Model project of home-visit living-skills coaching for individuals with severe mental illness in Japan

摘要

In Japan in 2005, a service called Home-Visit Living-Skills Coaching was legislated. However, this service is not disseminated, and the specific service contents, service effects, and running cost are still unclear. Therefore, we describe the service content and actual condition and evaluate the service effect. The number of inpatient days was evaluated at baseline, 6 months, and 12 months. Methods: The Home-Visit Living-Skills Coaching project was executed by three welfare agencies in Ichikawa City from January 2008 to March 2009. The participants included in this study were individuals with severe mental illness in Ichikawa (n = 33). We recorded every visiting contact with participants by using a service-code checklist for a one-year implementation period (January 2008-March 2009). Results: We clarified that Home-visit Living-Skills Coaching covers multiple needs of participants in their community lives. The percentage of daily household tasks represented only 23.2 percent of total service content checks. In this service, completing tasks for clients or helping clients directly was not the primary method, but the goal was, instead, to advise clients and to improve their skills. Thus, this service requires more expert knowledge and skills relevant to mental health for practitioners than just household assistance knowledge and skills. The Home-visit Life Coaching service may have a positive influence as reflected by the reduction in the number of hospital days when compared with the preimplementation period. Conclusion: The Home-visit Living-Skills Coaching service covered multiple needs of participants in their community lives, and it may contribute to keeping clients' lives more stable.