An integrated youth mental health service in a densely populated metropolitan area in Japan: Clinical case management bridges the gap between mental health and illness services

Abstract

Aims A global movement, including in Asia, is seeking to establish integrated youth mental health services that provide early intervention in the continuum from mental health to mental illness. Clinical case management (CCM), in which a case manager becomes not only a coordinator of services but also a provider of psychosocial support, can establish a ‘one‐stop network’ that supports youth in densely populated areas with various social resources. In 2019, we opened a community‐based centre called ‘SODA’ in front of a metropolitan railway station, which was designed to be highly accessible, stigma‐free and youth‐friendly to provide CCM. We aimed to clarify its services and effectiveness of CCM. Methods Data from 105 youths were investigated in a case‐controlled study, dividing them into two groups: those who had received CCM for 6 months, and those whose needs were met in fewer sessions. Results Twenty‐one subjects who received CCM for 6 months had difficulties in more domains than the others. The mean of the total service minutes for the subjects who received CCM for 6 months was 491.3 min: psychological support (accounted for 24.8% of the time), support for community living (31.2%), work support (13.8%), family support (10.5%) and support for cooperation with other organizations (19.8%). Global Assessment of Functioning (GAF) score improved significantly, from 46.6 at baseline to 59.3 at 6 months. Conclusion Even in metropolitan areas with numerous medical facilities, young people can face high barriers to access. CCM can be effective as an early intervention for subjects developing mental illness.

Effectiveness of a Comprehensive Mental Health Literacy Educational Programme for Junior High School Students: A Randomised Controlled Trial Examining Changes in Their Knowledge, Attitudes, and Behaviour

“…Compared with other countries, there is, reportedly, a lack of people to turn to in times of trouble in Japan [ 39 ], and there is an urgent need to create a society in which people feel comfortable asking for help [ 40 ]. The usefulness of integrated (one-stop) services in the community as an early intervention approach to improve accessibility to help-seeking pathways for young people is increasingly being reported worldwide, and further research and practice is desirable [ 41 , 42 ].…”

The Mental Health of Young Return Migrants with Ancestral Roots in Their Destination Country: A Cross-Sectional Study Focusing on the Ethnic Identities of Japanese-Brazilian High School Students Living in Japan

“…On the other hand, no significant difference in the tendency to seek help from formal resources (medical doctors and counsellors) was seen between the Japanese-Brazilian and the Japanese groups. This finding suggests that the development of community-based, integrated mental health care systems for migrants is important for providing easy access to help as well as a place where young people can feel comfortable seeking help [11,28,29]. Access to a social support network is an important factor in promoting good mental health.…”

“…This tendency is particularly pronounced among young migrants in Japan [10]. The onset of mental illnesses during youth is relatively common, and youths are the most important age group for targeted early psychiatric intervention to prevent the onset of mental illness and to improve their prognosis [11][12][13][14]. Very little research has been conducted on community-dwelling young migrants that quantitatively assesses their mental health characteristics and help-seeking behaviors, despite the urgent need for such research because of the growing number of migrants.…”

Needs of early intervention services in community-based integrated mental health care systems in Japan

“…The MEICIS project in Japan, funded by the MHLW from 2019, is examining and making policy recommendations on speci c early intervention services to address these unmet medical needs. For example, an integrated youth mental health service that has been implemented in other countries (e.g., "headspace" in Australia) was introduced in a metropolitan area of Japan from 2019 [17]. The MEICIS project has also been working on developing a system for public health nurses to enhance their skills and provide mental health care for people in need in Akita Prefecture, which is a depopulated area of Japan, using Information and Communication Technology (ICT) (Akita Mental health ICT Network, AMIN), in addition to examining the effective placement of clinical psychologists in outreach teams and considering the development of an easy-to-access system for foreign residents, who are increasing in number in Japan [19][20][21]33].…”

“…Since the onsets of many mental illnesses are thought to occur before the age of 25 years, the main target of primary and secondary prevention is young people [15,16]. In Japan, early intervention services for young people in the current system are quite limited, even in metropolitan areas [17]; therefore, the establishment of a Community-based Integrated Care System for Mental Disorders must include early intervention services. The MHLW is currently reviewing operational items to ensure that they are consistent with the principles of this system.…”