ABSTRACT
OBJECTIVE: In accordance with the partial amendment of the Law on Mental Health and Welfare for People with Mental Disorders, some mental health and welfare work is now under the jurisdiction of cities, towns and villages instead of prefecture. What is the role of prefectural health centres in realizing the change? To assess the smoothness of the transfer of the work from prefectures to the municipalities, we investigated the situation in the latter and the actual support provided by health centres. METHODS: A total of 103 health centres in the administrative divisions were recruited. A questionnaire survey was carried out to study the mental health and welfare work, the department in change and other data for cities, towns, and villages in the administrative division of each prefectural health centre. The actions of health centres were also investigated and analyzed. In addition, Japan was divided into 6 blocks of health centres, and comparisons among the 6 blocks were made based on the answers to survey questions. RESULTS: A total of 83 health centres responded to the questionnaire (the response rate was 80.6%), with 683 cities, towns and villages included in their territories about 60% of the municipalities had designated a person in charge of the transferred mental health and welfare services, the responsible department was decided in less than 40% of cases. There were differences among the 6 blocks in Japan in the rates of actions on mental health and welfare, and in the designation of the department in charge in municipalities. Over 95% of the health centres provided educational courses related this transfer of work for municipalities. About 80% of the health centres evaluated the merit of the partial amendment for promotion of mental health and welfare, and 60% were anxious about retrogressive policies for people with mental disorders. CONCLUSIONS: Educational courses supported the smooth transfer of services. The department in charge of the transfer of service in the cities, towns and villages was designated in less than 60% of municipalities.
