More Related Content Similar to st.lucia report (20) 2. Table of Contents:
1. Introduction
2. St. Lucia hospital background
a. Data points
b. Outside appearance
3. Observations on Japanese society
4. St. Lucia hospital experience
5. Outpatient treatment
a. Psychotherapy sessions
b. Work experience
6. Post hospital rehabilitation program (daycare)
a. Yamaboshi
b. Volleyball team
c. Patient case study: Kumagai
7. Outpatients
8. Housecalls
9. The Role of social workers
10. In Hospital nutritionists and cooks
11. In Hospital pharmacy
12. Observations and thoughts
a. The crushing pressure of society to patients and their families
b. Japanese society has shown some openness to mental illness
c. US vs Japan Approach to alcoholism
d. Quality elderly care service
e. The importance of teamwork
f. Japanese hospital management
13. Conclusion
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3. INTERNSHIP PROGRAM REPORT
6 week internship at St. Lucia Hospital in Japan
1. Introduction
Born and raised in Palo Alto, CA, I have always aspired to become a doctor. It
started when I was three years old, when I learned that I had received heart surgery for a
coarctation of aorta when I was four months old. I felt that I had to give back to medicine for
saving my life. Since then, I have formed a more concrete idea of why I want to become a
doctor, based on my interactions with actual doctors, and personal experiences in and out of
school.
I was raised in a bilingual environment with my Japanese mother and my American (US
citizen) father. I have visited Japan over twenty times, and went to a Japanese after school for
eleven years. With strong ties to Japan, when I heard that there was an opportunity to intern at
a hospital in Japan, I immediately took action to apply for the position.
The hospital I worked in was called St. Lucia Hospital. It was one of the largest
psychiatric hospitals in Japan; which, dealt with patients of all ages with a variety of symptoms
ranging from Alzheimer’s disease to asphyxiation disorder. The hospital could hold up to 263
patients, and had many more outpatients. There were around 250 staff members to help run the
hospital.
Main reasons for wanting to intern at a Japanese psychiatric hospital came from my
desire to 1) learn how a Japanese hospitals runs and if/ how it offers treatments combining
Western and Eastern medicinal practices and 2) learn more about bipolar disorder, an illness
that has personally affected my life. In the future, I want to explore ways to connect the medical
industries of Japan and the United States in a collaborative environment. I thought this
internship would be the perfect opportunity to get an introduction on how Japan ran its medical
practice.
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5. 3. St. Lucia Hospital Experience
The hospital was an impressive building. With a total of four floors and 263 rooms, it was
an imposing yet welcoming structure of orange paint and red tile roof. During the mornings, both
employees and outpatients crowded the hallways coming in and out of rooms. Each staff
member greeted each other and the patients like close friends, making the atmosphere of the
hospital warm and welcoming to those who were still coming in through the front door.
Over six weeks, I got to know most of the staff members walking through the hallways,
and many of the patients. Through my six week experience, I was able to successfully
contribute to each department.
4. Observations on Japanese Society
The following report will cover St. Lucia’s programs by comparing the workings of the
hospital with how the collectivist and conservative culture of Japan has slowly become more
Westernized. Traditionally, Japan has had a “group mentality” which permeates through its
culture. Most people want to “fit in” and contribute to Japanese society. Due to this collectivist
form of thought, many people are scared to admit that either they or one of their family members
has a mental condition. Often times, after a person with a mental illness is put into a hospital,
the family considers the person to be the hospital’s problem and deserts them; they want their
family to function “normally”.
Recently, there has been an increase in people visiting mental hospitals to get their
conditions treated with support from their families. This change has stemmed from a change on
the outlook of mental illnesses. The introduction of more progressive Western ideas on mental
illnesses, has helped to shape Japanese culture such that mental illnesses are gaining more
recognition as real conditions. As a result, psychiatric hospitals have begun to gain a better
reputation.
