学校へのアウトリーチ手法による思春期精神保健支援―「日本型ESMH」導入に向けての試み

The “Outreach” Method of Mental Health Support Improves Inappropriate Behavior of Adolescents in Schools：A tentative approach for the introduction of ESMH programs into Japan

抄録

　主に小中学生の思春期精神保健上の問題事例に対して，学校からの要請に応じて精神科医を含む専門職チームが，主に学校内でアウトリーチ手法を用いて見立てや相談，助言を行う「初期介入支援」を20例に対して行った。この結果，精神科医療の必要性が判断され受診支援を行った事例が8例(40％)，学校への助言により適応が改善した事例が6例(30％)あり，さらに不登校10事例のうち5例(50％)が再登校し，学校へのアウトリーチ手法による支援の有用性が示された。当支援と類似点の多い米国のESMHと対比して，日本へのESMH導入における課題を指摘し，当支援が日本の現状に合ったESMH導入モデルとなる可能性について考察した。

Summary

　In order to improve 20 cases of pupils with child and adolescent mental health trouble at primary and secondary schools, “Primary Outreach Mental Health Support Programs for Adolescents”, consisting of consultation and counseling, were presented for teachers in schools and in the board of education by a team of specialists in mental health, including psychiatrists. This program was carried out at the request of the schools involved.

　After the program 8 cases (40％) were successfully persuaded to consult a psychiatrist, despite the fact that they detested doing this at first, even though they needed medical treatment. In 6 cases( 30％), maladjustments were reduced by specialists’ counsel for teachers.

　We also used the program for 10 cases of long absence from school (more than 3 months). In 5 cases (50％), the pupils continued to attend their schools, which seems to suggest the efficiency of our program.

　We compared our program with “ESMH(Expanded School Mental Health)programs” in USA, and discussed the possibility that our programs might be a leading model of ESMH programs leading to their introduction and adoption in Japan.