[Niigata University of Health and Welfare] Towards a Support System Independent of Individual Experience: Visualizing the Difficulties of Community Support Staff and the Need for a System to Prevent "Burden and Isolation in Risk Response"

Professor Teruyuki Nomura of the Department of Psychological Health at Niigata University of Health and Welfare, part of the NSG Group, conducted research to clarify the structural difficulties and support needs faced by medical staff responsible for outpatient treatment in the community, in order to support the community living and social reintegration of individuals subject to the Medical Treatment Care Act.

The results indicated that the support needed in the field is strongly related to practical challenges such as risk response and collaboration with related organizations, as well as organizational support systems, rather than the number of years of individual experience. It was also suggested that a "liaison-type rear support" system, where designated inpatient medical institutions with specialized expertise support local designated outpatient medical institutions, is worth considering as a measure to prevent overload in the field and ensure continuity of care. This research outcome was published in the Journal of the Japanese Society of Social Psychiatry, Vol. 35, No. 2 (May 2026).

About the Research

[Research Overview]

In this study, a new scale was developed to assess the difficulties and support needs of 248 staff members at designated outpatient medical institutions responsible for outpatient treatment under the Medical Treatment Care Act. A nationwide web survey was conducted.

The results revealed that the support needs of the staff are strongly related to practical and organizational factors such as risk response, collaboration with related organizations, and in-house support systems, rather than the number of years of individual experience. It was also suggested that "liaison-type rear support," where designated inpatient medical institutions provide advice and coordination support to designated outpatient medical institutions, has the potential to prevent staff overload and maintain the quality of continuous support.

This research examined the ideal support system in the field of forensic psychiatry and is expected to be useful for the future enhancement of community mental health services and the development of support for caregivers.

[Key Research Findings]

1 Clarification of the structure of support needs held by staff

It was revealed that staff support needs are composed of six factors: "Operational System and Staff Care," "Individual Characteristics and Risk Response," "Collaborative Plan Tool Operation," "Collaborative Team Coordination," "Transition and Livelihood Security Support," and "Decision Making and Collaboration."

2 Organizational factors are more important than years of individual experience

Years of experience in psychiatry or with the Medical Treatment Care Act showed no significant correlation with support needs. The findings suggest that difficulties in the field are likely due to organizational and systemic issues such as staffing and concurrent responsibilities, rather than a lack of individual skills.

3 Suggestion of the effectiveness of "liaison-type rear support"

Clinical difficulties, particularly those related to risk response, were strongly associated with a wide range of support needs. On the other hand, support from in-house multidisciplinary teams was associated with lower levels of multiple support needs. These results suggest that establishing a "liaison-type rear support" system, where designated inpatient medical institutions provide specialized advice and coordination support, is effective in ensuring the quality of community treatment.

[Researcher Comments]

◆ Professor Teruyuki Nomura, Department of Psychological Health This research aimed to visualize the difficulties that field staff tend to shoulder solely through individual effort as organizational and systemic challenges. In particular, in the area of "risk management," which requires advanced judgment, we propose "liaison-type rear support" as a concrete support model to prevent staff isolation. We hope that these findings will lead to smoother operations in the field of forensic psychiatry and improved staff well-being.

[Original Paper Information]

Teruyuki Nomura, Koji Takeda, Junko Koike, Toshihiro Honma (Terui), Mariko Miyazaki, Takao Shimada, Maemi Wada, Chiyo Fujii

"A Study on the Structure and Related Factors of Difficulties and Support Needs of Staff at Designated Outpatient Medical Institutions under the Medical Treatment Care Act"

Journal of the Japanese Society of Social Psychiatry

Vol. 35, No. 2

164-176

May 2026

[Researcher Information]

Department of Psychological Health, Faculty of Psychology and Social Welfare, Niigata University of Health and Welfare

Professor Teruyuki Nomura

[Research Funding]

This research was conducted using research funds from the National Center of Neurology and Psychiatry, National Center for Mental Health and Neurological Disorders, Research Grant for "Research on Collaboration and Human Resource Development for Comprehensive Mental Health Services" (Principal Investigator: Chiyo Fujii), specifically the sub-project "Development of Community Forensic Mental Health Care Systems Incorporating PPI Perspectives" (Co-Investigator: Koji Takeda).

[Collaborators]

Koji Takeda, Junko Koike, Toshihiro Honma (Terui), Mariko Miyazaki, Takao Shimada, Maemi Wada, Chiyo Fujii

[Inquiries]

Admissions and Public Relations Department, Public Relations Division, Niigata University of Health and Welfare

Address: 1398 Shimami-cho, Kita-ku, Niigata City, Niigata Prefecture

TEL: 025-257-4459

[Niigata University of Health and Welfare] https://www.nuhw.ac.jp/

A comprehensive medical university with six faculties and 16 departments offering studies in nursing, medicine, rehabilitation, nutrition, sports, welfare, and medical IT, which is rare in Japan. Maximizing the advantage of being a comprehensive medical university, this university provides practical training in "team medical care" required in medical settings. Furthermore, with a university-wide organized support system for obtaining qualifications and employment support, it achieves top-class national examination pass rates and high employment rates nationwide. Additionally, leveraging its unique environment with sports-related departments, it offers learning that integrates sports with fields such as "sports" x "medicine," "rehabilitation," and "nutrition."

<About NSG Group>

NSG Group is a corporate group composed of 101 organizations that, with education and medical/welfare/nursing care as its core, develops a wide range of businesses including health and sports, construction and real estate, food and agriculture, trading companies, advertising agencies, ICT, hotels, apparel, beauty, human resource services, and entertainment. Aiming to make each region "the world's most prosperous and happy town," it engages in the creation of businesses that revitalize communities from a private sector perspective, with keywords such as "people," "security," "jobs," and "attractiveness."

<NSG Group Homepage> https://www.nsg.gr.jp/