5. Outpatient Treatment
Shortened to OT, outpatient treatment was inter hospital treatment that helped mentally
ill patients to recover from their conditions. There was a variety of programs, each designed to
help prevent the worsening of certain symptoms while promoting the curing of others. Some
programs included:
● Programs with patients with lighter conditions:
○ Wellness Recovery Action Plan
○ Japanese Pottery
○ Beach Volleyball
○ Dancing
○ Ping Pong
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6. ○ Japanese Tea Ceremony
○ Work Experience
○ Festival Preparations
● Programs with patients with heavier conditions:
○ Table tennis with balloons
○ Gardening
○ Napping
○ Reading Time
○ Music Therapy
a. Psychotherapy Sessions
Group psychotherapy was usually conducted in the first ward. The first ward was
composed of patients with lighter conditions and symptoms: alcoholism, depression, early
schizophrenia. The group therapy session was centered around a Western program called the
Wellness Recovery Action Plan or WRAP program. Developed by Professor Mary Allen
Copeland (Copeland 2015) in 1995, the program centers around patients being able to self
regulate to function as members of a society. The process involves the patients being aware of
the symptoms of their conditions and then actively trying to avoid them.
The program had six sections (Copeland 2015):
1. Daily Maintenance Plan a schedule that a patient created to live as a “normal” person
and achieve wellness.
2. Identifying Triggers helping to find the events or triggers that activate symptoms.
3. Early Warning Signs identifying signs that showed when a patient strayed from their
Daily Maintenance Plan.
4. When Things are Breaking Down making an action plan to help a patient get back to
their Daily Maintenance Plan when they are straying.
5. Crisis Plan making a plan for when a patient is unable to take care of themselves (i.e.
relying on a relative, being put in a hospital).
6. Post Crisis Plan how a patient can recover from a crisis and get back on track with
their Daily Maintenance Plan.
In Japan, group psychotherapy was new, and in the hospital, the staff were testing it out
to see if it helped with patients avoiding symptoms such as depressing thoughts, and circular
logic. Meetings were generally quiet. Many patients were reluctant to speak about their personal
experiences. However, when patients did speak out, they were showered with support and
praise from the others. In a period of an hour, only four or five patients spoke up, with staff
member taking initiative.
The hesitation that the patients felt when participating in the group psychotherapy
session illustrated the collectivist part of Japanese culture. Many of the patients at St. Lucia had
lived in Japan all of their lives. By speaking out on their conditions, or displaying a desire to live
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7. a normal life, they distinguished themselves from the rest of the patients in the circle. At the
same time, many of them wanted to have their conditions lessened and be functional members
of a society, knowing that a group psychotherapy session would be beneficial to that process.
Both of these sentiments put the patients in a predicament: they were conflicted as to which
community the hospital society or Japanese society they wanted to fit in more. Stating their
thoughts during the session helped the patients to begin to set up a mental schedule for
themselves to live in a “normal” society, distinguishing themselves from some of the members of
the hospital. The patients who did not speak out, remained firmly in the hospital society. The
desire to “fit in” was so important to some patients that they did not want to address their
symptoms in order to not be seen as an outsider.
b. Work Experience Session
Work experience was a valuable OT practice. In work experience, patients who were on
the verge of being released from the hospital got to “work” for a commission based salary. The
tasks were simple factory work: folding advertisements and packing boxes full of candles. The
patients who participated were paid on how much they had collectively finished. The money was
evenly distributed among the patients no matter the speed at which they worked. The
determined look behind the eyes of the patients who were working on their menial tasks further
illustrated their desire to contribute to Japanese society; as a member of Japanese society, the
patients felt an obligation to work and help Japan in any way.
6. Post Hospital Rehabilitation Program
There was a recently implemented system called the daycare at St. Lucia hospital. The
daycare at St. Lucia hospital was a post hospital rehabilitation program; a place for patients
between just getting out of the hospital and full recovery into Japanese society. It worked as a
halfway point for many former hospital patients. Its activities were similar to the ones conducted
by the outpatient treatment development department, and all of its staff were certified physicians
and therapists.
There were living quarters near the daycare for partial patients and many facilities such
as a gym and laundry machines. It was also in proximity to the hospital (across the street) so
that people who lived in the daycare area could go the hospital for occasional check ups.
The daycare functioned from nine in the morning to six in the evening and was divided
into two shifts. The first shift was the morning shift which lasted from nine in the morning to two
in the afternoon, and the second shift was from two in the afternoon to six in the evening. Many
members of the daycare came there multiple days a week, so I got to know many of them
personally.
The push to fully integrate the patients into Japanese society was highly emphasized in
the daycare. The tasks that the patients performed became more difficult and had more real life
applications. Some notable rehabilitation programs are a) Yamaboshi and 2) the volleyball
team.
