Niigata University of Health and Welfare: Toward a Support System Beyond Individual Experience — Visualizing Challenges Faced by Community Support Staff and the Need for Mechanisms to Prevent 'Burden and Isolation in Risk Response'

Professor Teruyuki Nomura of the Department of Mental Health at Niigata University of Health and Welfare, part of the NSG Group, has conducted research to clarify the challenges and support needs faced by medical staff providing outpatient treatment under the Medical Observation Act, which supports individuals in community living and social reintegration.

The results indicate that the support required at the frontline is more strongly associated with practical and organizational factors—such as risk response and collaboration with related agencies—than with individual staff experience. Furthermore, the study suggests that 'liaison-type back support,' in which specialized designated inpatient medical institutions support local designated outpatient facilities, is a viable strategy to prevent staff overload and ensure continuity of care. This research has been published in the Japanese Journal of Psychiatric and Mental Health Nursing, Volume 35, Issue 2 (May 2026).

About the Research

【Research Overview】

This study targeted 248 staff members from designated outpatient medical facilities responsible for outpatient treatment under the Medical Observation Act. The researchers developed a new scale to assess staff challenges and support needs and conducted a nationwide web-based survey.

The results revealed that staff support needs are more strongly associated with practical and organizational factors—such as risk response, collaboration with external agencies, and internal support systems—than with individual years of experience. Additionally, the 'liaison-type back support' model, in which specialized designated inpatient medical institutions provide advisory and coordination support to outpatient facilities, may help prevent staff burnout and maintain the quality of ongoing care.

This study examines the structure of support systems in forensic psychiatric care and is expected to contribute to the enhancement of community mental health services and the development of support systems for care providers.

【Key Findings】

① Clarified the structure of staff support needs

Staff support needs were found to consist of six factors: 'operational systems and staff care,' 'individual characteristics and risk response,' 'use of collaborative planning tools,' 'coordination among collaborative teams,' 'support for transition and securing life foundations,' and 'decision-making and collaboration.'

② Organizational factors are more important than individual experience

Years of experience in psychiatry or under the Medical Observation Act showed no significant correlation with support needs. The findings suggest that frontline challenges stem not from individual skill deficits but from organizational and systemic issues such as staffing levels and dual-role assignments.

③ Effectiveness of 'liaison-type back support' suggested

Clinical difficulties, especially those related to risk response, were strongly associated with a wide range of support needs. In contrast, support from in-house multidisciplinary teams was associated with lower levels of multiple support needs. These results suggest that establishing a 'liaison-type back support' system—where designated inpatient institutions provide expert advice and coordination—can effectively ensure the quality of community-based treatment.

【Researcher’s Comment】

◆ Professor Teruyuki Nomura, Department of Mental Health

This study aimed to visualize the challenges that frontline staff often internalize as personal burdens, reframing them as organizational and systemic issues. Particularly in high-stakes areas like 'risk management,' we propose 'liaison-type back support' as a concrete model to prevent staff isolation. We hope these findings contribute to smoother operations in forensic psychiatric care and improved staff well-being.

【Original Paper Information】

Teruyuki Nomura, Koji Taketa, Junko Koike, Toshihiro Homma (Teruhiro), Mariko Miyazaki, Takao Shimada, Maomi Wada, Chiyoe Fujii

"A Study on the Structure and Associated Factors of Difficulties and Support Needs Among Staff at Designated Outpatient Medical Facilities under the Medical Observation Act"

Japanese Journal of Psychiatric and Mental Health Nursing

Volume 35, Issue 2

pp. 164–176

May 2026

【Researcher Information】

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

Professor Teruyuki Nomura

【Research Funding】

This study was conducted using funds from the National Center of Neurology and Psychiatry's Research and Development Grant for Mental and Neurological Disorders, under the project "Research on Collaboration Models and Human Resource Development for Comprehensive Mental Health Services" (Principal Investigator: Chiyoe Fujii), specifically the sub-project "Development of Community Forensic Psychiatric Care Systems Incorporating PPI Perspectives" (Sub-investigator: Koji Taketa).

【Co-researchers】

Koji Taketa, Junko Koike, Toshihiro Homma (Teruhiro), Mariko Miyazaki, Takao Shimada, Maomi Wada, Chiyoe Fujii

【Inquiries】

Public Relations Office, Admissions and Public Relations Department 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/

One of the few comprehensive medical universities in Japan, offering 16 departments across 6 faculties in nursing, medicine, rehabilitation, nutrition, sports, welfare, and medical IT. Leveraging its strengths as a comprehensive medical university, the institution provides practical training in 'team-based care' essential in clinical settings. It has established university-wide organizational support systems for certification and employment, achieving national-class pass rates in licensing exams and high employment outcomes. Additionally, the university uniquely integrates sports with medicine, rehabilitation, and nutrition, offering interdisciplinary education.

＜About the NSG Group＞

The NSG Group is a corporate group comprising 101 organizations, with core businesses in education, healthcare, welfare, and nursing care. It also operates in health and sports, construction and real estate, food and agriculture, trading, advertising, ICT, hotels, apparel, beauty, human resources services, and entertainment. Aiming to make each region 'the richest and happiest town in the world,' the group creates regional revitalization initiatives from a private-sector perspective, using 'people,' 'safety,' 'work,' and 'charm' as key concepts.

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