イギリスの地域精神医療の現状とそこから学ぶもの―ロンドン郊外のLewisham & North Southwark の例を通して―

Abstract

In England, some mental hospitals have been closed and the numbers of beds in mental hospitals are decreasing with considerably high speed. The Department of Health and Social Security is considering to abolish aiming the conventional huge mental hospitals and to integrate them into general hospitals by the end of 1995. This paper introduces the outline and activities of the services in the observed communities and presents my impression and observation as a nurse, based on the history and present condition of psychiatric care in England. We had an opportunity to observe the practical community psychiatric care in Lewisham and North Southwark, the suburbs of London. In these communities, Lewisham & Guy's Mental Health NHS Trust (a corporation body within the National Health Service) provides mental health services. It manages all the services including hospitals, facilities for daily life in the community, and visiting nursing care. Even in England where the psychiatric care is highly innovated, such services are pioneering challenges, which worked well.