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8.
a. Yamaboshi Patient managed in hospital cafe
Every other week, the patients who went to the daycare organized an activity called
Yamaboshi. Yamaboshi was an in hospital cafe run by nine or so daycare patients. The
committee members would meet up every day leading up the day that they ran the cafe
planning menu items and decorations depending on the season and the type of cafe that they
wanted to set up; during Christmas they decorated the cafe with strung up lights and fake
snow, during Valentines Day, all of the confections served were made of chocolate.
The staff members of the daycare acted as supervisors to ensure everything ran
smoothly. Since many staff members of the hospital came to visit the cafe when it was opened,
the patients running the cafe often times became exhausted due to the sheer amount of people
coming in and the number of backed up orders. When it became too stressful, the patients
began to lash out each other, or beat themselves up. This was when the staff stepped in to help
bring up the morale of the cafe members.
The experience of Yamaboshi really gave the patients at the daycare the experience of
running a cafe from using a cash register to preparing foods and beverages for the customers. It
was interesting to see improvement within their ability to organize and work in the time I was
there.
b. The Volleyball Team
There were other tasks designed to bring daycare members to fully functioning members
of Japanese society. To create tasks that integrated both communication and teamwork, the
staff organized many sporting events for the day care members. There were table tennis
tournaments and badminton matches but by far the most popular sport was soft volleyball. Soft
volleyball was regular volleyball with a soft rubber ball. The patients at the St. Lucia day care
had their own team for a league composed of mentally ill soft volleyball players. This team went
to regional tournaments, and even had some representation at the national mentally ill soft
volleyball championship tournament. Many of the players began playing when they entered the
daycare. The team and the sport acted as an anchor for many of the members; they gained
confidence from playing, and the sense of camaraderie that formed between the players, helped
the players to cope with the various symptoms they had. It really helped many of the patients to
find a base from which to work with in both their lives at home, and the jobs that they were
working at.
c. Patient Case Study: Mr. Kumagai
Kumagai was a soft volleyball player on the St. Lucia hospital day care team. He was a
twenty five year old man who had problems with depression and bipolar disorder. Coming from
a normal household from the northernmost part of Japan, he had been practicing Japanese
sword fighting (kendo) from a fairly young age. Unfortunately, due to this inability to get into
college, or find a job after getting out of high school, he fell into a lapse of depression (he felt
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9. like he was a failure and feared interacting with people), and his whole family had moved out to
the more Southern part of Japan to put him in St. Lucia hospital where he could recover.
After falling into depression, and developing some symptoms of bipolar disorder, he
began to display conditions similar to that of a hikikomori (acute introvertism) and began to eat
excessively which drove his weight from 70 kilograms up to 130 kilograms. A hikikomori is a
Japanese word for a person who spend all of their time indoors, and does not come out:
antisocial behavior characterized by a strong fear of human interaction.
After being put in the hospital for around two years, Kumagai was deemed fit to go and
live in the daycare section of the hospital. Kumagai was the patient that I got the most personal
with while I was at St. Lucia; we bonded through the sports activities at the daycare.
Kumagai was often times stuck in a negative spiral of thought. He had fallen into
depression because he felt that he had failed, and was scared to take a step outside of his
comfort zone due to his fear of failing again. He consistently told the staff members that he
could not do certain tasks due to his conditions, and it was almost as if he victimized himself. At
the same time, he knew he had to take steps to help fix his depression, so he faced a constant
internal struggle between being too scared, not believing in himself, and knowing what he had to
do. In this storm of thought, his only calm came from his passion for kendo.
Knowing this, after he experienced an episode of depression, I urged him to go to a
nearby kendo tournament in exchange for a week’ s worth of factory work. At the kendo
tournament, he won a couple of matches. Kumagai gained confidence in himself through these
wins and the support from the people that came to his match (me included). After his
tournament, he continued to practice kendo, and repeatedly came back to the doctors with
better mental results.
Kumagai was personally important because he was one of the patients I benefited while
interacting with. However, Kumagai’s situation showed a lot about Japanese culture. Japanese
culture was actually kind of similar to Kumagai in a way. It put so much stress on contributing to
Japanese society, that when one of its citizens did not feel like they were contributing, they fell
into a depression. Most of those who fell into depression were treated as “outsiders” because of
Japanese culture and thus ostracized. Fortunately, Kumagai was able to get out of this negative
spiral because he found a support system. But, many Japanese people are not able to, and
because they feel like “outsiders”, they develop more disorders like bipolar disorder or antisocial
disorder.
