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Kagoshima patient in mental ward for 55 years with 'nowhere else to go'

An 80-year-old woman in a hospital in the southern Japanese city of Kagoshima said she has been in the facility for 55 years because she has "nowhere else to go."

The woman was one of more than 1,700 patients found by a Mainichi Shimbun survey to have spent more than half a century in the mental ward of a hospital.

Wearing a blue T-shirt and a pair of khaki pants, she lies in a bed in the back of a room for eight patients with a floor space of about 27 square meters, on the third floor of a locked ward. Sunlight often shines through the windows, but metal bars prevent her from going outside.

According to the hospital, the woman dropped out of junior college after graduating from a high school in the city. She changed jobs frequently, working at a pachinko pinball gambling parlor then taking live-in jobs at places where she roamed.

She was caught evading a fare for a train heading toward Mojiko in the city of Kitakyushu in the southern main island of Kushu, and was placed in the hospital in December 1963, due to schizophrenia symptoms.

The female patient wakes up around 4 a.m. and spends most of her day lying in bed. As she no longer has any teeth, she can only eat food such as porridge made from rice. She goes to sleep around 8 p.m. after taking sleeping pills. The patient replied to this reporter's question in just a few words, "it's painful to hear auditory hallucinations," and, "it's fun when I can change my mindset."

Her younger brother, who has passed away and was her sole remaining relative, visited the hospital just once more than 10 years ago. However, their last conversation was something closer to a greeting. "I don't want to live outside. I like it inside the hospital, and not outside," she said with a frown.

The woman's stay at the hospital is a self-admission and her living costs are covered by her disability basic pension.

Yasuhisa Matsubara, a 54-year-old office manager at the Mental Hospital Kagoshima where the woman is staying, explained, "There are many cases in which patients' parents pass away, and relatives 'don't want to become involved,' when we try to discharge such patients after they have been here for a long time. It is rare for places like group homes to welcome them, and they cannot live on their own because they don't have a guarantor (to rent an apartment)."

Compared to other advanced countries, Japan stands out for its number of hospital beds in mental wards, and experts have pointed out that a reduction in such hospital beds will prevent the number of prolonged admissions.

According to the Ministry of Health, Labor and Welfare, there were approximately 334,258 hospital beds for those with mental illnesses in Japan as of October 2016. Data compiled by the Organization for Economic Cooperation and Development (OECD) showed Japan had 2.63 hospital beds in mental wards for 1,000 people, the highest figure among the organization's 36 member countries. Although each country has a different way to compile statistics, Japan has almost twice the number of hospital beds in such wards as Belgium, which came in second with 1.37 for 1,000 people.

Most of the 1,773 patients in mental wards who have been hospitalized for at least 50 years were admitted between the latter half of the 1950s to the mid-60s. Akira Hashimoto, professor of psychiatric history at Aichi Prefectural University, analyzed that, "Patients who entered at a period when hospitals were increasing and the prevailing policy was admitting as many patients as possible, are prone to stay longer."

Before World War II, patients were allowed to be confined at homes under the Law for Control of the Mentally Subnormal, which came into enforcement in 1900, amid a lack of hospitals. However, as the law was abolished in 1950 and a new law, which would later become the Metal Heath Law, came into effect, confinement at homes became illegal and hospital beds increased.

In 2004, the health ministry set a goal to switch the focus from medical care in hospitals to community care, and intended to cut 70,000 beds from some 350,000 beds at mental wards back then, but this has yet to be achieved.

The ability of patients to adapt to society will become weaker as the period of hospitalization lengthens. Toshio Hasegawa, professor of psychiatry at Kyorin University stated, "Hospitals sometimes makes patients stay longer to fill the beds from a business perspective. The number of beds should be reduced, and patients should live in communities, such as group homes. We need to overcome the existing prejudice."

(Japanese original by Tetsuro Hatakeyama, Osaka Science & Environment News Department)

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