[Community cooperation initiatives pertaining to concomitant physical illnesses]

In the field of psychiatric care, while there is increasing demand related to concomitant physical illnesses (particularly during the emergency stage of such illnesses), this area is associated with several issues. As injuries resulting from attempted suicide among elderly patients with mood disorders increase, there has been a coordinated effort to improve mental healthy policies through government intervention (i. e., improving general practitioners' ability to deal with depression, and the establishment of psychiatric beds in concomitant illness wards). However, in addition to infrastructure issues, such as the location of, and access to, medical resources, communication loss and mutual unease are occurring between emergency medical services and psychiatric care providers. There is also a sense of distance between mental health professionals and the general medical community; timely and functional cooperation is not the norm. Fujita Health University Hospital has an emergency medical care center and psychiatric beds. For quite some time, the hospital has been dealing with over 100 cases a year, necessitating the emergency admission of patients with mental and concomitant physical illnesses from neighboring areas. The hospital provides continuous medical care in collaboration with psychiatrists and other mental health professionals. In light of this, within the Aichi prefectural regional health-care revitalization plan from 2011, this hospital has been commissioned to provide emergency psychiatric services for concomitant physical illness. Furthermore, Fujita has been upgrading its facilities with the aim of improving its response capabilities. However, it is impossible for this hospital to accept all emergent cases with concomitant illnesses within the whole of Aichi Prefecture, which has a population of over 7 million people. Thus, this does not reflect true medical collaboration with the community. In the debate over the formulation of a health-care plan commencing in the 2013 fiscal year, the issue of concomitant illnesses was highlighted when the subject of psychiatric emergency services was raised. There is some debate regarding the level of collaboration between emergency medical services, psychiatric hospitals, and general practices, with emergency medical care centers within the prefecture as the catchment area. A specific policy measure was then developed that included the creation of model pairs to facilitate concrete and effective collaboration between emergency units and psychiatric hospitals, the building of a support system for clinical management, and putting in place mechanisms to operate the system. Such efforts will hopefully promote the collaboration between psychiatric care centers and general medical treatment geared toward local circumstances.