7. Outpatients
Kumagai was both part of the day care and what St. Lucia called gairai (outpatients).
More than half of the patients being treated by the staff at St. Lucia hospital were these
outpatients. Outpatients were patients that had some mental disabilities, but could still function
in Japanese society. They came every so often to check in with the doctors. Since there were
so many of them though, the lobby was usually crowded with people waiting for check ups.
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10. Many outpatients came to see their doctors every week, and most were sent home with
a prescription or advice on how to live a healthier. Those who were deemed too unstable to
function in a society were told to go back into the hospital to “heal” themselves.
Functioning in a society was important to these individuals because the hospital
environment provided little freedom. There were chosen periods of time in which patients could
roam, but most were confined to their rooms at a given time. Many of these outpatients had their
own personal problems which helped to make symptoms worse.
8. House Calls
There was another option for people who were unable to go to the hospital by
themselves; this was called Houmonn kango (house call).
Houmonn kango was the Japanese way of saying visiting nurse. Visiting nurses were
professionally trained nurses who went to periodically check up on the outpatients of the
hospital who were unable to come to the hospital by themselves. The nurses act not only as a
nurse, but also as a therapist and a friend: a person that helps to make the lives of the patient
easier by listening to their problems.
I shadowed a number of house calls, but the one that stood out to me the most was
when we visited a married couple who both had schizophrenia. The couple had both been at St.
Lucia hospital and had both gone to the daycare after their mood stabilized. There they fell in
love, and decided to get married and have family. This was an interesting situation because
both of them were still somewhat mentally unstable. The nurse had to check up on all three
inhabitants of the clustered apartment. She made sure that the parents were living healthy
lifestyles, and looked for signs in their daughter for schizophrenia or other mental disorders. She
also talked to the couple about next steps. As their daughter grew up, it was necessary for the
parents to let her know that they both had mental illnesses and the parents also had to find a
different place to live: the apartment they lived in had four rooms and would soon get too
crowded. The nurse helped them look for an apartment complex next to the hospital, and made
a schedule for them to buy groceries during the week. The support system that the couple relied
on came from the hospital.
9. The Role of Social Workers
The hospital social workers played a key role at St. Lucia. Social workers have to receive
certification as therapists and as secretaries. The social workers main job was to get all of the
paperwork finished, communicate with the known relatives of the patients, and find the next
steps for the patients after they had moved out of the hospital. Due to the conservative mindset
of most Japanese people concerning the nature of mental illnesses, being a social workers was
difficult. Many families cut themselves off from the patient being admitted into the hospital. It
was the social workers job to somehow keep in contact with them to update the family on the
well being and state of the patient.
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11. The social workers took care of where the patients went after they were healed or in a
more stable state after being admitted into the hospital for a while. The patients that were
abandoned by their families had to find living accommodations that would allow them to live a
healthy lifestyle, while being in close range to the hospital for regular visits. If the patients were
going back to live with their families, the social workers had to make sure that the environment
that the patient was returning to was not conducive to their symptoms re emerging.
In one case, a twenty year old man had both schizophrenia and dementia. His mother
had “abandoned” him by cutting off all ties with him and living on her own. Unfortunately, his
mother also had dementia, and was prone to violent outbursts and selfish behavior. The social
workers called the mother but she did not answer. They went to her house, but she did not
answer. Eventually, the social workers had to give up on the mother and figure out living
arrangements for her son who still believed that his mother was out there for him.
Social workers frequently sorted out difficult problems like these. When I helped the
social workers out, I had to assist one of the workers with finding a retirement home for one of
the patients who was going out of the hospital. Her family had made it clear that she was going
to be a liability, so we had to find a retirement home that could both fit the budget and be close
enough to the hospital for regular check ups.
10. In Hospital Nutritionists and Cooks
The nutritionists made delicious and balanced meals for the patients every single day.
They made different types of food every day within a chosen parameter of calories and vitamins.
The task of making food for every patient in the hospital was made more difficult by the
various conditions that each patient had. Many of the patients at St. Lucia hospital had
experienced their mental conditions later in life; older people developed Alzheimer’s or
dementia. Food had to be processed in a way that would enable these older people to eat it. It
was usually grounded down into a paste or cut up for patients who were unable to chew or
swallow well. The nutritionists also changed the amount of calories in each meal based on the
patient.
