医療観察法対象者の地域移行におけるMTDLPの有用性—指定通院医療機関との連携による就労移行支援

Usefulness of MTDLP in regional transition of the clients of a Japanese forensic psychiatric ward: Employment transition support in collaboration with designated outpatient medical institutions

要旨：殺人未遂事件を起こした統合失調症の対象者に生活行為向上マネジメント（以下，MTDLP）を用いて関わり，「生活行為申し送り表」を通して指定通院医療機関の作業療法士と情報共有し，共に対象者の就労移行を支援した．この結果，対象者は就労継続支援事業所にてやりがいを感じられる仕事に就くことができた．本介入から，MTDLPは対象者の主体的な治療参加を動機づけ，合意目標の達成を目指して対象者と両親，専門的多職種チーム，指定通院医療機関のスタッフの連携を促進するとともに指定入院医療機関と指定通院医療機関における連携を強化し，対象者のシームレスな支援を可能にすると考えられた．

　The Management Tool for Daily Life Performance (MTDLP) was used in the forensic psychiatric ward in Japan during intervention of a schizophrenic client who had attempted murder. Through “the Report of Daily Life Performance,” client information was shared with the occupational therapist at the designated outpatient medical institution, and we worked collaboratively to support the patient to find gainful employment. As a result, the client was able to find a worthwhile job at a facility of continuous employment support. This intervention suggests that MTDLP motivates the client to participate in his treatment actively and promotes cooperation between the client and his parents, the professional multidisciplinary team, and the staff of the designated outpatient medical institution to achieve the consensus goals. In addition, MTDLP was thought to strengthen the collaboration between designated inpatient and outpatient medical institutions and to enable seamless support for a client.