Demographic and clinical characteristics of foreign nationals accessing psychiatric services in Japan: a multicentre study in a metropolitan area

Abstract Background International immigration to Japan, where homogeneous ethnicity is a population characteristic, has been growing. Although immigration is recognised as a risk factor for multiple mental-health related issues, there are few regional reports on foreign nationals accessing the psychiatric services in Japan. We aimed to reveal their current status and provide information to develop an optimal service system. Methods A multicentre retrospective document review research was conducted. The subjects were foreign nationals who resided in Japan and presented at the psychiatry departments in three core regional hospitals in the Keihin region, which faces Tokyo Bay and is well known to include the largest traditional industrial zone in Japan, over a period of 3 years. We investigated the patients’ demographic and clinical information including country/region of origin, spoken language, use of a medical interpreter, pathway to hospitals and outcome. Results The percentage of foreign patients among all patients (1.4%) was quite low. Their age distribution (45.8 years on average) was dissociated from the age distribution of foreign nationals who resided in Japan. Regarding the country/region of origin, China (35.1%) was the most common country, followed by the Philippines, Korea and Brazil. Several subjects (22.9%) could not speak Japanese; therefore, interpretation was required by family members/friends (17.1%) or a professional interpreter (5.4%). Neurotic and stress-related disorders were the most common diagnosis (24.4%). The proportion of psychoactive substance use was higher than that for Japanese national data as immigrants are known to be at risk for it. Conclusions The results suggest that foreign nationals who reside in Japan are less likely to contact appropriate services for mental illness, especially young people at relatively high risk of mental illness do not access services. Furthermore, lack of medical interpreters may impede the mental health conditions of foreign nationals. The development of a community-based integrated care system accessible to foreign nationals seems to be indispensable.

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Demographic and clinical characteristics of foreign nationals accessing psychiatric services in Japan: A multicenter study in a metropolitan area

10.21203/rs.3.rs-37402/v3 ◽

2020 ◽

Author(s):

Youji Takubo ◽

Takahiro Nemoto ◽

Momoko Iwai ◽

Minako Kashima ◽

Eriko Yamaguchi ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Age Distribution ◽

The Philippines ◽

Psychiatric Services ◽

Current Status ◽

Tokyo Bay ◽

Region Of Origin ◽

Foreign Nationals ◽

Common Diagnosis

Abstract Background: International immigration to Japan, where homogeneous ethnicity is a population characteristic, has been growing. Although immigration is recognized as a risk factor for multiple mental-health related issues, there are few regional reports on foreign nationals accessing the psychiatric services in Japan. We aimed to reveal their current status and provide information to develop an optimal service system.Methods: A multicenter retrospective chart review research was conducted. The subjects were foreign residents who presented at the psychiatry departments in three core regional hospitals in the Keihin region, which faces Tokyo Bay and is well known to include the largest traditional industrial zone in Japan, over a period of three years. We investigated the patients’ demographic and clinical information including country/region of origin, spoken language, use of a medical interpreter, pathway to hospitals, and outcome.Results: The percentage of foreign patients among all patients (1.4%) was quite low. Their age distribution (45.8 years on average) was dissociated from the age distribution of foreign residents in Japan Regarding the country/region of origin, China (35.1%) was the most common country, followed by the Philippines, Korea, and Brazil. Several subjects (22.9%) could not speak Japanese; therefore, interpretation was required by family members/friends (17.1%) or a professional interpreter (5.4%). Neurotic and stress-related disorders were the most common diagnosis (24.4%). The proportion of psychoactive substance use was higher than that for Japanese national data as immigrants are known to be at risk for it.Conclusions: The results suggest that foreign residents in Japan are less likely to contact appropriate services for mental illness, especially young people at relatively high risk of mental illness do not access services. Furthermore, lack of medical interpreters may impede the mental health conditions of foreign residents. The development of a community-based integrated care system accessible to foreign residents seems to be indispensable.

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Demographic and clinical characteristics of foreign nationals accessing psychiatric services in Japan: A multicentre study in a metropolitan area

10.21203/rs.3.rs-37402/v4 ◽

2020 ◽

Author(s):

Youji Takubo ◽

Takahiro Nemoto ◽

Momoko Iwai ◽

Minako Kashima ◽

Eriko Yamaguchi ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Age Distribution ◽

