The Sasagawa project: a model for deinstitutionalisation in Japan

Area of Science:

• Psychiatry
• Mental Health Services Research
• Community Psychology

Background:

• Japanese psychiatric care predominantly relies on hospital-based services.
• Deinstitutionalization initiatives are crucial for improving patient quality of life and community integration.
• Systematic approaches are needed to manage the transition from inpatient to residential care.

Purpose of the Study:

• To evaluate the effectiveness of the Sasagawa Project, Japan's first systematized deinstitutionalization initiative.
• To assess the quality and continuity of care during the transition from hospital to residential living.
• To explore a model for managing patient transitions in psychiatric care.

Main Methods:

• Continuous cognitive behavioral therapies (CBT) based on the Optimal Treatment Project protocol were administered.
• Seventy-eight patients with chronic schizophrenia, deemed suitable for discharge, participated.
• Care was provided both before and after the hospital closure, during the transition to Sasagawa Village residential care.

Main Results:

• The transition to residential care appeared smooth with relatively few disruptive incidents during the first 12 months.
• Ten patients experienced incidents that interrupted their stay in the residential setting.
• The study suggests that a less intensive residential care setting contributed to the smooth transition.

Conclusions:

• The Sasagawa Project demonstrates a potentially effective model for deinstitutionalization and community care transition in Japan.
• The project highlights the importance of continuous therapeutic interventions during and after the transition.
• This approach may serve as a valuable model for other countries considering similar psychiatric care reforms.