[The Situation of Psychiatric Medicine and the System of Dispatching Medical Doctors Half a Century Ago in Okinawa].

Abstract

This article describes the situation of psychiatric medicine and the system of dispatching medical doctors half a century ago in Okinawa, based on the author's knowledge and experi- ence gained as an expert participating in the mental health survey of Okinawa in 1966 (herein- after referred to as the Okinawa survey) and as the responsible officer of the Ministry of Health and Welfare in Japan in charge of dispatching medical personnel from mainland Japan to Okinawa. The Okinawa survey adopted the same high-level statistical methods as its counterpart mental health surveys in Japan. The survey clearly illustrated the situation of psychiatric dis- orders and psychiatric medicine in Okinawa, and influenced subsequent psychiatric medicine in Okinawa. After rejoining mainland Japan in 1972, the situation of psychiatric medicine in Okinawa changed markedly. In the Okinawa survey, the prevalence of mental disorders was 25.7 per 1,000 of the popu- lation, and the number of persons with mental disorders was estimated to be 24,060. Approximately 17,000 persons (71%) with mental disorders did not receive treatment or guidance. In 1966, mental institutions in Okinawa consisted of five mental hospitals and one clinic. The num- ber of psychiatric beds was 915. The Ryukyu Mental Health Law came into effect in Okinawa before rejoining mainland Japan. The characteristics of this law were the confinement of per- sons with mental disorders in private residences and the waiver of psychiatric medical fees using public resources. After rejoining mainland Japan, the confinement of persons with mental disorders in private residences was discontinued, but the waiver of psychiatric medical fees was continued. The Okinawa Mental Health Association contributed to psychiatric medicine and mental health services in Okinawa before rejoining mainland Japan. Taking the opportunity of the Okinawa survey, officers in charge of mental health services and public health nurses started mental health activities in public health centers. The dispatch of medical doctors is one of the medical supports for Okinawa. Psychiatrists are dispatched mainly from public mental hospitals such as the Shimofusa National Mental Hospital. Compared with 1966, the present situation regarding the quantity of psychiatric medicine, in Okinawa, such as the number of beds, has improved. It is expected hereafter that comprehensive psychiatric rehabilitation and stress care sys- tems will improve psychiatric medicine in Okinawa.