学校支援活動におけるメンタルヘルスの現状と課題 - 調査研究委託事業を通して -

本研究では、学校支援活動の中から２年間にわたって受けた某県の学校教育調査研究委託事業の活動を土台に、学校（本研究では高等学校）におけるメンタルヘルスの現状と課題について検討した。その結果、①相談者の数は３０７名であり、内訳は教員が最も多く、続いて生徒、保護者の順であった、②相談内容は、学校全般に関することが最も多かった、③メンタルヘルスの問題への取り組みに関しては、「学校全体の意識」が重要であることが明らかになった。This research is based on a school education research project sponsored by other businesses. The project was conducted for 2 years throughout school support activities. We have examined the current situation and tasks of mental health at schools. The results : 1. The total number of consultants is 307. Teachers make up the largest percentage followed by students and students\u27 guardians. 2. The most popular counseling topics are about general school activities. 3. We have found that the most important point of approaching the tasks of mental health is : "Awareness of whole school"

保健福祉相談機関における思春期のメンタルヘルスサポート ―保健所における思春期相談活動を通して―

本研究では、保健福祉相談機関（本研究では保健所）における思春期専門相談の相談員としての活動を通して、思春期のメンタルヘルスサポートについて検討することを目的とした。その結果　(1)来談者数が前年度の類似事業時より増加傾向にあった（対前年度より来所者、相談件数とも約２倍増）、(2)思春期の子どもたちのメンタルヘルスをサポートするための１つの支援として学校のメンタルヘルスの維持・増進をはかる必要性、(3)関係諸機関の継続的な連携活動の必要性が明らかになった

Research on help-seeking behavior and inhibiting to consult with others of the junior high school students: A literature review

In this study, a literature research related to junior high school students’ help-seeking behavior and consulting behavior was conducted to clarify the factors inhibiting their consulting behaviors. The junior high school student’s troubles or consultations and the factors of inhibiting consulting behavior indicated in past research were classified into three categories: 1) junior high school student’s troubles; 2) junior high school students’ consultations; and 3) something to inhibit consulting behavior. After examining something to inhibit consulting behavior, the troubles or consultations that inhibit consulting behavior and the factors and reasons that influence it were compiled. Results revealed that junior high school students inhibit consulting behavior depending on the level of their troubles or consultations and that consulting behavior can differ according to gender. In addition, the findings indicated that for something to inhibit consulting behavior, multiple factors of inhibiting consulting behavior exist, including the formation of friendly relationships and parent–child relationships, both of which are influenced by other inhibitory factors such as the sense of self-affirmation and self-esteem

精神保健に関する知識と理解に関する研究 ―福祉専門職志向入学生の特徴―

われわれは福祉専門職教育課程の大学学部に入学して直ぐの学生における精神疾患に対するイメージを調査した。調査対象者（113名）は精神保健を受講する直前に、うつ病と統合失調症に関する所定の調査表に、個別に回答した。うつ病および統合失調症の事例について夫々36.4％および54.8％が適切に認識し、病因や経過および転帰についてもほぼ妥当に理解していた。しかし、そうした事例の治療法や治療薬に対する認識や、精神保健福祉に関係した情報知識への関心は必ずしも高くなく、今後こうしたことについて本格的に学び、知識を蓄積することで、適切な認識がより増えていくことを期待したい。偏見や差別に係る項目については、被験者個人における偏見意識はさほど強烈でないものの、身近なテーマとなると否定的態度になる傾向がうかがえ、地域集団としての社会的見解を聞くと更に否定的な言辞すなわち強い偏見が示唆された。彼らが将来、福祉専門職になった時、自分の中にあるこうした気持ちとどのように向き合っていくのか、また一般社会にあるこうした認識をどのように受け止め、専門家として対応し改善させていくのか、今後こうした点に考慮しつつ教育プログラムを開発していく必要性が示唆された

精神保健の知識と理解に関する研究 ―福祉専門職志向大学生と２０代地域住民との比較検討―

ヴィネット呈示によるうつ病および統合失調症の事例に関する認識は、夫々が学生群で３６.４％と５４.８％で、２０代住民群では２８.５％と２５.５％であり、前者の学生群でやや高い認識度であった。うつ病圏に関してはほぼ近似した認識が出来ているが、統合失調症圏では十分な認知が出来ていないといえるが、一方では両群間における精神保健福祉の理解に対するモティベーションの差を示唆しているのかも知れない。ただ、現時点でこの理由を明確に説明できる要因は不明である。更に、うつ病と統合失調症に対する偏見差別の有り様についても両群間に違いがあった。すなわち、より自分との関係が近くなればなるほど、両群とも関わりに回避傾向は増すのだが、その程度は学生群が２０代住民群より若干少ない傾向にあった。地域の人々の偏見差別に関する意識について、学生群はうつ病例や統合失調症例のいずれにおいても社会の人々は差別する人がそうでない人より多いと認識していたが、２０代住民群はうつ病事例においては差別されることは少ないと認識しており、やはり両群間に違いが見られた。これらの点については、様々な要因から今後更に検討していく必要があろう

