Operation Status and Improvement Plan of Continuing Hospitalization Judgement System in Mental Health Review Board / 보건행정학회지

BACKGROUND: The recent revision of South Korea's Mental Health Law emphasizes the role of the Mental Health Review Board. For this study, we examined the current status of continuing hospitalization judgement in Mental Health Review Board at the national level and aimed to determine the directions of improvement. METHODS: Using a qualitative case study as the research method, we interviewed 30 Mental Health Review Board members and analyzed the results. RESULTS: Each municipality had very different continuing hospitalization judgement methods. In our systematic review, which consisted of document inspection, we identified reliability problems due to limitations in Mental Health Review Board's operating systems, discharge orders, etc. Additionally, continuing hospitalization judgement needs to improve the objectivity, fairness, and effectiveness of their screening examinations. CONCLUSION: Based on the results of this study, we suggest policy proposals to improve these systems, such as standardizing examination processes, strengthening on-site inspections, increasing the independence and neutrality of judgment in Mental Health Review Board, building community mental health infrastructures, and establishing integrated management systems.

Assessment of Continuing Hospitalization Judgement Guideline in Mental Health Review Board / 신경정신의학

OBJECTIVES: The aims of this study are to test the applicability of the continuing hospitalization judgement guidelines of The Primary Mental Health Review Board and to provide the basic data for the development of valid guidelines. METHODS: The request sheets submitted to Cheongju Primary Mental Health Review Board for continuing hospitalization from April 2009 to July 2001 were reviewed. The results according to the guidelines were compared with board's final decision. The aim in making these comparison was to determine the factors affecting the board's decisions. RESULTS: Cheongju Primary Mental Health Review Board assessed 1223 requests during the period, and declined 65 of those requests. The sensitivity and specificity for dissent of the algorithm in the guidelines are 51.6% and 97.0%, respectively. The patterns of data in the sheets from the mental facilities were different from the psychiatric hospital or the clinic. The presence of a guidance's signature, mental status, and specialist's opinion could be factors affecting the board's decision. CONCLUSION: The result suggests that distinguished guidelines are needed for mental facilities. Social support systems and functional impairments may be meaningless because they did not affect the board's decision or could be replaced by other factors. The algorithm and judgement system should be revised to increase sensitivity for dissent. Further research is required concerning the development of standardized guidelines on the judgement for continuing hospitalization.

Follow-Up Survey of Discharged Patients by the Mental Health Review Board / 신경정신의학

OBJECTIVES: The purpose of this study was to examine the current situation and the limitations of the Mental Health Review Board and to identify the effectiveness of the community linkage for discharged patients. METHODS: The data was collected from the 116 patients who were discharged from August 2005 to July 2007 by the order of the Mental Health Review Board. The survey was conducted by telephone with using a structured questionnaire. RESULTS: 51 patients (44.0%) were able to be referred to community mental health services when they discharged. The readmission rate was 50.9% and the mean duration to the first readmission was 51.73 days (S.D.=103.5). The mean duration to the first readmission was significantly longer for the group that was referred to community services and that had a negative correlation with the stability of health security. The outpatient maintenance rate and the current admission status were also significantly different between the group that was referred to community services and the group that was not referred. CONCLUSION: The activities of the mental health review board have definite limitations in Korea such as the high rate of immediate readmissions after the discharge orders. A hospital-community integrated service system could be one possible solution to improve the maintenance of mental health patients in the community and to prevent their readmission.