The Philippines ◽

Psychiatric Services ◽

Current Status ◽

Tokyo Bay ◽

Region Of Origin ◽

Foreign Nationals ◽

Common Diagnosis

Abstract Background:International immigration to Japan, where homogeneous ethnicity is a population characteristic, has been growing. Although immigration is recognised as a risk factor for multiple mental-health related issues, there are few regional reports on foreign nationals accessing the psychiatric services in Japan. We aimed to reveal their current status and provide information to develop an optimal service system.Methods:A multicentre retrospective document review research was conducted. The subjects were foreign nationals who resided in Japan and presented at the psychiatry departments in three core regional hospitals in the Keihin region, which faces Tokyo Bay and is well known to include the largest traditional industrial zone in Japan, over a period of three years. We investigated the patients’ demographic and clinical information including country/region of origin, spoken language, use of a medical interpreter, pathway to hospitals and outcome.Results:The percentage of foreign patients among all patients (1.4%) was quite low. Their age distribution (45.8 years on average) was dissociated from the age distribution of foreign nationals who resided in Japan. Regarding the country/region of origin, China (35.1%) was the most common country, followed by the Philippines, Korea and Brazil. Several subjects (22.9%) could not speak Japanese; therefore, interpretation was required by family members/friends (17.1%) or a professional interpreter (5.4%). Neurotic and stress-related disorders were the most common diagnosis (24.4%). The proportion of psychoactive substance use was higher than that for Japanese national data as immigrants are known to be at risk for it.Conclusions:The results suggest that foreign nationals who reside in Japan are less likely to contact appropriate services for mental illness, especially young people at relatively high risk of mental illness do not access services. Furthermore, lack of medical interpreters may impede the mental health conditions of foreign nationals. The development of a community-based integrated care system accessible to foreign nationals seems to be indispensable.

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Demographic and clinical characteristics of foreign residents who visited hospitals for mental health problems in Japan: A multicenter study in a metropolitan area

10.21203/rs.3.rs-37402/v2 ◽

2020 ◽

Author(s):

Youji Takubo ◽

Takahiro Nemoto ◽

Momoko Iwai ◽

Minako Kashima ◽

Eriko Yamaguchi ◽

...

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Psychiatric Treatment ◽

Age Distribution ◽

Health Problems ◽

The Philippines ◽

Tokyo Bay ◽

Region Of Origin ◽

Neurotic Disorder ◽

Common Diagnosis

Abstract Background: International immigration to Japan, where homogeneous ethnicity is a population characteristic, has been growing. Although immigration is recognized as a risk factor for multiple mental-health related issues, there are few regional reports on foreign residents who visit a hospital for mental health problems in Japan. We aimed to examine such patients’ characteristics.Methods: A multicenter retrospective study using medical records was conducted. The subjects were foreign patients who presented at the psychiatry departments in three core regional hospitals in the Keihin region, which faces Tokyo Bay and is well known to include the largest traditional industrial zone in Japan, over a period of three years. We investigated the patients’ demographic and clinical information including country/region of origin, spoken language, use of a medical interpreter, pathway to hospitals, and outcome.Results: The percentage of foreign individuals among all patients was 1.4% (205/14511). The mean age of the foreign patients was 45.8 years, and the sex ratio was 1:1.9 (men: women). Regarding the country/region of origin, China (35.1%) was the most common country, followed by the Philippines (18.5%), Korea (16.1%), and Brazil (4.9%). Several subjects (22.9%) could not speak Japanese; therefore, interpretation was required by family members/friends (17.1%) or a professional interpreter (5.4%). Neurotic disorder (ICD-10 code: F4) was the most common diagnosis (24.4%).Conclusions: The percentage of foreign patients seeking psychiatric treatment (1.4%) was relatively low, compared with the percentage of foreign residents living in the Keihin region (4.4%). The age distribution of foreign residents who visited psychiatric department was dissociated from the age distribution of foreign residents in Japan. This suggests that young foreign residents with a relatively high risk for mental illness are not accessing appropriate services. The development of a community-based integrated care system accessible to foreign residents seems to be indispensable.

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Demographic and clinical characteristics of foreign residents who visited hospitals for mental health problems in Japan: a multicenter study in a metropolitan area

10.21203/rs.3.rs-37402/v1 ◽

2020 ◽

Author(s):

Youji Takubo ◽

Takahiro Nemoto ◽

Momoko Iwai ◽

Minako Kashima ◽

Eriko Yamaguchi ◽

...

