Open Door System and the Patients at the Hizen National Sanatorium: An Analysis of Admission and Discharge Patterns from “Patient Registers” and “Discharge Petitions”

Abstract

The Hizen National Sanatorium specializing in psychiatry implemented the first large-scale Open Door System in post-war Japan under the leadership of Director Masao Ito in the late 1950s. Whether the patients are placed in closed wards or not is an important issue today, however this reform has not been sufficiently researched. This paper aims to uncover the reality of the reform by utilizing primary sources and to examine the concept of “patients” under the management. As a result, it was newly discovered that not only Open Door System successfully implemented, but also the emphasis on voluntary admission continued to have an impact even 20 years after Ito’s resignation. However, this was a top-down reform that lacks patient involvement. This raises questions about how it is possible to describe the history of patients.