内閣総理大臣 安倍 晋三様

内閣府政策統括官(共生社会政策担当)武川  光夫様






〒164-0011 東京都中野区中央2-39-3

e-mail  contact@jngmdp.org

電話 080-1036-3685







私たちは、Nothing about us without us 「私たち抜きに私たちのことを決めないで」






People first.  私たちはまず人間である。


障害者権利条約は、1条の目的で この条約は、全ての障害者によるあらゆる人権及び基本的自由の完全かつ平等な享有を促進し、保護し、及び確保すること並びに障害者の固有の尊厳の尊重を促進することを目的とする、としている。






To the Japanese Association of Psychiatric Hospitals

The following is an article ‘Japan as No.1’ that was written by President Manabu Yamazaki M.D., in the Journal of The Japanese Association of Mental Hospitals, January 2012 issue, which we are accusing.

Manabu Yamazaki, MD.,

President, The Japanese Association of Psychiatric Hospitals

<Foreword> ‘Japan as No. 1’

A Happy New Year!

I would like to appreciate your entire cooperation of the last year for us.

We, all of the executives, are doing to do our best to aim for the reform and development of psychiatric practices in Japan this year.

I hope your more support and commitment to our Association than the former year.

Well I visited WHO’s office on the 28th of March 2011, and addressed to persons concerned a lecture about the history, today’s condition, and future of psychiatric practices in Japan.

Afterwards I attended the Forum to abolish the gap of state of metal health among people, to be held on the 10th of October, 2011, at WHO.

I gave a speech there on the important role of our Association in Japan.

I also addressed a lecture on the subject ‘Mental Health in Asia; the present situation and our problems’, in the regional meeting of WPA, on the 3rd of October 2011, to be held in Kaohsiung, Taiwan.

I have noticed that the conditions of psychiatric practices in Japan is not correctly understood by people involved, by my seeing psychiatric care systems and talking with persons concerned mainly in Europe and the States for these years.

Surprisingly people involved in psychiatric care in EU and the States never know the present state of psychiatric care in Japan not at all, except the too huge number of psychiatric beds amounted to 350,000, and have even the suspicion that the cruel treatment just like done in prisons must be usually common in Japan.

I think such views about us must be the entire prejudice that mental hospitals and their treatment for inpatients in Japan is same as those of Europe and the States of passed days, having had so many inhabitants with psychiatric illness unnecessarily maybe in 1950’s.

However I believe absolutely that such prejudice must have been founded by Japanese thinking too theoretically that so long staying in mental hospitals is wrong without doubt, stupid scholars strongly influenced by the overseas way, or people earning by blaming mental hospitals in Japan.

Of course we have to reflect that we have spoiled to sending information on psychiatric care in Japan to overseas people concerned so far.

By the way, in my idea, deinstitutionalism performed in Europe and the States are having two aspects; one is to solve monetary crisis of the Government, another is to have been performed as one of politic movements for special purposes.

You can understand why, if you see Italian situations of now.

Psychiatric unit having around 15 beds belonging to general hospitals in Italy can’t accept acute psychiatric patients, so that families of those patients are taking burdens caring such patients at their houses against their will. Some patients in the state of acute psychosis are too heavily sedated by long-acting neuroleptics, so not to violate their ADL at their homes.

Most of conditions of psychiatric care in northern Italy whose finance is enough are good, but in contrast psychiatric services in southern Italy are extremely desperate because of financial lack of local Government.

Anyway such countries reduced psychiatric beds as the States, U.K., Canada and Italy are facing the needs to increase psychiatric beds again as before, and are increasing them now!

By such reason, the words of ‘resettlement into community, shortening of hospitalized days and prevention from being hospitalized’ are absolutely stupid! When we will perform actions like those foolish actions as same as done in overseas countries as EU and the States, we will ruin ourselves surly.

If we will reform psychiatric care in Japan in the same way as done in EU and the States, families and patients in Japan also have to take heavy burdens instead of hospitals.

I remember a miserable patient I have seen in a mental hospital in London yet, who was pissing, but at same time pushing his head on the wall of a bathroom due to loss of strength of his body, slobbering by side effect of taking too massive neuroleptics.

This is why that we will mimic the reform of mental hospitals performed in Europe and the State is so stupid!

I think we shouldn’t imitate such obviously failed reform in EU and the States as I mentioned like above.

We have to perform the reform of mental hospitals in Japan more slowly, apart from reforms in overseas countries.

I believe that the all aspects like access, cost, and outcome of our medical services are most distinguished in the world.

I think mental hospitals in Japan is No. 1 in the world!.

So we, all of Japanese people involved in psychiatry, have to be proud of ‘Japan as No. 1’, and introduce the Japanese way to all over the world.

Finally I would like to say ‘A Happy New Year!’ again.

