Measures on medical services, protection and welfare for persons with psychiatric disabilities are implemented by prefectures and municipalities in accordance with central government statutes. A large number of professionals and relevant organizations/agencies are involved in the implementation. The chart below illustrates how the system is organized.
- 2. Certificate of Persons with Psychiatric Disability
- 3. Welfare Services to Support Persons with Psychiatric Disabilities Living at Home
- 4. Measures to Promote Reintegration and Participation
- 5. Institutional Services
2. Certificate of Persons with Psychiatric Disability
1. Overview of the system
The Certificate of Persons with Psychiatric Disabilityisissued to persons meeting specific criteria for mental illness for the purpose of providing various support measures with the cooperation of government organizations and promoting their reintegration, independence, and social participation.
Persons with psychiatric disabilities (including those with schizophrenia, manic-depression (emotional disorders), atypical mental illness, epilepsy, toxic psychosis, organic psychosis and other mental illnesses), and among those who are restricted in their daily or social activities.
Persons with intellectual disabilities are not eligible since they can receive the Certificate of Persons with Intellectual Disability.
3. Degrees of disability
The degrees of disability comprise grade one for the most severe, grade two, and grade three.
Grade one: Individuals whose disorder prevents them from conducting daily activities Grade two: Individuals who have or require significant restrictions in daily life. Grade three: Individuals who have or require some restrictions in daily or social life.
4. Application procedures
An application for the certificate must be submitted with a doctor’s diagnosis or copy of a Disability Pension certificate to the municipal office where an applicant lives. The application is subsequently sent to the prefectural governor or city mayor, in the case of designated cities.
In principle, the applicant must submit the application in person, but it is also possible for a family member or staff of medical institution to submit it on behalf of the applicant.
The certificate is effective for two years from the application date. Those who wish to renew the certificate must undergo another evaluation of eligibility.
5. Benefits of the certificate
(1) Simplification of application procedures for government funds for outpatient medical treatment (2) Use of facilities for persons with psychiatric disabilities for reintegration
3. Welfare Services to Support Persons with Psychiatric Disabilities Living at Home
1. Home help services
Home helpers visit the homes of persons with psychiatric disabilities and provide help with meals, bathing and washing, and other such routine tasks to enable them to be independent and promote their reintegration.
2. Short stay programs
Short-term stays are designed to promote the well-being of persons with psychiatric disabilities and their families. Facilities for persons with psychiatric disabilities can be used when family caregiver for persons with psychiatric disabilities fall ill, give birth, attend a funeral, or take care of another social obligation. Stays of up to seven days are permitted, but the period may be extended if special permission is obtained from the municipal mayor.
Group homes are designed to enhance the independence of persons with psychiatric disabilities through a living arrangement in which a small number of residents live together with support staff, who help them at meals, make sure they take their medication, and provide other assistance as necessary.
Support staff at group homes provide the following assistance: (1) Help at meals, instruction on medication, advice on the management of money, and other support for daily life (2) Necessary adjustments to ensure that residents do not encounter problems in their daily life, including prompt communication with medical institutions when problems arise because of illness (3) Overall observation of residents’ living conditions (4) Group homes must have at least 4 residents
4. Measures to Promote Reintegration and Participation
1. Social adjustment training programs
Under this setup, persons with psychiatric disabilities commute to workshops for a certain period of time and undergo social adaptation training to learn how to concentrate, get along with other persons, endure the stress of work, and adapt to their environment. The programs are aimed at their reintegration by preventing relapses and to promote their social independence.
2. Consultation and guidance for reintegration
Public Health Centers provide consultations and guidance for reintegration as part of their mental health programs. The programs are aimed to support the social adaptation of persons with psychiatric disabilities who are in the process of recovering.
3. Reintegration programs
Consultation corners are opened on weekends and holidays at social rehabilitation facilities for persons with psychiatric disabilities to promote their reintegration.
5. Institutional Services
These facilities provide a supportive environment and assistance to persons with psychiatric disabilities to promote their reintegration and participation.
1. Facilities for Reintegration
a. Daily life training facilities for persons with psychiatric disabilities
These facilities offer assistance to individuals who have difficulty living with their family at home by helping them adapt to daily life. They provide accommodations and other facilities by a minimal fee, as well as training and guidance necessary for reintegration. (Stay of up to two years permitted.)
b. Welfare homes for persons with psychiatric disabilities
These homes are aimed to promote reintegration into society and independence by offering accommodations and other facilities by a minimal fee and support necessary for daily life. (Stay of up to two years permitted.
c. Sheltered workshops for persons with psychiatric disabilities
These workshops are aimed for reintegration for persons with psychiatric disabilities who have difficulty having employment to live on their own. They provide necessary training and jobs by a nominal fee.
d. Industrial workshops for persons with psychiatric disabilities
These workshops provide employment for persons who have difficulty having regular employment. They also provide guidance needed to adapt to social life, thereby promoting their reintegration and participation in social economic activities.
e. Community life support centers for persons with psychiatric disabilities
These centers provide support and consultations on daily life issues to persons with psychiatric disabilities living in the community and conduct various exchange activities with the community, thereby promote their reintegration, independence, and social participation.
2. Subsidies for small-scale sheltered workshops
In order to enhance reintegration of persons with psychiatric disabilities living at home, the central and local governments provide subsidies through rehabilitation centers for persons with psychiatric disabilities for small-scale sheltered workshops and other such programs run by family support groups.
These programs provide the following: (1) Vocational guidance and training for daily life tailored to the needs of each individual. (2) On-site training at nearby sheltered workshops and other facilities to improve the skills of users.
The programs in principle should be designed for five or more users and must be offered for at least four days a week.