Each patient had a strict scheduled diet. If the patient was marked as being overweight
for their age and height, the doctors made it so that the patients would not receive as many
calories in their meals so that they would lose weight and go back to a “healthier” weight. The
nutritionists had to adjust to this constant changing.
The nutritionists essentially made a personalized meal for every patient in the hospital
three times a day. Since there were around 250 patients in the hospital, the nutritionists made
over 750 meals every single day. They were so dedicated that when the area around the
hospital was hit by a hurricane, many of the nutritionists slept over at the facilities in order to
produce the necessary meals for the patients of the hospital. The meals were given to the
patients by the nurses, who also distributed the medicine of the patients at the same time.
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12. 11. In Hospital Pharmacy
The medicine for the patients was produced by the pharmacy. The pharmacy measured
out and distributed all of the necessary medicine inside of the hospital. The orders came from
the doctors that were in charge of each of the patients in the different wards. Based on the
records made by the nurses, the doctors made minor adjustments to the medicine they were
giving the patients to see how their behavior would be affected in a certain time period. Often
times, a prescription of medicine was changed every five days. It was the pharmacy’s job to
receive the doctor’s orders and prepare the necessary medicine for the patients. The medicine
was put in little packets for the patient to consume; the pills were divided into packets based on
when they should be taken. Some pills were taken before meals in the mornings, and others
after meals at noon. Some patients wanted their pills to be put in powdered form, so pills were
grounded. The medicine was directly handed to the nurses in each of the wards for distribution.
12. Observations and Thoughts
a. The Crushing Pressure of Society to Patients and their Families
Traditional Japanese culture is unforgiving to those with mental illnesses. Mental illness
has been seen in two ways: 1) a temporary and completely treatable ailment 2) an illness to
deny and ignore. Conditions that the patients lived in usually made their conditions worse due to
this conservative form of thought.
A man named “Taniguchi” in his mid 50s was afflicted with both heavy alcoholism and
depression. He had been put into a string of other hospitals until he finally landed in St. Lucia
hospital. The strange thing about him was that no matter what hospital he had been discharged
out of, he always came back with worse conditions. Based on the social worker’s report, we
found out that his depression stemmed from how he was treated in his household. He received
a lot of pressure and negative judgement from his family and his friends. He could not find a
support system outside of the hospital, which caused him to turn inside on himself, and go back
into a spiral of depression. To forcefully bring himself out of his depression, he turned to
substances, which turned him into an alcoholic. His environment had caused him to turn from a
more positive and non alcoholic person back to his depressive and substance addicted state.
Unfortunately, this happens to many people with mental disorders in Japan. When the
families and relatives of a person with a mental illness do not recognize the legitimacy of the
condition that they have, they put an excessive amount of pressure on the patient; which, helps
to perpetuate the resurfacing of their conditions. When a person cannot handle the pressures
any more, they cave in on themselves which causes worse mental health. On the other hand,
when the relatives of a patient label the illness that a patient has incurable, the patient is cut off
from the family. The family puts the patient in a hospital, and then returns to functioning as a
“normal” family; the ostracization is promoted through both the parents and siblings.
The sad part is how the patients react to the pressures and decisions of their relatives.
When the pressure is put on the patients to recover, they usually let the stress build up,
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13. resulting in violent outbursts and the generation of new conditions like mania. When the patient
knows that their family has cut them off, they still try their best to desperately get better which
usually results in two ways: 1) the patient successfully recovers but is not accepted by their
family which causes them to develop symptoms again 2) the patient turns in on themselves and
tries to find what is wrong with them, causing anxiety and antisocial tendencies. When the
patient is not aware their family has cut them off, they continuously ask the staff members
whether or not their relatives have contacted them. They then focus on their flaws and break
down because they do not have a support system.
b. Japanese society has shown some openness to mental illness
The view of mental illnesses in Japan is a changing part of its slowly growing culture.
Japan has traditionally been a conservative country; it has always tried to adhere to the “old
ways”. With the introduction of Western ideas into both pop and business culture, Japan has
begun to allow more progressive forms of thought to break through its conservative barriers.