精神保健の知識と理解に関する研究 一般住民と精神保健福祉士、作業療法士、一般看護師、精神科看護師との比較検討 - 日豪共同研究の過程で -

本研究は、２００３年度に行った一般住民対象の「精神保健の知識と理解に関する調査」を精神保健福祉士、作業療法士、一般看護師、精神科看護師等に行い、彼らの精神疾患に関するイメージ、及び精神保健に関する知識や理解の現状を把握し、今後彼らをも含めた普及啓発活動の指針開発に対する基盤を確立することを目的とした。方法は、「精神保健の知識と理解に関する調査票」（日本語版）を専門家対象の質問紙調査仕様に改変したものを使用して、平成１６年秋から幾つかの全国学会・協会に対して調査協力依頼を行い、合意の得られた組織で無作為抽出された構成会員への郵送調査を行った。個別の調査依頼（４,５７５人）に対して総数１,１２４人からの回答が得られた。回収率は３４.６％であった。結果は、事例の認識度について、うつ病事例では一般住民２８.８％に対して、作業療法士７２.０％、精神保健福祉士７０.４％、一般看護師３６.１％、精神科看護師２９.１％であり、統合失調症事例では一般住民２５.３％に対して、精神保健福祉士７５.９％、作業療法士７３.４％、看護師３７.２％、精神科看護師３２.８％であった。事例への人的支援については、一般住民がカウンセラーに高い期待を示したのに対して、専門職では精神科医への期待が最も高かった。薬剤の認識は専門職間、一般住民と専門職とで差異を見た。治療法では一般住民が身体を動かすことに期待していたが、専門職は精神療法を高く評価した。地域の人々の偏見差別については、うつ病について一般住民と専門職との間で差異を見た。統合失調症へのなりやすさは、一般住民が「失業者」を懸念したが、専門職は「２５歳以下の若い人」が最も多いとした。精神保健に関する知識の習得については、専門職が一般住民よりやや高いが、内容によっては一般住民とほぼ同様であったり、専門職間で差異が見られるものもあった。今後は、グループ間の差異を更に確認し、各専門家にとって適切な普及啓発活動の指針を早急に開発していくことが重要であると考える。We conducted "research into the knowledge and understanding of mental health" in the general population in 2003. This time, we changed our target from the general population to Psychiatric Social Workers, Occupational Therapists, Registered Nurses and Psychiatric Nurses. The purpose of the research is to find out what their image, knowledge and understanding of mental diseases and mental health is. It is planned to use the research as basic information for educational and familiarization activities concerning mental health. We have used a research sheet which had been changed from the original "Survey Sheet on the Knowledge and Understanding of Mental Health (Japanese version)" into one especially for experts in the mental health field. From the autumn of 2004, we asked some organizations and associations all around Japan to conduct research. Organizations which agreed to cooperate selected their people randomly and we conducted the survey via mail. We sent the survey to 4,575 people and 1,124 people replied. The collect rate was 34.6%. As for the rate of awareness, in the case of depression, while the general population showed 28.8%, Occupational Therapists showed 72.0%, Psychiatric Social Workers showed 70.4%, Registered Nurses showed 36.1% and Psychiatric Nurse showed 29.1%. As for dementia praecox, while the general population was 25.3%, Psychiatric Social Workers were 75.9%, Occupational Therapists were 73.4%, Registered Nurses were 37.2% and Psychiatric Nurses were 32.8%. As for physical support, while the general population showed a high expectation towards counselors, the highest expectation among experts was toward psychiatrists. Concerning the awareness of medications, there was a difference between the general population and the experts. For treatments, while a physical workout was popular among the general population, mental therapy was dominant among experts. Concerning discrimination in the local community, there was a difference between the general population and experts in the category of depression. As for the question of the resistance characteristics towards dementia praecox, while the general population picked "dislocated worker" as the most vulnerable group, experts suggested "young people under 25 years of age" were the majority. As for the rate of knowledge about mental health, experts were slightly more aware than the general population, but it varied depending on the field. In some cases, the two groups showed about the same rate and in other cases we recognized a difference among the experts. As well as taking a close look at the differences among the experts, we will proceed with accurate educational and familiarization activities for experts. We think it\u27s important to introduce effective activities as soon as possible

