Factors of Parental Preparation of Children with Mental Illnesses for Their Independent Living after Their Own Death.

Families of children with mental illnesses are often concerned about living in the community after their parents' death. The cross-sectional study aimed to examine the association between how parents prepare adult children with mental illnesses to live independently after the death of the parent(s). The participants were 1112 members of 46 family support groups for mental illnesses in Tokyo, Japan. The age of the people with mental illness was 40s, and that of their parents was 70s. Logistic regression analysis showed that mothers' support in daily living, no income or pension for disabled people, staying at home during free time, and parental livelihood being the same as the person with mental illness were factors that were negatively associated with the independent living of people with mental illness. In contrast, parental participation in the family group and creating a system for securing regular living expenses of the person with mental illness were positively associated with independent living. The results suggest that parents need to promote their children's recovery and prepare them financially by forecasting their independent living after their own death.

[Preparations made and considered by parents of children with mental illness for their children's lives in the community after their own death].

Objectives　To examine how parents of children with mental illness prepare for their children's lives in the community after their own death.Methods　Twenty-two parents living in the Kanto region, who have children with mental illness, were interviewed from December 2016 to February 2017. Through qualitative inductive analysis, codes were identified from the narrative data that showed the preparation of parents and compared their similarities and differences. Similar codes were collected and subcategories and categories were created with increasing abstraction levels. Each category was considered with respect to the purpose and the reason why each preparation was done.Results　Participants were 9 fathers (40.9%) and 13 mothers (59.1%). Their ages were as follows: in their sixties (n=9; 40.9%), seventies (n=10; 45.5%), and eighties (n=3; 13.6%).　Ten categories emerged regarding parental preparation for their children's life after their death: 1) Forecasting their own death and recognizing the limitations of support; 2) Trying to share with their children about their own death; 3) With consideration of after their own death, organizing the necessary information for their children and their own belongings; 4) Consulting with their relatives about the lives of their children and inheritance, and considering the use of the social resources; 5) Trying to secure a residence and living expenses for their children; 6) Connecting with social resources, searching for recovery methods for their children, and their own health maintenance; 7) Stabilizing and recovering disease conditions of their children, supporting to take medication and outpatient visits; 8) Assessing the ability of their children to live considering their independent life; 9) Developing their abilities to live and sociality, and making reliable supporters other than parents; 10) Encouraging to have fun in their children's lives and considering their employment. Parents were preparing to hope their child would cope with difficulties in their lives after their own death, and maintain a stable life in the community by him/herself.Conclusions　The results suggested that parents should recognize the need of an independent life for their children in the community, to promote concrete preparations toward their children living in the community after their own death.

Mental health and social service needs for mental health service users in Japan: a cross-sectional survey of client- and staff-perceived needs.

BACKGROUND: The appropriate utilization of community services by people with mental health difficulties is becoming increasingly important in Japan. The aim of the present study was to describe service needs, as perceived by people with mental health difficulties living in the community and their service providers. We analyzed the difference between two necessity ratings using paired data in order to determine implications related to needs assessment for mental health services. METHODS: This cross-sectional study used two self-reported questionnaires, with one questionnaire administered to mental health service users living in the community and another questionnaire to staff members providing services to those users at community service facilities. The study was conducted in psychiatric social rehabilitation facilities for people with mental health difficulties in Japan. The paired client and staff responses rated needs for each kind of mental health and social service independently. The 19 services listed in the questionnaire included counseling and healthcare, housing, renting, daily living, and employment. Overall, 246 individuals with mental health difficulties were asked to participate in this study, and after excluding invalid responses, 188 client-staff response dyads (76.4% of recruited people, 83.6% of people who gave consent) were analyzed in this study. A Wilcoxon matched-pairs signed rank test was used to compare the perceived needs, and weighted and unweighted Kappa statistics were calculated to assess rating agreement within client-staff dyads. RESULTS: Over 75% of participants in our study, who were people with mental health difficulties living in the community, regarded each type of mental health service as "somewhat necessary," or "absolutely necessary" to live in their community. Most clients and staff rated healthcare facilities with 24/7 crisis consultation services as necessary. Agreement between client and staff ratings of perceived needs for services was low (Kappa = .02 to .26). Services regarding housing, renting a place to live, and advocacy had the same tendency in that clients perceived a higher need when compared to staff perceptions (p < .01). CONCLUSIONS: It is essential for the service providers to identify the services that each user needs, engage in dialogue, and involve clients in service planning and development.

[Actual circumstances of suicides and related factors according to newspaper coverage of television programs].

OBJECTIVES: This study investigated the actual circumstances of suicides and related factors based on TV program pages in newspapers. METHODS: Information was extracted from the television schedule columns of one major newspaper introducing programs from 2004 to June 2009. During information extraction, reliability was maintained by having 2 researchers specializing in mental health make determinations independently. We examined the column for program names and introductions of 6 broadcast TV channels within the television schedule for data analysis. After information was extracted using the established selection criteria regarding suicide and related information, information extraction was performed for sub-themes in the TV programs. Information was also classified with regard to specialization and program genre or other related context as well as the presence or absence of an experiential narrative. In addition to carrying out the qualitative classification of these collected information data, we compared the numbers and proportion (%) in chronological order and context. Moreover, programs dealing repeatedly with one case were analyzed for trends in the contents of program introductions and in the media. RESULTS: Depending on the season, some programs constantly broadcast about suicides, mainly in spring and autumn. Most of these programs air on Tuesday and Wednesday. We also analyzed programs that repeatedly discussed the same case and identified eight cases repeatedly discussed by more than ten different programs. We also considered bullying, homicide, and depression, which appeared most frequently as subthemes of suicide. An unprofessional approach was observed in 504 programs (81%), whereas only 47 (7.6%) showed expertise. CONCLUSION: Depending on the season and day of the week, suicide is constantly broadcasted on TV programs. We also considered mental health because bullying was a common subtheme in this context. An unprofessional approach was seen in most programs. We also studied programs that repeatedly discussed the same case because overexposure of offenders in programs can lead to secondary suicides.