国立国府台病院精神科におけるリハビリテーション活動の歴史的経過とその反省

抄録

I Historical background
The history of the psychiatric rehabilitation activity at the Konodai National Hospital began in 1945. At the time, agricultural works were the main subject, and the work had been organized gradually in 1948, and the kinds of works increased and recreational therapy was also adopted. In 1952, occupational therapy regulations were made, and a staffineeting for the rehabilitation activity was held once a week. Occupational therapy staff were gradually increased, and in 1957 open ward was made which was actually the place of work, and patients came from various wards of the hospital were observed and received guidance. Thus group work at the center was gradually developed, and this hospital, having 350 beds in the psychiatric department, and because of being a psychiatric department of general hospital, no budget for the work and recreation was given, and in spite of the serious efforts of the staff the same situation had been continued until 1960.
In 1960, patients made their self-governing organization. The purpose of the organization is to make more therapeutic and effective activity under the poor dudget and personnel circumstances. The name of department was changed from occupational therapy to the department of social therapy. In 1963, because of extremely lack of nurses, centralized system of occupational therapy had to be discontinued. Since then, the works have deen guided in each ward, and the center of the rehabilitation activity was transfered to the self-governing activity, ; club activity, and psychotherapeutic group work. Since then, this system has been operating.
II Therapeutic consideration for centralized system of occupational therapy Because of extreme lack of nurses, observation and guidance of the patient are not carried out sufficiently. The expansion of equipment, more skilled work, etc. are difficult because of poor budget, and it is difficult to assign a proper work for certain type of disease condition, In each section of the hospital, as the result, patients who need guidance were not treated and patients who had less problem were sent for working.
III General status of the present rehabilitation activity
The works are done in each ward under sufficient observation and guidance for rather disturbed patients, Less disturbed patients work in club activity, and group work, and the direction of the work is investigated in the staffineeting of social therapeutic group.
IV Consideration for the activity doing in the self-governing activity
A. Merit: Spontaneity, responsibility, social adaptation have been grown in contrast to the effects of occupational therapy and also the improvement of human relations may be expected.
B. Problem: Since patients participate into the therapy and management, confusion arouse and the ward staff became overcautious and authoritative to the patients. Absolute lack of the ward staff and budget are the problem although the system operates on the more rational basis comparing with the previous system.
Considering the rehabilitation program at this hospital, it seems to be disimproved, but it was a history of great progress, and conventional old preservative way of thinking was about to change in a direction of very positive mass psychotherapy. Howevcr, in order to expect more active development of this program, we have to dissolve the problems of the shortage of both human and economical sources.