Social support networks and health-oriented behaviors among skid row residents with disabilities utilizing social rehabilitation services in Kotobuki, Japan

抄録

This study investigates the social support networks, health-related behaviors, and indigenous theories influencing these of mentally or physically disabled residents of Japan's skid row for the purpose of gaining insights that may improve the quality of care provided for this population. Ethnographic data was collected on fifteen subjects who received welfare and who attended either a disabled workshop or a psychiatric daycare in the skid row known as Kotobuki. Participatory fieldwork and semi-structured interviews were used to collect this data, which was analyzed qualitatively. We found that most subjects no longer maintained close relationships with family outside of Kotobuki, and that social support networks within Kotobuki were characterized by lack of depth and usefulness. Reasons for the weakness of the social support networks observed in Kotobuki included awareness of the dangers of the neighborhood, a fundamental lack of trust and wariness towards the other highly mobile residents, a desire to avoid money-related troubles, and the extremely small sizes of the rooms. Those subjects who did maintain close relationships with family outside of Kotobuki and those who had significant experience of regular company work as opposed to day laboring, demonstrated little sense of belonging and even weaker relationships within Kotobuki than the other subjects. Subjects spent little time with anybody else outside of either a workshop or a daycare, and they tended to fill the remaining hours of the day with walks, watching TV, and lying down. However, health itself did not serve as subjects' primary motivation for the walks or medical visits. Support provided by medical and social service workers was invaluable to the subjects, who despite their medical issues did not have a social structure to support each other. How best to foster relationships with emotional support is a subject requiring long-term consideration.