- 文化人類学 (ISSN:13490648)
- vol.77, no.2, pp.306-318, 2012-09-30
Japan has more in-patient days than any other country, as well as the highest number of beds in mental hospitals as a ratio of the total population. People with mental disorders used to be hidden away under the law, either in the medical or welfare system, and suffered from a social stigma. In recent years, however, mental patients have left such isolated medical institutions and started to live among the general community, not as psychiatric patients but as persons whose will is respected and who can get social-welfare support. As that drastic paradigm shift happened rapidly, Japanese institutions for persons with mental illness have come to design various support systems in response. This paper describes the experiences of several schizophrenic persons who utilize a social welfare facility in Hokkaido: Bethel's House in Urakawa, which has developed unique ideas about dealing with schizophrenic symptoms. The members of Bethel's House diagnose their own symptoms on their own terms, and are able to study their physical conditions, sensuous feelings, and mental worlds through their own experiences of living in the community. They carry out that work studies with friends - the other members of Bethel's House - and develop and train skills for communication with their friends and the rest of the real world. The paper looks at the case of a woman at Bethel's House who had difficulty holding down a job because of voices she heard and hallucinatory delusions she saw. She only realized that the voices and hallucinations might be coming from her own mind after talking with the other members of the house. Although she suffered from the voices, she gradually gained skills to communicate with her "friends." The staff members of Bethel's House did not try to ignore the voices, but instead were told to greet them (the "friends" were just the voices that she had heard). The staff members also urged her to try to experiencing talking with her friends using those greetings. Through such daily communications, schizophrenic persons at Bethel's House, such as this woman, learn to have specific physical experiences using their own words, thereby constructing practical communities. We also found that medical institutions and welfare facilities in Japan have kept away schizophrenic experiences, having removed patients from the community in the context of psychiatric treatment, responsible individuals, and human rights. In contrast, Bethel's House lets schizophrenic persons live with their voices and hallucinations, meaning that they live in a continuous world that includes both the hospital and the outside world. On the other hand, some residents in Urakawa Town wanted to exclude Bethel's House from the community because they felt it was accommodating "irresponsible" or "suspicious" persons, or subsidizing non-working people with public monies from the town budget. Although individual daily contact was maintained between Urakawa residents and the members of Bethel's House, those exclusionary attitudes against social institutions meant that Bethel's House has come to function as an asylum for schizophrenic people in such situations, increasing the feeling of isolation in schizophrenic persons' lives, both internally and externally.