CONTRIBUTION OF DAY CARE CENTER TO PSYCHIATRIC REHABILITATION

Abstract

Setagaya Rehabilitation Center was opened seven years ago as the second public rehabilitation center for psychiatric patients in Japan. It consists of two day care units and two halfway house units. The experience in day care was described in this paper. Each units of day care contains 40 patients and 9 or 10 staffs. There are many staffs as compared with the number of patients, and it is characteristic that the team consists of various kinds of staffs (doctor, nurse, clinical psychologist, occupational therapist, social worker, etc.).A typical case of schizophrenic patient who visited day care was presented. He fell ill in his early adolescence and entered a mental hospital for several times. He was abulic and autistic in his daily life, and out-patient clinic could not offer proper solution. Effective rehabilitation process for him was described. Disturbances from which most of chronic patients suffer are not necessarily in medical symptoms such as hallucination or delusion, but are in social life, especially in interpersonal relationship or occupational ability. To improve those annoying disturbances, rehabilitation program in day care unit must be well planned and realistic as in ordinary social life in order to offer patients an opportunity to restitute social independence.563 patients made use of day care units for the past six years and a half. Most of them were schizophrenics. Treatment results at the time of discharge were investigated. According to its analysis, some improvement was observed in 80%. The percentage of patients who lapsed in their day care treatment was 20%. Even if underestimated, over one half patients were much improved and became more adaptable to vocational life or school life. These results may indicate that day care is a useful facility for psychiatric rehabilitation.