David LeCount Report
The professionals and consumers impressed me with their commitment to examine and develop community-based treatment alternatives. There was a genuine appreciation that community-based programming compared to institutional care is far more effective. It was generally understood that the longer people remain in institutions it becomes anti therapeutic, as it significantly deprives them of their ability to properly care for themselves. There was also a recognition that even people with most serious and persistent mental health issues should be able to live in the community with supports, as this will allow them to recover more fully and quickly, and become contributing citizens. There was an appreciation that the service design needs to be developed, organized, and structured within a natural community environment. However, I was concerned by their frustration and the feeling of impedance in making this change process possible for more people. Frustration with the central bureaucracy and the establishment is apparent in development of a master plan, policies, direction, funding strategies, and training to make changes occur in a more timely manner.
Given what Japan has been able to do in the development of comprehensive psychiatric hospitals across the country, the same culture that created and built this industry has the potential to realign resources into the establishment of excellent community-oriented treatment practices. Institutional services can be transferred to the community with the hospital being used primarily for an occasional brief episode of care. In so doing, best practices could be developed, implemented, formally taught, and disseminated throughout the country.
The challenges before us relate to our ability to first do no harm, treat all people with dignity and respect, and protect human rights. We need to emphasize least restrictive environments and treatment modalities, be consumer centered and recovery oriented, and afford people the opportunity to live in the community the same as everybody else, based on their abilities and not judge solely on their disabilities. We also need to focus on peoples' strengths, afford people the opportunity to develop their highest potentials, and we must be the consumer advocates and enablers, helping to facilitate these transformations. By empowering people and accepting those with disabilities, we help provide them with a sense of belonging and the opportunities to realize their dreams.
There are 335,000 people living in psychiatric hospitals in Japan that are counting on us to support these basic human values and principles. Mental illness is the World Health Organization's number one priority for 2001. What an exciting time and important turning point for Japan to make significant changes in their mental health system in accordance with this priority. It is my belief that Japan has the potential to be one of the finest mental health systems in the world.