Process toward Acceptance of People with Mental Disabilities in a Local Community: Case Study of Ainan, Ehime Prefecture

Abstract

Historically, people with mental disabilities have been isolated from the local community. Against the trend of deinstitutionalization in Western countries, the number of psychiatric beds in Japan increased from the 1960s to the 1990s. In more recent years, policies regarding mental health have been enforced at the community level, but so far have not yielded dramatic results. Under such circumstances, this article examines support activities for people with mental disabilities in the town of Ainan, Ehime prefecture, as this town's activities are considered more advanced than in the rest of the country. The local psychiatric hospital has been central to Ainan's community, and leaders of support activities include local residents as well as mental health professionals. In this study, the process toward acceptance of people with mental disabilities in the local community is illustrated through the transformation of actors' relations and “negative attitudes.”

First, staff at the local psychiatric hospital and neighborhood residents became familiar with one another. After the director of the hospital set up a rehabilitation facility, its inhabitants began to blend into the local community through participation in local agriculture, aquaculture, and traditional events. Next, mental health professionals organized a support group to discuss issues related to the rehabilitation of people with mental disabilities. Throughout these discussions, the professionals advocated for the enlightenment of local residents. As a result, a support group was organized for local residents as well. Local leaders, such as professionals and managers of local enterprises, serve as the core of this organization, which has encouraged many local volunteers to take part in this group. In recent years, the aim of support activities has changed to become more inclusive.

Initially, local residents had a negative attitude toward people with mental disabilities, although this has transformed gradually into an attitude of acceptance due to changes in actors' relations. The main factor in the transformation was face-to-face relations with people with mental disabilities, which have since allowed these people to acquire roles within the local community. The number of psychiatric beds in Ainan has decreased notably in comparison with other municipalities in Ehime prefecture; however, a difference has surfaced in actors' awareness regarding the ideal method for implementing support activities. Furthermore, the lack of successors to lead these efforts has intensified with an aging, decreasing population.