[Securing Houses for People with Mental Disorders -From Experiences of Supporting Destitute Individuals-].

The Home Association (NPO) mainly supports single destitute individuals, and there are many with dementia or disabilities among its service recipients. Also, Home Co., Ltd. has helped people transition from facilities or hospitals into the community when they cannot obtain approval for housing from surety companies. In the meantime, surety business has faced problems as their clients age and associated accident rates rise. On the other hand, the land- lords have also aged themselves and management of their properties has become increasingly difficult. In light of this situation, we started what we call the "drawing-close community project," where we draw close to the anxious landlords, focus on the vacant houses as a resource, combine housing issues and livelihood support, and provide a community salon where people can get together. This project explores the possibility of landlords and real estate business people taking the lead in the project and also playing a major role in rebuilding the commu- nity. In order to realize the slogan "live in a familiar land until the last moment, even with dementia," livelihood support prevents functional impairment from impairing people's lives and promotes life in the community where residents' connections are valued. Energy to live is enhanced when life is based on mutual support and the residents feel the reassurance of being "protected" and take pride in "protecting" others and the community. The community salon facilitates mutual support in the community, as well as provides employment opportunities for those with unsteady employment and those who have been socially withdrawn. It also helps reduce the risks commonly seen in the community, such as domestic nursing and growing pov- erty. In order for landlords and property businesses to provide vacant houses without concerns, "livelihood support" must be socially credible and its quality must be maintained at a high level. We have proposed to administrative bodies that livelihood support should be recognized and they support, financially or otherwise, the employee training, thereby officially authorizing the livelihood support activities. Housing and livelihood support also works closely with other professional services, such as medicine, nursing and prevention. If "transition to the community and reduction of hospital beds" are to be promoted, we should acknowledge that it is an important issue how livelihood support and medical services can closely cooperate with each other, while being considerate toward each other.

Characteristics of Individuals With Mental Illness in Tokyo Homeless Shelters.

OBJECTIVE: Japan has the largest number of psychiatric beds in the world and has been in the process of deinstitutionalization since 2004. The majority of psychiatric inpatients are elderly long-term patients, who are at risk of homelessness after they are discharged. There is little information about homeless people with mental illnesses in Japan, and the aim of this study was to describe characteristics of people with a mental illness in homeless shelters in Tokyo. METHODS: A face-to-face survey was conducted from December 2012 to March 2013 by the staff of a nonprofit organization (NPO) that helps socially isolated persons. Of the 1,056 people who received help during the study period, 684 completed the survey. RESULTS: Eighteen percent of the 684 survey participants had a mental illness. Of the 210 individuals who lived in shelters, one-third had a mental illness. The mean age of shelter users with mental illness was 64.9; they tended to be referred from hospitals, and their mental well-being was poorer than other NPO service users in the study. Among the service users with mental illness, those living in shelters were older than those living in the community and more likely to have a history of trouble with alcohol, poor family relationships, and impaired instrumental activities of daily living. CONCLUSIONS: Unmet mental health needs were noted among discharged hospital patients living in Tokyo homeless shelters. An integrated and community-based support system with more effective health care delivery, including critical time interventions, is needed.