Presentation Information
[SY-62-03]Community-based Integrated Mental Health Care System for People with Mental Health Needs in Japan: Addressing Unmet Mental Health Needs through the Public Mental Health Sector.
*Masayuki Noguchi (Okayama Prefectural Mental Health & Welfare Center(Japan))
Keywords:
community mental health care,unmet mental health needs,Community-based Integrated Mental Health Care System for People with Mental Health Needs,multidisciplinary outreach team,public mental health
Since 2019, Japan has implemented the Community-based Integrated Mental Health Care System for People with Mental Health Needs (CIMHS). Japan’s mental health care system comprises three sectors: psychiatric, public mental health, and welfare. The public mental health sector includes municipal health and welfare departments, public health centers, and prefectural mental health & welfare centers. A key responsibility of this sector is to coordinate the CIMHS within its jurisdiction—whether at the municipal or prefectural level.A critical issue faced by the public mental health sector is supporting individuals with unmet mental health needs (UMHNs), particularly those disengaged from psychiatric treatment. Psychiatric institutions are bound by regulations requiring formal treatment contracts with clients, which limits their ability to reach individuals who are reluctant to engage in care. In contrast, the public mental health sector is permitted to contact and support these individuals directly.People with UMHNs often experience multiple, interrelated challenges such as inadequate housing, poverty, poor hygiene, malnutrition, social isolation. Typically, municipal public health nurses or social workers serve as the first point of contact. When cases become particularly complex, public health centers are expected to provide additional support. Prefectural mental health & welfare centers—comprising psychiatrists, clinical psychologists, and other professionals—offer further assistance through supervision, training workshops, and the deployment of multidisciplinary outreach teams.Engaging people with UMHNs is profoundly challenging. However, the “eco-social perspective” proposed by Kirmayer (2019, 2024) offers valuable guidance:Understanding distress within unique socio-cultural contexts of people with UMHNs; Collaborative engagement with clients, supported by multidisciplinary and multi-sectoral service provider to address the social determinants of mental health; Strengthening social resources to support recovery and reintegration into the community. The public mental health sector is expected to meet this challenge through its continued efforts in developing and implementing CIMHS.