• Korean Journal of Social Welfare
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• v.39
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• pp.350-373
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• 1999

The patient population of U. S. state mental hospitals has changed drastically since the 1960s, when the deintstitutionalization movement began. This paper is designed to look at what happened to the number of inpatients of state hospitals in California during the last 150 years and, from this, to explore implications for the future of the mental health system in Korea, especially for the viability of mental hospitals. The data had been collected by field research(visits to state hospitals and State Department of Mental Health, and interviews with mental health administrators) and accessing statistical publications and various reports. Since the first state hospital opened in 1851 the statewide inpatient population of individuals who were mentally disabled has grown and peaked at 37,489 in 1959. The number of patients in state hospitals, however, began declining in the early 1960s and was reduced to 10,874 by 1971, and to 4,973 by 1986. As of 1997, there were only 4, 263 inpatients remaining in the state hospital system. This dramatic decrease slowed down somewhat in 1980s and 1990s, but this trend seems irreversible except for the inpatients referred by the court. Now the beds in state hospitals are filled with more and more forensic patients, which constitutes nearly 70% of the total inpatient population. Based on these findings, it is well expected that the number of inpatients of mental hospitals in Korea will also be reduced in a significant way as the community-based mental health care system is gradually replacing the traditional one. Mental hospitals need to introduce more diversified programs for the care of the mentally ill, and concurrently more vigorous aftercare programs are required in the community.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.1-14
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• 2003

Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.

• 대한예방의학회:학술대회논문집
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• 2002.05a
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• pp.73-83
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• 2002

우리 사회에서 일정 정도 이상의 사회와 가정에서의 기능상의 부적응을 초래하는 정신적 문제는 경제활동인구에 있어 가장 흔한 보건의료상의 문제일 것으로 추측되고 있으나, 현재까지는 정신보건제도 마련에 있어 가장 극심한 부적응을 보이는 정신적 장애를 지닌 환자를 위주로 수용시설과 지역사회에서의 재활과 관리에 그 초점을 두어 왔다. 즉 직업스트레스와 같은 일시적인 사회심리적 갈등으로 인한 신체증상의 호소나 알을 및 약물중독으로 인한 사고의 발생으로부터 일생동안 관리되어야 하는 지능저하나 학습장애와 같은 만성적인 문제에 이르기까지 다양한 스펙트럼을 보이는 사업장과 지역사회에서의 정신적 문제들 중 그 일부만이 제도적으로 관리되어 왔다. 실제 그 동안 직장 내 정신보건문제에 대한 행정적 관심은 일부 장애인의 취업 문제를 제외하고는 없었다고 하여야 할 것이다. 그러나 한편으로 우리 사회의 산업구조와 경제사회적 조건의 변화에 따른 노동내용과 조건상 유연화의 증대가 많은 직장에서 노동강화로 이어진다는 점, 그리고 가족 및 교류집단을 비롯한 전통적인 사회적 지지구조가 와해되고 있다는 점과 정신적 문제로 인한 기능상 부적응의 척도가 한편으로 사회적 가치관의 변화에 따라 계속 그 영역이 넓어지는 방향으로 변화하고 있다는 점등에서 직장 내 정신보건 문제는 앞으로 더욱 그 비중이 커질 것으로 판단되고 있다. 문제의 심각성에 대한 관심이 요구되는 현재의 시점에서 제도적 접근에 대한 검토 또한 시작되어야 할 것으로 판단되고 있다. 현재까지 기업 내에서 이루어지고 있는 정신보건관리의 현황을 단편적으로 파악해 보았을 때, 단지 일부 기업에서 취업시 내지는 부서 배치시 성격검사를 비롯하여 적성검사를 실시하고 있으며, 기업윤리확보 차원에서 비정규적으로 사기앙양을 주목적으로 하는 집단적인 교육이나 단체훈련이 이루어지고 있으나, 정신심리적 문제를 개인적 차원에서 그리고 또한 조직적 차원에서 체계화된 프로그램으로 관리하고 있는 사례는 아직 없다. 앞으로 직장 내 정신보건문제에 대하여 제도적인 접근을 하기 위하여서는 다음과 같은 세가지 조건들이 구비되어야 할 것으로 판단된다. 첫 번째로 문제점 그 자체의 내용과 그 규모에 대한 정확한 파악과 예측이 가능하여야 한다. 즉 제도 전체의 운영을 객관적으로 평가하고 개선할 수 있는 기제가 함께 있어야 제도가 실제적인 기능을 할 수 있다는 최소한의 목적이 달성될 수 있다. 두 번째로 문제점의 관리를 위한 효과적인 개입내용 및 개입지점의 확보가 가능하여야 한다. 특히 직장 내에서 수행할 수 있는 프로그램이 개발되어야 하며, 이는 시범사업과 시장을 통한 소비자, 즉 사업주들의 자발적인 선택을 통하여 검토되고 걸려져야만 한다. 마지막으로 제도 운영의 대상, 특히 정신보건문제를 안고 있는 노동자들의 자발적인 동의가 확보될 수 있어야 한다. 이는 정신적 문제가 안고 있는 편견과 그로 인한 차별이 가져다주는 문제를 함께 고려하면서 제도가 운영되어야 하며, 이에 있어 제도 운영상 노동자들의 주체적인 참여가 필요하기 때문이다. 이상 고려되는 직장 내 정신보건문제에 대한 제도적 접근을 담기 위하여서는 프로그램 개발이나 전문가 집단의 양성과 같은 단순한 기술적 접근과 이들의 인허가 및 사업화에 따른 적용기준 및 의무의 설정과 같은 제도적 접근에 그쳐서는 그 실효성을 담보하지 못할 것으로 판단된다. 보다 중요한 것은 이러한 정신보건문제에 대한 노사의 공감대를 이루어 내는 것이며, 사회 전반적인 인식의 확산과 더불어 바람직한 관리모습에 대한 사회적 가치관을 도출해 내는 것이 제도적인 접근의 성공을 보장할 수 있는 기반 조건이 될 것이다. 이러한 점에 있어 정신보건문제를 바라보는 기존의 가치관이 부정적이고 고착화된 모습만을 강조하였으나, 이제는 점차 긍정적이 사회활동에 수반되는 역동적인 모습으로서 비추어지는 것이 많아진다는 측면에서 그 전망을 밝게 하여 주고 있다.

