從日本精神醫療現況試論：臺灣地區未來精神醫療系統之發展

PROSPECTIVE VIEW OF PSYCHIATRIC CARE SYSTEM IN TAIWAN: BASED ON OBSERVATION or CURRENT STATUS IN JAPAN

本文描述日本精神醫療現況，針對其精神醫療制度缺失的由來，特别是精神衛生法的漏洞等因素加以分析。根據觀察所得之資料與文獻回顧，與我國現行之精神醫療系統的問題加以比較與探討。由於我國曾經在六十年代初期即引入美國社區精神醫學的理論，並擷取其精義加以實驗而延伸出一套特有的精神醫療模式，加上許多客觀上有利之條件，作者認為採取以公立療養院為核心醫院的精神醫療與心理衛生工作網之構想是正確的。但作者認為此一構想的推展，假若沒有精神衛生法（或心理衛生法）的維繫，可能會遭遇許多困難。因此建議各界集思廣益研擬相關法令加以實施，俾因應未來之需要。

This paper describes the private mental hospital-based psychiatric care system in current Japan. The causal factors of longterm psychiatric hospitalization of the mental ill patients are analyzed on which the fault of Japanese Mental Health Act is focused. Based on above observation and literatures review, the issue of psychiatric care system in the presentday Taiwan is discussed. Since there is no apparently existed obstacle, authors suggest a well-modified and unique model of mental health care delivery system (Taipei model) is worthwhile to developing in this country in order to further establish a mental health care network in the near future. The authors conclude that, a trapavoided mental health act should be legislated to maintain as well as facilitate this movement.