Evaluation of Everyday Living Areas for Deinstitutionalized Community-Living People with Mental Illness

Abstract

Deinstitutionalization of psychiatric care has been associated with increased homelessness, crime, and suicide, partly owing to insufficient, adequate, and accessible community resources. Therefore, appropriate resource placement is a key deinstitutionalization issue. The study’s aim was to identify residential group homes for people with mental illness in Kochi Prefecture, Japan, and the social resources necessary for social reintegration using a geographic information system (GIS). Everyday living areas (ELAs), as defined by the Japanese Community-Based Integrated Care System for People with Mental Illness (CICSM), were assessed using ELA location simulations. We used GIS to determine the spatial distribution of group homes, visiting nursing stations, psychiatric hospitals, daycare centers, and employment support offices. Following the CICSM definition of ELAs, we identified areas that people with mental illness could reach within 30 min on foot/by bicycle and counted the number of social resources in them. The ELA location simulation results suggest that policymakers should avoid uniform distribution of ELAs according to the CICSM definition. Establishing ELAs in suburban areas requires careful consideration of the available community resources, number of people with mental illness, existing support systems, and feasibility of the location.