This study aims to develop a community-care model integrating psychiatric day-care (day-care) and house-call support for people with mental illness that allows continued living in the community without isolation, after identifying the elements required for such services that integrate house-call support (elements for effective support). The study looked at 17 institutions, in a prior nationwide study, carrying out characteristic initiatives, and consent was obtained. In addition, interviews were performed and the analysis was using the method of Grounded Theory approach. As a result of the analysis, 187 elements for effective support were discovered, across six categories, including the establishment of an organizational system for services and the sharing of philosophies and goals, and 27 subcategories. Moreover, the results suggested that when introducing an integrated service, the follow-up process is different for those who experienced long-term hospitalization than for those who have withdrawn from society. For persons with mental illness to continue living in the community, it appears important that day-care and house-call support services work together, going beyond their occupational fields, and providing services suited to individual needs.
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