One of these thoughts is the awareness of the longevity of mental illnesses and their causes. It
is still an ongoing battle. Many Japanese people still do not understand the conditions of certain
mental illnesses and many stick to the old ways. However, with the introduction of ideas such as
the WRAP program, or by hiring the social workers, the relatives of mentally ill patients have
slowly become more informed on the symptoms of the patients.
As mental illnesses gain more legitimacy, the status of psychiatric hospitals have also
increased, resulting in more patients and more funding to spread awareness of the conditions
that many Japanese citizens have but are too scared to admit. As recognition grows, the
awareness of mental illnesses has gone up, which has slowly convinced some Japanese people
that mental illnesses are treatable over long periods of time.
c. US vs Japan Approach to Alcoholism
Alcoholism in the United States is usually treated with the twelve step process
associated with alcoholics anonymous. This approach focuses on the complete prevention of
further alcohol consumption with medals commemorating how far a person as gone without
abusing the substance.
In Japan, the approach was a little different. It began with the person being diagnosed
with alcoholism, writing down all of their daily habits when they were abusing the substance in
question: usually beer or Japanese rice wine. The person was then asked to reflect on all of
their habits, allowing the alcoholic to find the fault in their dependency on alcohol.
The Japanese approach was based on health and balance. The alcoholics who were at
St. Lucia hospital did not eat enough food and get enough nutrients, which made the effects of
the alcohol more acute. The alcoholic patient frequently missed the bigger picture because they
were consumed by the psychological and mental detriments of alcohol abuse. Due to their
abuse, they fell into an physically unhealthy lifestyle which in turn negatively affected everything
around them. By having the patients reflect on themselves and their surroundings helped the
patients to be more self aware of the ways that alcohol was affecting their lifestyles.
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14. After the self reflection, the alcoholics set up a schedule similar to the WRAP program
schedule. It was a schedule that they had to follow which set up times to prepare and eat
healthy foods with a certain vitamin and calorie count. It really reflected the Japanese
philosophy behind a healthy lifestyle: a routined life.
d. Quality elderly care service
The third ward was where the elderly patients stayed. It had the most staff member and
was frequently the most busy out of all of the wards. During my stay at St. Lucia, I had the
pleasure of bathing some of the elder women in the third ward.
Many of the women had dementia or Alzheimer’s disease which lead them to believe
that they were women in their twenties. Seeing me in the bathroom, many of the patients started
bursting out in tears, claiming that they would never get married. I had to carefully wash the
elderly ladies despite tears, screams, and fighting to make sure they were clean.
The whole process was very hectic and messy. The elders had uncontrollable bowel
movements which lead to excrement being left everywhere. With the screams of the elders still
in the air, the steamy bathroom was rather unpleasant. However, this experience taught me the
value of this hospital. Without the psychiatric hospital, many of these elders would be in a very
tough position. They were incapable of doing most things by themselves. It really reflected the
culture surrounding elders in Japan. They had done their work contributing to Japanese society,
so it was society’s turn to pay them back.
e. The importance of teamwork
St. Lucia hospital owed much of its success to its welcoming and effective staff. The
atmosphere of the hospital was warm because each staff member knew each other and the
patients they were in charge of. Creating this air would not have been possible without
considerable teamwork between the staff workers.
The staff workers at St. Lucia hospital were a family. The hospital was divided into
several “teams”, that worked to make the hospital run. These teams were usually the nurses in a
ward, the nutritionists, the staff at the daycare, and other staff workers at different departments
in the hospital. The pharmacy helped to produce the necessary medicine that the doctors
prescribed for the patients. The nutritionists made balanced and delicious food to ensure the
health of the patients. The nurses made sure the medicine and food went to each of the
patients.
The hospital held bonding exercises to build more chemistry among the hospital
members. Hospital members had gatherings where they went on picnics and went bowling
together. The different “teams” also had team building exercises such as setting goals to make
their section of the hospital more effective. There were also “team vs team” exercises where
different parts of the hospital sent out representative teams to compete against each other in
events like volleyball. The events organized both in and out of the hospital amongst co workers
helped to bring the hospital together as a whole. Some staff members even married other co
workers in the hospital, and had their children managed in a preschool run by the hospital.
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15.
f. Japanese hospital management
Every part of a Japanese hospital works together to form the machine that is the
hospital. The rate at which most people “healed” from their mental conditions was alarmingly
fast and effective. The hospital itself was like a working family: they were continuously trying to
get their patients in a better state.
