How Japanese public health nurses manage neighbors’ complaints toward mentally ill persons with problematic behaviors?

抄録

Despite enhancing deinstitutionalization since 2004, Japanese people do not have an adequate understanding of mental illness. As a result, they had more negative attitudes toward mentally ill persons than people of other nations. In addition, mental health care services have remained insufficient in Japan, and their readmission rate is still high. Relapse causes problematic behaviors in mentally ill persons. Neighbors often complain to public health nurses about it. However, no previous study has focused on managing neighbors’ complaints toward mentally ill persons, and improving the identification of the early warning signs of relapse of them is urgently required. The purpose of this study was to explore how public health nurses managed neighbors’ complaints toward mentally ill persons with problematic behaviors. In this multiple-case study, 11 Japanese public health nurses were interviewed in 2013. Based on the neighbors’ complaints, the public health nurses understood the association between the problematic behaviors of the mentally ill persons and their probability of relapse, and assessed their ability to live independently in the community. The public health nurses were able to change the role of the neighbors from a complainer to a key communicator for the mentally ill persons. To prevent hospitalization of the mentally ill persons, public health nurses managed neighbors’ complaints as useful clues to identify their probability of relapse, as well as to reduce neighbors’ stigma toward them. The findings will help to reduce neighbors’ misunderstanding of their mental illness, the readmission rate and medical costs of them.