With my wishes for your cooperation and kind support for us.

Thank you.

To the Japanese Association of Psychustric Hospitals

31th of January, 2012

Japan National Group of Mentally Disabled People

Re, We protest and ask for retraction of the article ‘Japan as No.1’ that was written by President Manabu Yamazaki M.D., in the Journal of The Japanese Association of Mental Hospitals, January, 2012.

And furthermore, we demand you to write a written apology, and answer to our following written inquiries.

The small article ‘Japan as No.1’ written as a New Year’s greeting, by President of your Association( in the Foreword of the Journal of The Japanese Association of Mental Hospitals, January, 2012.) is never approved and overlooked not only inside but outside Japan, from the point of view that it is extremely full of misunderstanding important facts and truth.

We can’t understand his negative evaluation on the reforms of psychiatric services in EU and the States., as well as the false justification of poor conditions of most mental hospitals in Japan.

We can’t believe why Japanese psychiatric systems having the greatest number of psychiatric beds amounted to 350,000 in the world and doing continuously the worst institutionalism just like jails, are No.1!

We want to know why he insists that reducing psychiatric beds should be not good, and both of efforts for ‘return back into community’ and shortening averaged hospitalized days should be the matter.

We can’t know why he blames for people trying to improve mental care system and working advocacy of human right of people with mental illness, in those abusive words.

We can’t overlook his opinion as the President’s message, because it must be entirely main policies of the Japanese Association of Mental Hospitals.

We believe your Association has showed officially your views in the form of President’s message, then we have to point that your Association has lost the public mission in the psychiatric care in Japan right now!

Repeatedly we request an apology and retraction for President’s article in mass, and protest firmly against President’s article.

And we ask for your official answers to following our questions, by the end of February.

I, Concerning on ‘internationally prevalent prejudice against huge beds and continuation of cruel treatment like jails or former European asylums, in Japan’; that your President wrote in your Association’s Journal.

1. Why do you prohibit people involved in advocacy of human rights of inpatients from entering in the mental hospitals?

Do you think how many hospitals are permitting people outside entering, inspecting and helping inpatients? ; we think they are very partly.

We want to why you do prohibit people from entering for inspection, though you are saying ‘Japan as No.1’

2. Physical restricts and seclusion for inpatients are most highly seen in Japan all over the world, and unfortunately they are increasing even now!

How do you justify many kinds of violation of human rights of inpatients, forced treatment and forced work remaining in mental hospitals?

Though the side effects of any improved types of Electric Convulsion Therapy(ECT) are fully known, ECTs are increasingly performed in Japan.

We don’t think ECTs are appropriate treatment.

On the other hand you recognize that you are No.1 all over the world, how do you think about ECTs including those questions?

Why don’t you allow ‘some notorious mental hospitals’ for so poor condition, as members of your Association?

We believe what we mentioned above are never ‘unreasonable prejudice’, but misunderstanding by your Association. How do you think about this?

3. If you have enough confidence to give humane treatment for inpatients,

you should permit ex-patients groups and people involved in advocacy, entering in hospitals as well as opening their assessment in public, though in due process privacy of individuals should be kept then.

II. On concerning what he wrote that some people in Japan has been promoting ‘unreasonable prejudice against mental hospitals in Japan.

Though he says those people are, men thinking theoretically, stupid scholars badly influenced by the overseas way, or people earning by blaming mental hospitals in Japan, do you think so really?.

1. What is this, really indeed, the saying by President of The Japanese Association of Mental hospitals really? We have no words to say more to him.

We think Dr. Manabu.Yamazaki should resign his official post to another person, after he finished an enough apology to people concerned not only inside but outside Japan.

It may be thought he is not suitable to the public role of President of your Association. What do you say?

2. If the small article written this January by President Yamazaki is the official view of your Association, do the Japanese Association allow slandering people to say objections?

If this is true, you, the Association have to dissolve your organization very soonest, then you would be wise to reorganize yourself as a recognized organization supported by highly judgment to be able to hearing criticism from others. You could change in such way. How do you think about this?

III. Concerning on the view that deinstitutionalism developed in Europe and the States has two aspects; one is financial difficulty to maintain mental hospitals, and another is part of political movements seen in Italy.

1. Everybody knows all over the world that both of deinstitutionalism in the States having started at Kennedy’s Presidential Message and the reform in Italy were the great movements for human rights. We believe such s view about deinstitutionalism are universally understood among people concerned in the world.

Why do only Japanese mental hospitals deny it? We think your understanding about the deinstitutionalism is not recognized as reasonable matter. Why can you insist that only your way should be good against all of overseas trends in psychiatric care? What do you say?

IV. Concerning on What he wrote that Government of the States, UK, Canada and Italy, and so on are increasing psychiatric beds again nevertheless former reducing.