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Psychiatric Treatment ◽

Age Distribution ◽

Clinical Information ◽

Health Problems ◽

The Philippines ◽

Tokyo Bay ◽

Neurotic Disorder ◽

Common Diagnosis

Abstract Background: International immigration to Japan, where homogeneous ethnicity is a population characteristic, has been growing. Although immigration is recognized as a risk factor for multiple mental-health related issues, there are few regional reports on foreign residents who visit a hospital for mental health problems in Japan. We aimed to examine such patients’ characteristics. Methods: A multicenter retrospective study using medical records was conducted. The subjects were foreign patients who presented at the psychiatry departments in three core regional hospitals in the Keihin region, which faces Tokyo Bay and is well known to include the largest traditional industrial zone in Japan, over a period of three years. We investigated the patients’ demographic and clinical information including nationality/region, spoken language, use of a medical interpreter, pathway to hospitals, and outcome. Results: The percentage of foreign individuals among all patients was 1.4% (205/14511). The mean age of the foreign patients was 45.8 years, and the sex ratio was 1:1.9 (men: women). China (35.1%) was the most common nationality, followed by the Philippines (18.5%), Korea (16.1%), and Brazil (4.9%). About one-fourth of the subjects could not speak Japanese; therefore, interpretation was required by family members/friends (17.1%) or a professional interpreter (5.4%). Neurotic disorder (ICD code: F4) was the most common diagnosis (24.4%). Conclusions: The percentage of foreign patients seeking psychiatric treatment (1.4%) was relatively low, compared with the percentage of foreign residents living in the Keihin region (4.4%). The age distribution of foreign residents who visited psychiatric department was dissociated from the age distribution of foreign residents in Japan. This suggests that young foreign residents with a relatively high risk for mental illness are not accessing appropriate services. The development of a community-based integrated care system accessible to foreign residents seems to be indispensable.

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Mental health services for single homeless people

BJPsych Advances ◽

10.1192/bja.2020.54 ◽

2020 ◽

pp. 1-11

Author(s):

Philip Timms ◽

Jenny Drife

Keyword(s):

Mental Health ◽

Mental Illness ◽

Personality Disorder ◽

Health Services ◽

Substance Misuse ◽

Homeless People ◽

Psychiatric Services ◽

Background Information ◽

The Past ◽

The Uk

SUMMARY Homelessness has long been associated with high rates of psychosis, alcohol and substance misuse, and personality disorder. However, psychiatric services in the UK have only recently engaged actively with homeless people. This article provides some background information about homelessness and mental illness and describes the elements of inclusion health and some of the models of service for homeless people that have been established over the past 30 years.

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Managing offenders with psychiatric disorders in general psychiatric services

New Oxford Textbook of Psychiatry ◽

10.1093/med/9780199696758.003.0269 ◽

2012 ◽

pp. 2009-2014

Author(s):

James R. P. Ogloff

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Health Services ◽

Health Services ◽

Mentally Ill ◽

Psychiatric Patients ◽

Psychiatric Services ◽

Mentally Ill Offenders ◽

General Mental Health ◽

General Community

It has been shown that the prevalence of mental illness among those in the criminal justice system is significantly greater than that found in the general community. As presented in Chapter 11.4, for example, the per capita rate of psychotic illness in prisons is approximately 10 times greater than that found in the general community. Tragically, relatively few services exist that provide continuity of mental health care between gaols and the community. This produces a situation where individuals whose mental illness may have been identified and treated in gaol find themselves without services in the community. Typically, only when in crisis do they find their way into general psychiatric services either in community settings or in hospital. This situation has produced considerable stress on already taxed mental health services. Given the prevalence of offence histories among psychiatric patients, it is important for mental health professionals to be aware of the unique issues—and myths—that accompany patients with offence histories. At the outset it is important to emphasize that the duty of mental health services is to address mental health issues. That ought to be the focus of mental health services. As this chapter makes clear, though, for some patients, there is a relationship between the mental illness and offending and by addressing the mental illness, the risk of re-offending might well be reduced. Moreover, many of the ancillary issues that lead to relapse and destability in psychiatric patients also may lead to offending. Addressing these issues will both help provide long-term stability for patients and will help reduce their risk of offending. As a result, there is a need for general mental health services to acquire expertize to identify and manage patients with offending histories. This chapter will provide information about the relative risk of offending among psychiatric patients and the relationship (or lack thereof) of inpatient aggression and community-based violence and offending. A framework will be provided for assessing and treating patients with offending histories and issues using a typology of mentally ill offenders. The role of forensic mental health services in bolstering general psychiatric services, and in sometimes providing primary care for mentally ill offenders, will also be discussed.

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Is there a Power Elite in Canadian Psychiatry?

Canadian Psychiatric Association Journal ◽

10.1177/070674376901400213 ◽

1969 ◽

Vol 14 (2) ◽

pp. 199-207

Author(s):

D. B. Coates

Keyword(s):

Mental Health ◽

Mental Illness ◽

Private Practice ◽

Critical Role ◽

Psychiatric Services ◽

Professional Organizations ◽

Power Elite ◽

Apparent Lack ◽

Considerable Evidence ◽

History Of

This paper poses a number of questions regarding the recent history of psychiatric organization in Canada. Using public documents regarding organizational structure, it was suggested that during the decade 1956–1966, there was considerable evidence of a national shaping of policy regarding psychiatric services by a small but influential group of reformers. For other questions such as the organization and dispensing of research funds, access to more privileged sources would be required. In its organization, Canadian psychiatry is of no greater interest than many other professional organizations. However, because of its critical role at a time when health services generally were in transition, the psychiatric elite played an extremely important part in influencing the restructuring of psychiatric services around private practice, around general hospital and medical integration and the ideology that mental illness is identical with physical illness. The blurring of differences between psychiatry and mental health were discussed briefly and the apparent lack of conflict between bureaucratic and professional roles.

