Presentation Information
[SY-87-02]How to Safeguard Psychiatric Units in General Hospitals: Overcoming Closure Risks for Community Support
*Michitaka Funayama (Ashikaga Red Cross Hospital(Japan))
Keywords:
general hospital psychiatry,psychiatric ward,closure risk
Psychiatric units in general hospitals are vital to communities, providing essential mental health services before referral to long-term care, providing inpatient treatment for conditions like acute psychotic episodes, suicide-related behaviors, and advanced therapies, address physical comorbidities, and facilitate differential diagnose. Despite their importance, psychiatric units in general hospitals often face closure. Japan has experienced a decline in psychiatric care in general hospitals due to a prolonged economic downturn. Between 2002 and 2022, the number of psychiatric units in general hospitals fell by 15.4%, and psychiatric beds decreased by 43% due to financial pressures and staffing shortages. While downsizing is unavoidable for streamlining and cost-efficiency, complete closures of psychiatric units in general hospitals within a county or prefecture would have severe impacts on communities. The Japanese Society of General Hospital Psychiatry is implementing strategies to address this crisis, which may serve as a model for safeguarding such units under adverse conditions. We have collaborated with the Ministry of Health to increase reimbursement for psychiatric units within the national universal health insurance system. Our efforts have increased reimbursement for psychiatric inpatients in general hospitals. We are also working to integrate general hospital psychiatry into Japan's medical policy, focusing on areas like suicide intervention, medical-psychiatric complications, palliative care, perinatal psychiatry, and decision-making support, in collaboration with the Ministry of Health.Strengthening ties with universities is vital for sustaining psychiatric units in general hospitals amid psychiatrist shortages, as unaffiliated hospitals face higher closure risks. Such partnerships create a win-win situation by offering valuable training for psychiatry residents and interns, who gain insights into the link between medical and psychiatric conditions—benefiting communities often overlooked by standalone departments or psychiatric hospitals. Finally, making data on psychiatric unit performance publicly accessible will help highlight the often underrecognized importance of these multifunctional units in general hospitals.