Patients' Rights in Psychiatric Care
Psychiatric care has major two characteristics. One of them is that involuntary hospitalization is in the legal system. The other is that there is full of social prejudice against patients with mental illnesses. Therefore, patients, who are consumers of healthcare services, have the violation of the rights that patients should have, and we can see that patients with mental illnesses have the violation of their rights in cases and/or public healthcare system. Therefore we have developed field survey, figured out the issue, and developed solutions to (1) the right of receiving medical treatment, (2) the right of refusal of medical treatment, (3) informed consent in psychiatric care, (4) competency to give consent to treatment, (5) normalization of people with mental illnesses, and (6) anti-prejudice studies. At first, we deduced prejudice against people with mental illnesses from (1) the myth that people with mental illnesses would lack competency and (2) negative feeling due to characteristics of mental illnesses.
Then, we overviewed the concepts and assessment methods of competency to give consent to treatment. We thought that information disclosure assumes legal rights, and has therapeutic meaning. We established an original assessment method of competency --- the Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory (SICIATRI) --- and reported its reliability. We discussed its use in clinical settings from ethical viewpoints. The SICIATRI is credited with an assessment method out of 12 inventories in the world.
We showed that “schizophrenia” in Japanese --- “Swishing-bunretdu-byo” which means disease that the mind breaks up --- is one of the roots of prejudice against people with schizophrenia. Therefore, we showed in research that changing the name of “schizophrenia” in Japanese leads to decrease prejudice. The name of “schizophrenia” in Japanese has changed to “Togo-shicchosho” (which means disease that the mind has insufficiency of integration in 2002.
Euthanasia is one of the most difficult of the patients’ right issues. We reported that the view for euthanasia was linked to respect of personal independence. We also critically overviewed all the court cases about euthanasia in Japan. In another study, we found that the load that families with patients with mental illness would perceive was associated with lower GAF level than severity of symptoms.
Inventories developed by Kitamura et al.
We offer inventories as PDF file as bellow.
- 【1】Patients’ Rights in Psychiatric Care: Presented Paper
- 【2】Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory (SICIATRI) : Explanation and Achievement
- 【3】Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory (SICIATRI) :Japanese Version and English Version
- 【4】Disclose Content Check List (DCCL)
- 【5】SICIATRI form
- 【6】DCCL form
- 【7】SICIATRI exercise
※ You can get a PDF file of each paper from “Research Publication” section on this web page.