1. We think people intending to increase beds are only part of psychiatrists in the world, especially like conservative people in Italy.

However such overseas trend can’t justify the old fashioned and worst institutionalism ; the number of psychiatric beds is ‘No.1’ in the world as its number as well as ratio of beds between population.

So overseas trends doesn’t justify to maintain the huge psychiatric beds in Japan. What do you say?

V. Concerning on his saying that the words of ‘back into community, shortening of hospitalized days and prevention from being hospitalized’ will lead to ruin ourselves , and strength burdens of families, by performing actions like those foolish actions as same as EU and the States.

1. We would like to ask him why the words of ‘back into community, shortening of hospitalized days and prevention from being hospitalized claimed in EU and the States’ are thought to be so stupid.

And also we want to know why the psychiatric care reformed in EU and the States will strength burden for both of families and patients by reason of unwillingly increased family-care.

We think this idea is just your excuse for your maintaining huge beds in Japan?

We demand the clearest explanation of you officially concerning that people doing their utmost efforts to promote ‘back into community, shortening of hospitalized days and prevention of being hospitalized’ should be all stupid.

You have to explain directly for expatients’ group and people concerned doing those efforts why they are foolish.

We request you should answer to people like those what points of efforts to improve psychiatric care are stupid. We think you should have responsibility to explain about President’s message of this January.

VI. Concerning on his saying that reform in Japan should be done more slowly and carefully than in the States and Europe, not to repeat mistakes of reform in EU and USA.

We demand your responsible answer to us later again, after we have confirmed whether reform in EU and USA was really the failure or not, by corresponding with overseas people concerned.

1. We would like to know how long time do you need actually to finish the reform in Japan? And, what part of mental hospitals in Japan will you improve so carefully?

2. For example, why won’t you many of highly long stayed inpatients who have been hospitalized in mental hospitals unwillingly for over thirty years promote to return back into community? Are you just watching they well die in hospitals in future?

As the principle of UN(1992) shows, any persons with disabilities can have right to live in community! We think institutionalism is going against such human right. How do you think about human right of such highly long stayed inpatients?

VII. Concerning on his saying that the level of psychiatric care in Japan is No.1 in the world, at cost, access and outcome which shows quality of barometer of medical provision.

1. What is the reliable evidences of his saying ‘I think mental hospitals in Japan is No. 1 in the world’? The word of ‘think’ is not appropriate then. He should say always his idea upon actual facts.

Don’t you know that many mental hospitals in Japan are situated outside cities? Is this showing good access for patients?

How do you think that legal number of psychiatrists in mental hospitals is very lowered, entirely apart from legal number of doctors in the other ‘common’ hospitals?

What is the actual meaning of his word ‘outcome’? What is the evidence that ‘outcome’ in mental hospitals in Japan is the best in the world?

We demand the clearest answers for these questions of ours.

2. We think any kinds of barometers measuring quality of medicine should be examined on enough comparison with overseas data. Then you have to say that Japan is No.1, as results of thorough investigation of all kinds of scientific data, but not by choosing selfish parts of data.

It’s obviously irresponsible that he never discusses the cost-performance which is the key concept of medical economy. Such incomplete understanding by your Association might be mistaken not only inside but also outside Japan.

So we think you should take back the President’s message of this January!

For the reasons written above, we protest and ask for retraction of the article ‘Japan as No.1’ that was written by President Manabu Yamazaki M.D., in the Journal of The Japanese Association of Mental Hospitals, January, 2012.

And furthermore, we demand for you to open the written apology.

(All translated by Taro NAMASE, Ryoji ARIZUKA)

日本精神科病院会長 山崎學氏文章 (協会誌巻頭言 会長 山崎 學Japan as No.1日精協雑誌 2012 1月号) に対する、「抗議・撤回および公式謝罪要求文」および「公開質問状」





貴協会誌 2012年1月号に掲載された会長山崎 學氏のJapan as No.1と題された協会誌巻頭言文章(以下「巻頭言文章」)は、その内容に関して、日本国内のみならず、諸外国の事例も含め事実関係の著しく偏った見方が存在するのみならず、その表現に関しても、日本の精神科病院、医療に対して批判を行っている人間や団体に対する、もはや誹謗中傷そのものとしか言いようのない表現、また精神科病床数、平均在院日数(いずれも言うまでもなく日本は世界一である)の削減、短縮、退院促進活動、人権擁護(アドボカシー)活動等に真摯に取り組んでいる当事者団体、関係諸団体に対するまさに侮辱そのものと思われる表記・内容が随所にみられ、到底容認されるべき文章ではない。








