Abstract
Psychiatric services in Japan are still predominantly hospital-based. Images of hospitalization deepen the stigma of mental illness, prompting people suffering from mild mental disorders to avoid early intervention. This deters people from seeking help from facilities specializing in mental health. These attitudes result in a longer duration of untreated psychosis and a higher suicide rate among young people even in a country with sophisticated healthcare services. The concept of an attenuated psychosis syndromes (APS)/prodromal state might not yet be widely recognized among Japanese psychiatrists. Nevertheless, the Japanese mental healthcare system is slowly changing with increasing numbers of mental health clinics in urban districts. Screening and diagnostic tools for attenuated psychosis symptoms such as the Structured Interview for Prodromal Syndromes/Scale of Prodromal Symptoms (SIPS/SOPS), the Comprehensive Assessment of At-Risk Mental States (CAARMS), and the PRIME Screen are all available in Japanese. In Japan, one or two Yogo (Japanese for “caring and nursing”) teachers who have completed a course in nursing and health education during their teacher training are assigned to each school (from primary to high school) to care for students’ health. Regarding APS, a case of a 14-year-old junior high school student is presented. After reviewing biopsychosocial factors using Exner’s Rorschach Comprehensive System, treatment goals focused on the development of social skills and better coping skills for somatic symptoms were implemented. Currently, Japanese researchers on early psychosis are becoming increasingly aware of relationships between biological and psychosocial aspects of early psychosis. Implications for research and practice in Japan are discussed.
Published Version
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