Depression and health system

Group 4

Presenters: Kholoud Al-harbi &

Kawthar Alsaleh

Japanis an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia.

Population: 128M

• Area: 378,000 sq km

GDP per capita: 29,400US$

High population density.

Describe the mental health system in Japan

Depression and mental health epidemiology in japan

Attitude towards depression/mental health problem in the Japan

Risk factors of depression and thief prevalence in Japan

Strategies or polices of suicide prevention in Japan

O B J E C T I V E S :

Introduction

Mental health is as important as physical health to the overall

well-being of individuals, societies and countries.

Yet only a small minority of the 450 million

people suffering from a mental or behavioral disorder are

receiving treatment.

1

How would you describe

the mental health system

in japan ?

* there is :

• No GP

• No catchment area. Patient can choose wherever they want to go.

• Universal health insurance with copayment

• Fee for service scheme for medical service

• Private and public hospital on the same scheme, with same price.

Health system in Japan :

Mental Health Services in Japan:

(Social welfare ) :

• Half-way homes (rehabilitation facilities)• Group Home• Home help• Job coaching/supported employment• Care management

( Medical ) :• Mental Hospitals (80% private)

• Out patient clinics (private practice)

• Home visit by nurse

• Daycare center

• Pt. and Family Psychoeducation/SocialSkills Training/Occupational therapy

Mental Hospitals

28.1 beds per 10,000 people. (No of pt. 330,000)

# Forms of establishment :

University hospitals 5%

Public hospitals 15%

Privet hospital 80%

Mental Hospitals

All beds of national and public mental hospitals accepts involuntary hospitalization.

68% of the private mental hospitals also have beds for involuntary hospitalization.

In Japanese mental health services private facilities are playing a central role.

Number of Psychiatric Inpatients andLength of Stay

• Among the newly hospitalized patients at psychiatric hospitals, 50%

discharged within about 2 months.

• 30% are staying for less than a year.

• 40% are over 65 years old ,this is because the patients who cannot

get discharged from the psychiatric hospital and move to the other

rehabilitation facilities are aging.

How often does a depression occur in japan ? 2

• The World Health Organization estimates that depression affects 121 million people worldwide.

• In the 10 higher income countries surveyed, an average of nearly 15% of the population had suffered from depression at least once in their lives.

• By contrast, people living in low to middle income countries reported an 11% likelihood of having had the disease.

Country Depression

France 21 percent

U.S. 19.2%

Netherlands 17.9%

New Zealand 17.8%

Belgium 14.1 %

Spain 10.6%

Israel 10.2%

Italy 9.9%

Germany 9.9%

Japan 6.6 %

Among the high-income countries, Japan, Germany, Italy, and Israel reported the smallest percentages, ranging from under 7% to 10%.

Percentages of people who have experienced or will experience depression at some point in their lives:

How often does a depression occur in japan ? 2

Visiting hospital due to other diseases and injuries in addition to mental illness increased by 8 percent to 4,991 per 1,000 subscribers

in fiscal 2011 from 4,604 in fiscal 2008, it became clear that the visits due to mental illness have more than doubled.

Mood disorders such as depression accounted for 54 percent of cases in fiscal 2011.

Neurotic disorders such as panic attacks, along with mood disorders, which are both associated with long work hours and stress, exceeded 80 percent in all categories of mental illness.

some information about the ‘mental health epidemiology in Japan

3The Attitude

towards

depression/

mental health

problem in Japan

3

A study last year by the Ministry of

Health, Welfare and Labor found that

24% of Japanese people had suffered

from some kind of mental health

problem. Another report found that

one in five adults had considered

killing themselves, with actual suicide

rates at 51 per 100,000 people.

How person with

depression see him

self?

There is study between the nursing students and patients

with depressions in some cities in Japan

• In terms of nursing students’ attitudes toward people with mental disorders, emotional attitudes were more positive among students in Yamanashi; recognizable and behavioral attitudes were more positive among students in Bangkok.

