Comparison of Major Procedures of Korean Mental Health Law with Other Developed Countries / 신경정신의학

OBJECTIVES : The Mental Health Act is an initiative aimed at changing and shaping mental health services and protecting human rights of persons with mental disorders. Since the Mental Health Act was legislated in 1995, four amendments have been made according to the issues that arose from public concerns. However, there are still many debates about the human rights protection of the mentally ill. This study aimed to provide information regarding major aspects of the Mental Health Act by comparing them among several developed countries. METHODS : Current Mental Health Acts of the state of Michigan in the United States, Scotland in England, the state of Victoria in Australia, and Japan were reviewed. Issues regarding the Korean Mental Health Act were collected from seminar materials, news media contents, and mental health professionals. RESULTS : The definition of subjects in Korean Mental Health Act was more inclusive than other countries and was derived from a medical classification of mental illness. Family members or guardians were granted important responsibilities for deciding the involuntary admission of mentally ill patients in Korea and Japan. In Western countries, Mental Health Review Tribunals or courts have the primary responsibility for important decisions about mentally ill patients. The regulation of immediate discharge after request by voluntarily admitted patients was not enacted in all countries except Korea. The mandatory procedure for involuntary admission in Western countries includes an individual case review with personal interview by a Mental Health Review Tribunal or court. CONCLUSION : The Korean Mental Health Act appears to meet the basic standards of Guidelines from international organizations. Our traditional culture and inherent health systems seem to influence the legal regulation of mental health service and might be related to the problems of human rights protection of mentally ill patients in Korea.

Community Psychiatry Training for Psychiatry Residents: A National Survey / 신경정신의학

OBJECTIVES: There is a increasing need to recruit and retain more psychiatrists who can plan and implement organized programs to work with chronic mentally ill patients in community settings. The aim of study is to discover what training is currently in place to prepare psychiatrist for work in "community" or "public" settings. METHODS: Survey questionnaires were mailed to 85 residency training directors and 10 leaders of community mental health in 2005. Response rate was 75%. RESULTS: Academic seminar about community mental health were not administered to residents in 63% of training hospitals. Forty one out of 64 training hospitals had community mental health rotation programs. Community mental health center (50%) and day hospital (36%) were the most common type of programs. Few general hospital had affiliation with community mental health programs. The amount of time for clinical rotation varied from less than three months part time to 6 months fulltime, with most frequent form of one day per week for three month in second or third year of psychiatry residents. CONCLUSION: Further steps are needed to improve residency training curricula and to encourage well qualified psychiatrist to choose careers in community psychiatry.