Stigma in response to mental disorders: a comparison of Australia and Japan

BACKGROUND: There are few national or cross-cultural studies of the stigma associated with mental disorders. Australia and Japan have different systems of psychiatric health care, and distinct differences in cultural values, but enjoy similar standards of living. This study seeks to compare the nature and extent of stigma among the public in the two countries. METHODS: A household survey of the public was conducted in each country using similar methodologies. The Australian study comprised a national survey of 3998 adults aged over 18 years. The Japanese survey involved 2000 adults aged 20 to 69 from 25 regional sites distributed across the country. Interviewees reported their personal attitudes (personal stigma, social distance) and perceptions of the attitudes of others (perceived stigma, perceived discrimination) in the community with respect to four case vignettes. These vignettes described a person with: depression; depression with suicidal ideation; early schizophrenia; and chronic schizophrenia. RESULTS: Personal stigma and social distance were typically greater among the Japanese than the Australian public whereas the reverse was true with respect to the perception of the attitudes and discriminatory behaviour of others. In both countries, personal stigma was significantly greater than perceived stigma. The public in both countries showed evidence of greater social distance, greater personal stigma and greater perceived stigma for schizophrenia (particularly in its chronic form) than for depression. There was little evidence of a difference in stigma for depression with and without suicide for either country. However, social distance was greater for chronic compared to early schizophrenia for the Australian public. CONCLUSION: Stigmatising attitudes were common in both countries, but negative attitudes were greater among the Japanese than the Australian public. The results suggest that there is a need to implement national public awareness interventions tailored to the needs of each country. The current results provide a baseline for future tracking of national stigma levels in each country

Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan

BACKGROUND: Surveys of the public in a number of countries have shown poor recognition of mental disorders and beliefs about treatment that often diverge from those of health professionals. This lack of mental health literacy can limit the optimal use of treatment services. Australia and Japan are countries with very different mental health care systems, with Japan emphasising hospital care and Australia more oriented to community care. Japan is also more collectivist and Australia more individualist in values. These differences might influence recognition of disorders and beliefs about treatment in the two countries. METHODS: Surveys of the public were carried out in each country using as similar a methodology as feasible. In both countries, household interviews were carried out concerning beliefs in relation to one of four case vignettes, describing either depression, depression with suicidal thoughts, early schizophrenia or chronic schizophrenia. In Australia, the survey involved a national sample of 3998 adults aged 18 years or over. In Japan, the survey involved 2000 adults aged between 20 and 69 from 25 regional sites spread across the country. RESULTS: The Japanese public were found to be more reluctant to use psychiatric labels, particularly for the depression cases. The Japanese were also more reluctant to discuss mental disorders with others outside the family. They had a strong belief in counsellors, but not in GPs. They generally believe in the benefits of treatment, but are not optimistic about full recovery. By contrast, Australians used psychiatric labels more often, particularly "depression". They were also more positive about the benefits of seeking professional help, but had a strong preference for lifestyle interventions and tended to be negative about some psychiatric medications. Australians were positive about both counsellors and GPs. Psychiatric hospitalization and ECT were seen negatively in both countries. CONCLUSION: There are some major differences between Australia and Japan in recognition of disorders and beliefs about treatment. Some of these may relate to the different health care systems, but the increasing openness about mental health in Australia is also likely to be an explanatory factor

Public beliefs about causes and risk factors for mental disorders: a comparison of Japan and Australia

BACKGROUND: Surveys of the public in a range of Western countries have shown a predominant belief in social stressors as causes of mental disorders. However, there has been little direct cross-cultural comparison. Here we report a comparison of public beliefs about the causes of mental disorders in Japan and Australia. METHODS: Surveys of the public were carried out in each country using as similar a methodology as feasible. In both countries, household interviews were carried out concerning beliefs about causes and risk factors in relation to one of four case vignettes, describing either depression, depression with suicidal thoughts, early schizophrenia or chronic schizophrenia. In Japan, the survey involved 2000 adults aged between 20 and 69 from 25 regional sites spread across the country. In Australia, the survey involved a national sample of 3998 adults aged 18 years or over. RESULTS: In both countries, both social and personal vulnerability causes were commonly endorsed across all vignettes. The major differences in causal beliefs were that Australians were more likely to believe in infection, allergy and genetics, while Japanese were more likely to endorse "nervous person" and "weakness of character". For risk factors, Australians tended to believe that women, the young and the poor were more at risk of depression, but these were not seen as higher risk groups by Japanese. CONCLUSION: In both Japan and Australia, the public has a predominant belief in social causes and risk factors, with personal vulnerability factors also seen as important. However, there are also some major differences between the countries. The belief in weakness of character as a cause, which was stronger in Japan, is of particular concern because it may reduce the likelihood of seeking professional help and support from others