• In terms of behavioral attitudes toward mental disorder, rates of nursing students in Bangkok thinking that “wanted to help the mentally ill” and that would “like to be a psychiatric nurse in the future” were higher than that of those in Yamanashi.

• Nursing students having contact experiences had more positive attitudes toward people with mental disorders than those having no contact experiences.

How people or community sees the

patients with mental health/depression:

To improve depression care in Japan, it will be crucial

to develop and implement focused interventions that

motivate non- psychiatric doctors to play a role in

depression care and to educate them about possible

roles they can play.

Japan prompted a $222 million government campaign to raise awareness of the issue and to make counseling services more widely available

Special policy linked to individuals suffering from mental illness or

depression

4 Risk Factors Of Depression And ThierPrevalence In Japan

Depression is a major

cause of morbidity

worldwide. Lifetime

prevalence is 3% in

Japan.

Alcohol common

among middle aged Japanese

GenderJapanese men

to women ratio 2:1

The first episode of depression

between of 20 and 40

Risk Factors

Tobaccoassociated with

alcohol consumption in

Japan

Ethnic and cultural

differences often impact the ways in

which their members express their feelings and

willingness to seek treatment

Occupational stress

the type of employment

contract has a significant impact

on depression

Risk Factors

5Briefly describe

strategies or

polices of suicide

prevention in the

Japan

Globally ,

Suicide is among the top 20

leading causes of death globally

for all ages.

Every year, nearly one

million people die from suicide,

this roughly corresponds to one death every

40 seconds!

In JapanSuicide in Japan has become a significant national social-issue.

Japan has one of the world's highestsuicide rates, and the Japanese

government reported the rate for 2006 as being the ninth highest in the world.

71% of suicides in Japan were male,

It is the leading cause of death in men aged 20–44.

Suicide Rate: 24.4

Factors of suicide unemployment(due to

the economic recession in the

1990s),

depressionsocial

pressures

How suicide is prevented in Japan

Center for Suicide Prevention (CSP) Mission :

To Prevent suicide and provide support for the survivors,

thus helping to create a stable society where people can lead healthy,

meaningful lives..

Functions of CSP

o Studies on Suicide Epidemiology

o Studies on mental illnesses behind suicides

o Studies on care for the survivors

o Studies on care for the non‐fatal attempters

o Information gathering and distribution : through Website , Booklets, Posters and pamphlets

o Collaboration Network for Suicide Prevention

o Human resource development

Human Resource Development

Training of suicide countermeasures for prefecture.

Training of treatment of suicide attempters and survivors.

Training for clinical psychologist and psychiatric social workers.

Training for collaboration activities.

"counter-suicide White Paper"

• In 2007, the government released a nine-step plan, a "counter-suicide White Paper," which it hopes will curb suicide by 20% by 2017.

• The goal of the White Paper is to encourage investigation of the root causes of suicide in order to prevent it, change cultural attitudes toward suicide, and improve treatment of unsuccessful suicides.

• In 2009, the Japanese government committed 15.8 billion yen towards suicide prevention strategies.

White paper

1)Launch of Suicide Prevention Week and implementation of enlightenmentprograms

2) Implement of suicide prevention education for students and pupils.

3) Promotion of public awareness regarding depression

Efforts to train human resources tocope in the early stages.

Improvement of the tools for the diagnosis and treatment of mental disorders

Promotion of promulgation of /spreading of public awareness for teachers

Improvement of resources for local and occupational health staff

Implementation of training for Long-Term Care Support Specialists

Implementation of training for Social worker and children’s social workers

References

http://www.siliconindia.com www.who.com http://www.npo-

jam.org/en/pdf/en_data_001.pdf http://ajw.asahi.com/article/behind_news/social

_affairs/AJ201308220075

http://www.japantoday.com/category/arts-culture/view/new-documentary-explores-taboo-subject-of-mental-illness-in-japan

http://www.lib.yamanashi.ac.jp/igaku/mokuji/kiyou/kiyou18/image/kiyou18--069to075.pdf