質問1 精神科病院における患者の処遇に関して、外部の人権擁護(アドボカシー)団体等の、立ち入り調査や救援活動を認めている精神科病院は日本の精神科病院全体のごく一部なのではないかとおもうがいかがか。またなぜ日本の多くの精神科病院は処遇に自信があるにもかかわらず、人権擁護(アドボカシー)団体の調査や訪問を拒否し続けているのか詳しくご事情をご説明頂きたい。
質問2 世界一であるといわれる身体拘束・隔離がこの間急激に増大しているといった点やいまだ後を絶たない患者に対する各種人権侵害(医療の名を借りた自由・人権の不当な剥奪、強制治療(様々な観点からの批判が存在するES療法の増加等も含む)やいまだ見られる使役等)、また数多く存在する「劣悪病院」の諸問題等、これらの点は、貴方が主張する「偏見」の問題ではなく、会長や日精協自身がが「正しく現実を認識していない」のではないかと思われるがいかがか。


質問3 貴方が日本の精神科病院での処遇に自信があるのならば、今後、当事者団体や人権擁護(アドボカシー)
団体の訪問や調査等またその結果の一般への情報公開等にも日本全国の精神科病院は「無条件」に協力すべきではないか(むろん、プライバシーの尊重の問題等に「正当に配慮」するのは当然とした上である )。



質問2 また「年頭冒頭文章」が日本精神科病院協会全体の見解なのだとすれば、日精協は外部等からの真摯な批判者を誹謗中傷することを協会全体で認めている団体ということになろう。即刻協会そのものを解散し、批判に謙虚に耳を傾け、見識と自己改革能力もった団体として再出発すべきであろうとも思われるがいかがか。


質問1 欧米やイタリアに関する認識に関して。いわゆるケネディー演説から始まったアメリカの精神医療改革にせよ、イタリアの精神医療改革にせよ「人権運動」だったことは、世界中の多くの関係者が共有している認識ではないのではないか?「脱施設化」に関する上記見解は一面的に偏った認識と思われるがいかがか

質問1 精神科病床の増床を進めようとしているのは、例えばイタリアでは精神科医の中でも一部のいわゆる「保守派」と言われているグループであると聞いている。アメリカ、イギリス、カナダ等世界全体の動きは当方も充分承知してはいないが、現時点まだごく一部の動きに過ぎないとおもわれる。いずれにせよ35万床という実数でも対人口比でも世界一の精神科病床数の日本での削減に反対する論拠には全くなりえないと思うがいかがか。


Ⅵ 「欧米の失敗の轍を踏まないように、 精神科医療改革は時間をかけて慎重に進めるべきです」








質問2 医療には様々なバロメーターが存在するが、各種バロメーターも検討、国際比較したうえで「日本の精神科医療は世界一」とエビデンスに基づいたうえで主張するべきではないだろうか?十分な科学的データーに基づかず一部のバロメーターだけを取り出し、しかも「コスト」や「アウトカム」だけを取り上げ、医療経済学重要な「コストパフォーマンス」分析さえない著しい「誤解」が生じかねないような主張は日本精神科病院協会として即刻撤回すべきであると思うがいかがか。



以下協会誌巻頭言        会長 山崎  學 Japan as No.12012/01


アピール 9・24「君が代」強制大阪府条例はいらん!全国集会 における野田正彰医師の障害者差別発言に抗議する






fax 03-5942-7626









何らかの精神障害であるから、橋下氏は間違っている、あるいは家庭環境に問題があったから橋下氏は間違っているという「批判」はまさに障害者差別であり、出自を問題にする母子家庭差別です。一体誰が家庭を選んで親を選んで生まれてくるのでしょうか? 発達障害とされた人はそれだけで批判されなければならないのでしょうか? コミュニケーションに障害があるとされた人はその障害を批判されなければならないのでしょうか?

当日会場周辺では在特会等がこの集会そのものについて抗議を行ったそうですが、彼ら在特会は気に入らない対象に対してこの間「きちがい きちがい」と連呼しています。しかし野田医師の発言はまさにこうした在特会の諸君の差別と同根であり、在特会の諸君の「きちがい」発言に専門用語をまぶし、精神科医・大学教授という権威でお化粧した発言にほかなりません。



「日の丸・君が代」強制反対ホットライン大阪 全国集会実行委員会

メール hinokimiosk@yahoo.co.jp

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〒662-8501    兵庫県西宮市上ケ原一番町1-155



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これは本人の同意がない場合、医療報酬としては請求できないという理由で、医療保険以外で多職種チームによる強制的介入を行おうというものである。望んでいないのに自宅に侵入され介入されるという重大な人権侵害が税金を使って行われようとしている。いかなる根拠でこのような人権侵害が許されるのか? 憲法および国際人権法違反と断ずる。しかも恐るべきことにこのチームにはピアサポーターも位置づけられており、いわば精神障害者自身を専門職による人権侵害の手先として利用する、恐るべき精神障害者の分断である。私たち精神障害者はこうした犯罪行為に加担するいわば岡引になることを拒否する。






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