Comparative study on psychiatric treatment referens and the formation of systems for the protection of right in the USA, Canada and Japan

1.在北美，精神病患者住院的倡导制度已经建立，政府在这方面的责任也很明确。保健服务由公共和私营部门的宣传组织独立监测。病人家属被视为重要的利益相关者，各种社区支持系统是为病人及其家属进行宣传的关键因素。相比之下，在日本，精神病院是私人建立和管理的;因此，政府没有深入参与为住院精神病患者辩护。此外，社区支助系统没有充分建立，使病人出院的愿望优先于其家人的愿望。我们发现，保证足够的卫生服务资源与多种选择是必不可少的，为病人的宣传工作的完成。2.在美国和欧洲，当病人出院并开始在社区生活时，为他们提供治疗是一项主要任务。一些州和县有规定，要求住在社区的病人接受治疗。这些条例对患者权益保护的影响仍有待研究。3.在美国，自1990年以来，一种社会“康复”模式坚持认为病人不应该仅仅是被动接受治疗的人，这已经成为各县和州精神卫生服务政策的一部分，并导致建立了促进病人积极参与治疗的计划。虽然精神健康服务消费者方面有积极的社会运动，但在引入管理式护理制度后，公共和私营部门正在争夺社会资源。应具体分析医疗和福利服务领域的市场竞争对消费者权益保护的影响。

1.In North America, the advocacy system for the hospitalization of mental patients is well established, and the responsibility of the government with regard to the system is clear. Health services are independently monitored by advocacy organizations in the public and private sectors. The families of patients are regarded as important stakeholders, and various community support systems are key factors in advocacy for both patients and their families. By comparison, in Japan, mental hospitals are privately established and managed ; therefore government is not deeply involved in advocacy for hospitalized mental patients. In addition, the community support system is not sufficiently established to prioritize patients' wishes to be discharged over the wishes of their families. We found the assurance of sufficient health service resources with multiple alternatives to be indispensable for the accomplishment of advocacy for patients. 2.In the United States and Europe, the provision of treatment for patients when they are discharged and start living in their communities is a major task. Some states and counties have regulations obliging patients living in communities to receive treatment. The effect of these regulations on advocacy for patients remains to be examined. 3.In the United States, a social "Recovery" model insisting that patients should not merely be passive recipients of treatment, has been part of the mental health service policies of counties and states since 1990, and, resulted in the establishment of programs for promoting active involvement of patients in their treatment. Although there have been active social movements on the part of mental health service consumers, the public and private sectors are competing for social resources after the introduction of the managed care system. The influence of market competition in the field of medical and welfare services on advocacy for consumers should be specifically analyzed.