• Korean Journal of Social Welfare Studies
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• v.48 no.3
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• pp.83-116
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• 2017

The purpose of this study is to raise the issue of the existing deinstitutionalization debate, considering only the shipment process to these two spaces, and still leaving the inter-facility circulation of vulnerable mental handicapped who are still hanging around the facility. In particular, we sought to supplement the discussion of deinstitutionalization by illuminating the problems of those who have to rely on facilities, as well as the mental health facility system and the homeless facility system. In the case of homeless persons with mental disabilities who repeatedly use the mental health facility system and the homeless facility system, they confirmed the pattern of using the facilities by constantly changing the place to manage the overlapping risk of mental illness and homelessness. Also it is triggered by the voluntary nature of the parties with no resources and resources. This situation appeared to be inevitable in the absence of resources and supportive systems that would actually enable a life in the community. Nevertheless, I asserted that the life of the mentally handicapped, which is circling the facility, is extremely unstable and is not desirable from a welfare point of view.

• Korean Journal of Social Welfare
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• v.50
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• pp.265-288
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• 2002

The use of alcohol is recognized as having negative consequences on clinical and psychosocial outcomes in service users with major mental illnesses. This necessitates an introduction of intervention measures in domestic mental health service in Korea. Since research basis on which such measures are developed lacks, this paper aims at exploring drinking patterns of Korean service users and suggesting directions and strategies for intervention. The data came from 151 service users recruited at 14 service settings in Seoul Metropolitan area. The quantitative part of the data includes their recent drinking experiences in terms of patterns and severity; the qualitative part includes information on the drinking context. The data were compared among three types of service settings, each of which differs in physical availability of alcohol by their users. Each group revealed distinctive features in drinking patterns, the author thus suggested directions and strategies of intervention specific to type of service setting.

• Korean Journal of Social Welfare
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• v.58 no.2
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• pp.33-56
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• 2006

Primary care takers, especially older parents, who live with and care for an adult child with mental illness struggle with the dilemma of who will provide for their child's social and emotional needs and physical care requirements when they can no longer care so. Therefore, 'Permanency plan(financial, residential, legal plan)' is very important for social integration and normalization of mental illness adults. This study aims to introduce the mental health systems in New Zealand and to investigate the permanency plan strategies(benefit, supplements, and the laws) of the government and community support services of NGOs through the interviews with team leaders of representative NGO, Te Korowai Aroha. Permanency plan strategies of New Zealand Government and NGOs are as follows. 1) Financial plans for adults with mental illness include main benefit(invalid benefit), various allowances(family allowance and disability allowance), and wage subsidies for employment. 2) The Government provide accommodation supplement and re-establishment grant for residential plan. And NGOs have supported accommodation program to provide support and accommodation that are important for social integration. 3) Adult mental illness is provided the support of welfare guardian and property manager under the Protection of Personal and Property Rights Act. According the results, this study concluded that social services for the mental illness which secure supported accommodation and benefits is strongly needed. At the same time, mental health delivery system is needed to make distinction between social services and clinical services.