The cogs in the machine would not have run well without an effective manager. That
manager was the head of the hospital or Dr. Taro Oji. He helped to coordinate the events, and
all major decision of the hospital had to be approved by him before they were executed. He
oversaw the workings of each department and ensured that each part of the hospital supported
the other parts.
The closeness of the hospital members also revealed the dedication of Japanese people
to their jobs and their desire to contribute to their society. They want to be useful to their country
and to other people, so they work hard to “fit in” and help the machine of Japanese society run
better.
13. Conclusion
The experience at St. Lucia hospital was both eye opening, saddening, and hopeful. It
showed the inherently semi destructive nature of Japanese culture, and a hope for change.
The current state of Japanese culture and its view on mental illnesses will not be
beneficial for its citizens. Too much emphasis and pressure is put on being a better contributor
to society; which, causes many people to put an excessive amount of stress on themselves and
the people around them. Those with innate mental illnesses will experience, their symptoms
becoming stronger and more acute due to strained relationships between their relatives and the
pressure they put on themselves to contribute to Japan. Those who do not have a mental
condition have a higher chance of developing one if they miss a step or make a mistake. They
are then ostracized and their conditions worsen.
Although St. Lucia was a warm and welcoming hospital where people could really
recover and become functioning members of a society, the main problem generator of mental
illness was the culture surrounding mental illness itself. The negative connotation it had, and the
accepted responses to it contributed to people not addressing their issues until it was too late.
Japanese hospitals need to work on Westernizing the Japanese view on mental
illnesses. Mental illnesses and other psychiatric problems have to be seen as a legitimate
ailment that does not completely exclude a person from a community or society. If people in
Japan, become more accepting of mental illnesses as a whole, more people could be treated
earlier on, and more cases can be stopped before it's too late.
Although I do not know where Japan will be ten years from now, I hope that I can help to
Westernize the Japanese view of psychiatric issues, and legitimize them to the public. I want to
create a world where people are not scared of admitting their own problems and seeking help. I
think that Japan would really benefit from diverging from the traditional culture to a more
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16. accepting and non judgemental society where “fitting in” is not as important as getting help to
let people function as humans.
Though Japan has a culture that does not embrace those with mental illnesses, St. Lucia
hospital is one of the many hospitals taking strides to help integrate Western forms of medicine
into Japan. The staff at St. Lucia does this by introducing programs such as WRAP group
psychotherapy, and having group homes where mentally ill patients can live independently
under the hospital. At the same time, St. Lucia still has many Eastern methods that help to heal
its patients in a more “natural” way.
The staff at St. Lucia hospital used a method of healing which involves the integration of
health/ nutrition with medicine. Eastern medicine believes that personal health is a key to
healing any ailment. The staff at the hospital put lots of emphasis on continuously hydrating the
patients with barley tea, and making sure that they completely ate the meals that were given to
them. They valued a healthy lifestyle, because many believed that the human body was the
most powerful healing factor; they believed that a healthy mind began with a healthy body. In
order to get the necessary nutrition into the patients, the staff got creative with their menus and
the drinks they served. Sometimes they mixed medicine into a drink, or had to forcefully make
the patients eat their food.
Another Eastern practice that could be seen in St. Lucia hospital was the respect for
elders that many of the staff members had there. The ward with the elder patients got the most
nurses, and it was held as the most important ward. Patients there were treated with foot baths,
and regular baths almost every single day. They were also given ground up food, and treated
like human beings. Previously, I volunteered at a retirement home in Palo Alto called Lytton
Gardens. The treatment of elders there was good, but it always seemed like the elders were
being looked down upon, or inferior to the staff. At St. Lucia hospital, the staff members treated
the patients with respect and honesty despite them having Alzheimer’s disease, dementia, or
bipolar disorder.
Though the integration of Western and Eastern medicine is still a work in progress, I feel
that both sides have a lot they can learn from each other. Many psychiatric hospitals in the
United States do not put an emphasis on personal health like St. Lucia hospital does. At the
same time, St. Lucia hospital uses non electronic records which may be outdated to many
hospitals in the United States. I think it would be beneficial to both sides, if there could be an
integration of ideas, combining the best of both worlds to make a global standard for the best
type of healthcare to be provided for the people living on this Earth. My hope is that in the
future, I can be a medical bridge between the East and the West, to help share the ideas and
themes that both sides have so that together, they can heal more ailments in a variety of ways.
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