The effectiveness of the mental health social worker‐led multiprofessional program in preventing long‐term hospitalization and readmission in acute psychiatric inpatients in Japan: A retrospective analysis

Author:

Yanagisawa Yuta12,Kimura Hiroshi123ORCID,Komatsu Hideki1,Watanabe Hiroyuki14,Iyo Masaomi1

Affiliation:

1. Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan

2. Department of Psychiatry Gakuji‐kai Kimura Hospital Chiba Japan

3. Department of Psychiatry International University of Health and Welfare Narita Japan

4. Division of Medical Treatment and Rehabilitation Chiba University Center for Forensic Mental Health Chiba Japan

Abstract

AbstractAimThe large number of new long‐stay (NLS) patients and high readmission rates in psychiatric hospitals are longstanding concerns in Japan despite reforms to encourage multidisciplinary support of such patients. Staffing shortages of specialists, especially mental health social workers (MHSWs), may be one of the reasons for these problems to remain unsolved.MethodsThe authors examined the effectiveness of the MHSW‐centered multidisciplinary care model in preventing NLSs and rehospitalization in terms of both patient dynamics and cost by retrospective comparison of before and after program implementation.ResultsAfter our program was introduced, NLS was almost completely prevented. In addition, a significant decrease in readmissions of involuntarily admitted patients was also observed. On the other hand, the resulting decrease in treatment costs and hospital revenues was mismatched by an increase in personnel costs.ConclusionWhile MHSW‐centered multidisciplinary care is effective for the community integration of patients, there are cost challenges. State policy changes are needed to resolve staffing problems, along with the introduction of appropriate indicators of community integration.

Publisher

Wiley

Reference29 articles.

1. Organization for Economic Cooperation and Development. OECD health data.https://data.oecd.org/healtheqt/hospital-beds.htm(2022). Accessed 9 Sept2022.

2. Ministry of Health Labor and Welfare. Policy for discharging long stay psychiatric patients to community.https://www.mhlw.go.jp/file/05-Shingikai-12201000-Shakaiengokyokushougaihokenfukushibu-Kikakuka/0000051138.pdf(2014). Accessed 9 Sept2022.

3. Psychiatric Admissions and Length of Stay During Fiscal Years 2014 and 2015 in Japan: A Retrospective Cohort Study Using a Nationwide Claims Database

4. Ministry of Health Labour and Welfare National Center of Neurology and Psychiatry. 630 survey.https://www.ncnp.go.jp/nimh/seisaku/data/(2022). Accessed 9 Sept2022.

5. Identification and definition of long-stay mental hospital population.

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