医療観察法通院処遇における支援課題の地域間共通点と相違点の分析—テキストマイニングを用いた検討

Regional Commonalities and Differences in Support Challenges of Comunity Treatment Orders under the Medical Treatment and Supervision Act : A Text Mining Study

抄録

　本研究の目的は，通院処遇における支援上の課題を，地域間の共通点と相違点に着目して明らかにすることである。5つの自治体において，通院処遇に関わる多機関・多職種の支援者に対してグループ・インタビューを行い，得られたデータをテキストマイニングで分析した。その結果，全自治体に共通する課題は「医療観察法の専門的治療に係る課題」と「一般精神保健との接点に関する課題」に大別された。一方，自治体ごとの課題としては，「一般精神保健と共通する課題」に加えて，「地域の支援基盤に依拠する課題」が抽出された。現在の通院処遇には，多様な課題が複合的に存在し，円滑な処遇に向けた主要な課題は自治体ごとに異なることが示された。

　This study aimed to clarify issues in providing support for outpatient treatment under the Medical Treatment and Supervision Act (MTSA), focusing on similarities and differences across prefectures. Focus group interviews were conducted with multi-professional and multi-agency care providers involved in outpatient treatment orders in five prefectures. The data obtained were analyzed using text mining. The findings indicated that the common issues across all prefectures were extracted as two major categories: issues related to the specialized treatment required under the MTSA and issues concerning the interface with general mental health care. In contrast, prefecture-specific issues included not only those shared with general mental health care but also issues rooted in the local support infrastructure. These results demonstrate that, while diverse and complex challenges exist in outpatient treatment, the primary issues that may provide pathways to improvement differ across prefectures.