Development of private psychiatric hospitals and public confinement in prewar Japan : the system of bed supply under the Mental Patients' Custody Act and the Mental Hospitals Act

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  • 戦前期日本における私立精神病院の発展と公費監置 : 「精神病者監護法」「精神病院法」下の病床供給システム
  • センゼンキ ニホン ニ オケル シリツ セイシン ビョウイン ノ ハッテン ト コウヒカンチ : 「 セイシン ビョウシャ カンゴホウ 」 「 セイシン ビョウインホウ 」 シタ ノ ビョウショウ キョウキュウ システム

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This study seeks to clarify the historical process by which Japanese psychiatry came to be over-dependent on private hospitals, through an analysis of the practice of public commitment of modern Japanese psychiatric policy in the prewar period. This reconsideration of the pattern of development of mental hospitals will show how the supply of psychiatric care structurally developed throughout the pre and post war periods, an aspect neglected by previous studies. This article demonstrates some important facts of Japanese psychiatry; first, that police and heads of local governments played a leading role in public confinement under the Mental Patients' Custody Act. Second, psychiatric beds were mostly supplied by private hospitals, while the government covered the costs. As a result, private beds came to have a public nature, indicated by their relation to public safety and relief to the poor. By understanding these facts it will be possible to explain the reasons why, in terms of the system of bed supply, Japanese psychiatry relies so heavily on the private sector, and why long-term hospitalization or 'great confinement' has been utilized.

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