community Treatment (ACT) team and its daily practices, supplemented by video interviews with service users. Since the early 2000s, Japan has changed several psychiatric policies to enhance community care. In 2011, the government recognized mental illness as one of the five major national diseases, and in 2018 introduced the "Community-Based Integrated Care System for People with Mental Illness," promoting social inclusion. Furthermore, psychiatric care in Japan currently faces ongoing systemic reforms, particularly since the United Nations' recommendation, based on the Convention on the Rights of Persons with Disabilities, urging the abolition of involuntary hospitalization. Despite these changes, psychiatric care remains predominantly hospital-centered, reinforced by reimbursement systems favoring inpatient treatment. Consequently, funding for community-based care remains limited, hindering the implementation of effective strategies. This issue arises from entrenched national policies and traditional medical education emphasizing custodial care. Thus, hospitalization costs and involuntary admissions have increased, exacerbated by workforce shortages in community care, particularly in rural areas affected by Japan’s declining birth rate. To address these challenges, many mental health providers have adopted outreach services over the past 25 years. The Association of Community Mental Health & Outreach has facilitated collaboration and advocacy among these providers for 15 years. Our urban-based ACT team provides comprehensive outreach services, encompassing not only medical services but also social services through collaboration with welfare agencies. Employing a recovery-oriented approach, we emphasize personalized care and support transitions from ACT to other appropriate services. This presentation aims to highlight practical strategies to advance user-centered mental health outreach services in Japan and internationally.