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Non-linear relationship between an index of social deprivation, psychiatric admission prevalence and the incidence of psychosis

Psychological Medicine ◽

10.1017/s0033291799001464 ◽

2000 ◽

Vol 30 (1) ◽

pp. 177-185 ◽

Cited By ~ 67

Author(s):

T. J. CROUDACE ◽

R. KAYNE ◽

P. B. JONES ◽

G. L. HARRISON

Keyword(s):

Mental Health ◽

Mental Illness ◽

Linear Function ◽

Social Deprivation ◽

Additive Models ◽

Psychiatric Services ◽

Local Regression ◽

Psychiatric Admission ◽

The Relationship ◽

Admission Prevalence

Background. Indicators of population socio-economic disadvantage expressed as weighted deprivation indices show strong relationships with mental health and underpin national funding of psychiatric services. A new index of social deprivation, the Mental Illness Needs Index, has been devised specifically to predict need for psychiatric services. Its validity has not been established outside the area in which it was developed.Methods. We explored the relationship between the Mental Illness Needs Index and two alternative indicators of need for mental health services: the prevalence of psychiatric admission for electoral wards in Nottingham (calculated from Hospital Episode Statistics for the years 1992 and 1993) and ward-based incidence rates for psychosis (ICD-10 F1X-F33). Relationships were explored graphically using local regression models, and estimated using Generalized Linear and Additive Models, and Poisson regression.Results. Social deprivation was strongly related to admission prevalence and psychosis incidence (Spearman's rho 0·63 and 0·44 respectively). Neither admission prevalence, nor the incidence of psychosis were linearly related to social deprivation. Areas with above average social deprivation had both more new cases of psychoses and a higher proportion of the population admitted than expected from a linear function.Conclusions. Application of a linear function to funding gradients may underfund high and low need areas and overfund median need areas. Improving the precision of estimates of the relationship between social deprivation and need for services is crucial to more equitable resource allocation.

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Where next for early intervention programmes?

Early Intervention in Psychiatric Disorders Across Cultures ◽

10.1093/med/9780198820833.003.0017 ◽

2019 ◽

pp. 201-208

Author(s):

Dinesh Bhugra ◽

Antonio Ventriglio ◽

Eric Y.H. Chen

Keyword(s):

Mental Health ◽

Primary Care ◽

Mental Illness ◽

Early Intervention ◽

Community Mental Health ◽

Social Care ◽

Psychiatric Services ◽

Early Interventions ◽

Duration Of Untreated Illness

Early intervention treatments and approaches are reaching across the globe. There is no doubt though that these services are a low priority, especially in countries where adequate resources are not available. The practice of psychiatry has, in the last 50 years, moved from asylums, to community mental-health teams, to home treatments and early intervention. There appears to be an increasing body of evidence to suggest that early interventions can work in reducing the duration of untreated illness and aiding better recovery, but this needs to be researched in conditions other than psychoses, for which evidence is strong. This chapter provides recommendations for researchers, clinicians, and policymakers. All these recommendations are based on the principle of equity between physical and mental illness, and better integration between psychiatric services and social care and between primary care and psychiatric services.

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Characteristics of patients seen by a community perinatal mental health service

Psychiatric Bulletin ◽

10.1192/pb.bp.108.020693 ◽

2009 ◽

Vol 33 (10) ◽

pp. 368-370 ◽

Cited By ~ 1

Author(s):

Amanullah Durrani ◽

Roch Cantwell

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Health Service ◽

Health Service ◽

Affective Disorder ◽

Bipolar Affective Disorder ◽

Perinatal Mental Health ◽

Effective Management ◽

Common Diagnosis ◽

Childbearing Women

Aims and MethodRecent guidelines on perinatal mental health highlight the need to predict, detect and prevent mental illness in childbearing women, but there are a limited number of studies in this field. This study describes the characteristics of 277 service users newly referred to a specialist community perinatal mental health service over 1 year, and discusses the implications for effective management of mental illness related to childbearing.ResultsThe most common diagnosis was affective disorder (51%), of which 8% had bipolar affective disorder. Almost three in five women had previous non-pregnancy-related psychiatric contact and a fourth had previous ante/postnatal psychiatric contact. More than half were on medication at conception, most commonly antidepressants (43%).Clinical ImplicationsThis study highlights the opportunities for identifying women at high risk of postnatal mental illness and the need for adequate pregnancy planning advice for women taking psychotropic medication.

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