• The Journal of the Korea Contents Association
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• v.13 no.1
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• pp.221-233
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• 2013

This study aims to explore how to cognize and perform case management process to community psychiatric rehabilitation center in Busan area. The case of case manager for 12 people obtained by conducting focus group interviews were in-depth analysis. Many commissioned by a variety of human service organizations in the contract and the client-centric intake has been received. Assessment, rather than a function of mental disabilities center service needs, planning difficulties in securing resource discovery and felt. Intervention phase focuses on direct service and when several agencies responsible for the case management approach. The possession of responsibility was unclear. Mainly monthly facilities within the checking step checks are being made, there was a desire for the realistic-supervision. Completion stage expectations showed a performance evaluation oriented, and individualized case management that can be represented well on the rating scale.

• Journal of Digital Convergence
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• v.16 no.11
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• pp.605-611
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• 2018

This study examines the effects of recovery-oriented practices on psychiatric symptoms of people with mental disorder and further explores the impact of recovery-oriented practices in each subcategories on psychiatric symptoms, thereby demonstrating the intent of restoring the community mental health rehabilitation center. For this, a survey was conducted on 378 people with mental disorder who used community mental health rehabilitation center and correlation and hierarchical regression analysis were conducted. The study found that among the five subcategories of recovery, including age and duration of illness, 'Life Goal,' 'Involvement,' and 'diversity of treatment options' alleviate symptoms of people with mental disorder. Based on these findings, community mental health rehabilitation center has presented the combined significance of psychiatry and social welfare programs to facilitate the recovery of the mentally handicapped by reflecting the value and factors of recovery-oriented practice.

• The Korean Journal of Rehabilitation Nursing
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• v.9 no.2
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• pp.109-116
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• 2006

Purpose: This study is a descriptive research in which the pathological syndromes of the schizophrenic patients in the community mental health centers, the degrees of the insights, and the correlations between them were examined. Method: The subjects included 114 SPR pt. people who were enrolled in community mental health centers located in D City. The research was conducted during the period from Aug. 1st, 2002 to Jul. 30th, 2004. The instruments were PANSS developed by Kay(1987) and SUMD developed by Amador(1993). Results: Among the pathological syndromes, positives ones were $12.64{\pm}3.80$ on the average, negative ones were $32.00{\pm}5.36$, and general pathological syndromes were $30.50{\pm}6.24$. In the evaluation of the insights, the mean score was $11.81{\pm}5.09$. There were some significant correlations between positive syndromes and general pathological ones (r=.572, p=.000), and negative syndromes and general pathological ones(r=.262, p=.029), while there was no significant correlation between the insights and the sub-measures of general pathological syndromes. Conclusion: Therefore, the schizophrenic patients taking advantage of the community mental health centers have more negative syndromes than those in hospitalized, and rehabilitation programs are needed to help them continuously. And the further study of the correlations between the pathological syndromes and the degrees of the insights are required, and still, it should be analyzed what effects the insight acquirement brings about to the improvements of the pathological syndromes after the application of the insight-oriented programs.

• Journal of Digital Convergence
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• v.11 no.1
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• pp.381-388
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• 2013

The study was done to identify factors influencing the health risk behavior of the chronic mental illness in the community. A cross-sectional study design was used in this study. The sample was 255 chronic mentally ill persons from D city and C province and who agreed to participate in the study. Data were collected on August-september, 2011 and analyzed using the SPSS/WIN 20. Stress event, insight and depression had significant correlations with health risk behavior. Hierarchial regression analysis showed gender (men), diagnosis (schizophrenia), stress event, insight and depression together explained 24% of variance in health risk behavior. Findings of this study allow a comprehensive understanding of health risk behavior of the chronic mentally ill persons in community. It is necessary to integrated health promotion programs designed for this population should focus on these factors for effective behavioral modification.