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

美国、加拿大、日本精神科治疗参考及权利保护制度形成比较研究

• 批准号: 13610197
• 负责人: TAKAHASHI Ryoko
• 金额: $ 1.92万
• 依托单位: Kanazawa University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13610197/
• 关键词: Mental Health; Right Protection; Advocacy; Welfare; Market Competition; ACT; Recovery; United States; 地域支援; 地域ケア; 医療政策; アメリカ合衆国:日本; 脱施設化; 神経医療; PACT; 患者の権利; 医療社会学

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.

1.在北美，精神病人住院的倡导制度已经建立，政府在这方面的责任也很明确。卫生服务由公共和私营部门的倡导组织独立监测。患者家属被视为重要的利益相关者，各种社区支持系统是为患者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，社区支持系统没有充分建立，无法将患者的出院意愿置于其家人的意愿之上。我们发现，确保有足够的卫生服务资源和多种替代方案，对于完成对患者的倡导是必不可少的。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居住在社区的患者接受治疗。这些条例对为病人辩护的效果仍有待检验。3.在美国，自1990年以来，一种社会“康复”模式一直是各县和州精神卫生服务政策的一部分，坚持认为患者不应仅仅是治疗的被动接受者，并导致建立了促进患者积极参与治疗的方案。虽然心理健康服务消费者的社会运动一直很活跃，但在引入管理医疗制度后，公共部门和私营部门正在争夺社会资源。具体分析医疗福利服务领域的市场竞争对消费者维权的影响。

项目成果

高橋 涼子: "医療・福祉領域における権利擁護制度の検討(1)"金沢法学. 46・1. 137-157 (2003)

高桥凉子：“医疗福利领域的权利保护制度审查（1）”金泽法46・157（2003）。

社会学から見た生と死

社会学视角下的生与死

• 发表时间: 2004
• 期刊: 生と死を考える(細見博志編)
• 作者: 高橋 涼子

医療・福祉領域における権利擁護制度の検討(1)

医疗福利领域维权制度检查（一）

• 发表时间: 2003
• 期刊: 金沢法学 46-1
• 作者: 高橋 涼子;R.Takahashi;高橋 涼子
• 通讯作者: 高橋 涼子

On Birth and Death in Modern Society : From Sociological viewpoint

论现代社会的生与死:从社会学的角度

• 发表时间: 2004
• 期刊: Theories of Birth and Death in Our Society, (H.Hosomi ed.) (Hokkoku-Shinbunsha)
• 作者: 高橋 涼子;R.Takahashi
• 通讯作者: R.Takahashi

細見博志他: "生と死を見つめて"北國新聞社(印刷中). (2003)

Hiroshi Hosomi 等人：“审视生与死”《北国新闻》（正在印刷）（2003 年）。