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Intensive management system needed to solve youth suicides
  • By Yang Geum-deok
  • Published 2017.09.05 16:06
  • Updated 2017.09.05 16:06
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To prevent the recurrence of mental disorders and the patients’ suicides, Korea should introduce community-oriented intensive management system, experts said Monday.

Also needed is the creation of an early intervention center specialized to treat schizophrenia mainly affecting the younger generations, they added.

Academics presented these and other steps at a workshop to “develop the early-intervention policy to help young people recover from severe mental disorders,” jointly organized by Rep. Yang Seung-jo양승조, chairman of the National Assembly Health and Welfare Committee, and Korea Society for Schizophrenia Research대한조현병학회.

“Countries like Australia, England, and Germany have introduced early intervention centers since the 1990s,” said Professor Kim Sung-wan 김성완 of Chonnam National University Hospital전남대병원. “Their examples showed early intervention and intensive treatment are useful not just from medical aspect but social and economic perspectives.”

For example, according to Professor Kim, Australia spent 400 billion won ($350 million) for five years from 2011 to establish Early Psychosis Prevention and Intervention Center (EPPIC) and Headspace.

England also announced it would invest 1.7 trillion won to support the treatment of mentally-disordered patients in 2016 and set a goal to treat half of them within two weeks.

“There aren’t proper places in Korea to cure mentally-disordered patients at an early stage compared with foreign countries,” Kim said. In the case of mental illness, the suicide rate among affected teenagers is so high as to require intensive management that we should set up a specialized healthcare center and provide psychosocial programs, including the management of short-term patients.”

Other experts agreed. “Schizophrenia isn’t chronic, and severe mental illness and lee than 50 percent of patients with the disease show bad symptoms. We should prevent secondary loss caused by social environment,” said Professor Ahn Seok-kyun of Severance Hospital세브란스병원. “As the preventive effects of maintenance therapies are evident in the first two to three years, it is necessary to set up a strategy to maintain the early stage with drugs with a government policy.”

Some stressed the need for the intensive management. “To prevent the recurrence and chronicization of the disease at an early stage, intensive management of their cases is essential before and after hospitalization. Advanced countries have already set the model without exceptions,” said Lee Myung-soo이명수, head of Gyeonggi Province Mental Health Welfare Center. We have to introduce the system not as pioneering projects but as a universal system throughout the country.”

Lee went on to say, “It is necessary to add the intensive care team to the existing Community Mental Health Center (CMHC) to provide services by population, and provide financial support to them not as state subsidies but from the budget of health insurance.”

The participants also called for the need to provide insurance coverage for serious mental illness. Given the importance of early treatment of mental disorders, they noted, officials should set insurance benefits high for the early and intensive treatment and limit hospitalization period to enhance the effects of treatment.

“Korea is seriously lacking in healthcare services concerning severe mental illness,” said Professor Kim Yun of the Seoul National University Hospital서울대학교. “As medical insurance has provided coverage for only physical diseases, people think it rather strange to spend money to manage mental patients and their accommodating facilities.”

“The nearly non-existent support for mental illness means there is a high possibility of giving benefits to mental patients, however,” he said.

Professor Kim said healthcare costs for the mentally ill should come not from local government budgets but medical insurance fund while stressing the importance of cooperative system between primary medical institutions and mental hospitals.

“Because of unrealistic medical costs, university hospitals, which should deal with mental patients more than now, have tended to focus on less serious diseases,” he said. “Officials should apply the budget to make a flexible response to supply and demand, and set high benefit levels for short-term intensive care by designating such institutions.”

Other experts called for the government to conduct various kinds of pilot programs, set separate budget, work out assessment methods, and provide sufficient information for patients’ families.

“many mental patients stopped studying, but we made them resume study, and many of them entered university,” said Park Kyung-deok박경덕, chairman of KPMHNA정신간호사회. “Private hospitals can’t do this, so the government has to create an institutional basis for mentally-disordered patients to recover.”

The Ministry of Health and Welfare (MOHW)보건복지부 said it agreed on the need for early treatment. As far as the creation and operation of a separate center are concerned, however, the ministry maintained its position to share roles with the existing centers.

“It is true that the discussion of insurance coverages has focused on in-depth treatment, casting aside mental illnesses despite the latter’s high priority,” said Cha Jeon-kyung, director of the ministry’s Mental Health Policy Division. “We need to put the priority back on the early treatment of mental illness and think about case management and medical costs.”

“We are making a guideline for press reports about mental illness and offer education jointly with the police,” he said. “Because mental health services should be solved in the public domain, I hope you stress the need for increasing healthcare service for this area.”

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