WHO Collaborating Centres In The Western Pacific Region Sharing Rehabilitation Good Practice
E-Newsletter- Issue No. 5 (April, 2014)

From NRCD, Japan Development of a standard rehabilitation
program

The Support Systems for Persons withCognitive Disorder due to an Acquired
Brain Injury: A Higher Brain Dysfunction
Support Promotion Project in Japan Establishment of 70 local base supportorganizations for people with higher brain
dysfunction
nationwide
(for
which
appropriate existing facilities including
university hospitals, municipal hospitals,
welfare institutions and health centers weredesignated by each local government)Reported by Dr. Kumiko Imahashi, Dr. ReikoFukatsu, Dr. Yasoichi Nakajima, Mr.Yuzuru
Kamezawa, and Dr. Kozo Nakamura, WHO CC
It is a known fact that the memory, attention,
executive function and social behavior are
impaired following a traumatic brain injury(TBI) and cerebrovascular accident (CVA), andas a result, those affected individuals are often
excluded from social participation. Since thoseimpairments are not readily apparent, they aresometimes referred to as “invisible disabilities,”and patients often have difficulty obtainingpublic understanding and supports. Younger
generation patients especially face a major
challenge of returning to school or work.
We have 2.3 such new patients per 100
thousand people each year in Japan, and thetotal number of the patients is estimated to beapproximately 300 thousand nationwide, andamong which 70 thousand patients are younger
than 65 years of age.
NRCD has been playing a central role in theoperation of a Higher Brain Dysfunction
Support Promotion (HBDSP) project, which isfunded by the Ministry of Health, Labour andWelfare (MHLW), since 2005, and expanding
support networks for these patients nationwide
through local governments. The purpose of theproject is to facilitate their returning to school,work and communities. Some of the project
accomplishments include: Development of diagnostic criteria

 Distribution of approximately 300 support
coordinators
 Provision of approximately 70 thousand
consultations a year Construction of local support networks byeach base support organization
 Organization of biannual conferences by
NRCD (in which local officials andcoordinators gather to report their efforts
and study common issues in group work)
 More than 200 publications
Research and Project Partnership
In parallel to the project, NRCD has been
conducting several research funded by theMHLW and Health and Labour Sciences
Research Grants. Under NRCD, the 70 local
base support organizations are grouped into 10
geographical blocks, each of which is headed bya local academic expert, for this project.
National Summary Data
The following information is based on datafrom the HBDSP National Database: Demographic characteristics: average age =42, male (82%)
 Cause of disability: TBI (54%), stroke (33%),
encephalitis or encephalopathy (9%), braintumor (2%) and others (2%)
Page 6

WHO Collaborating Centres In The Western Pacific Region Sharing Rehabilitation Good Practice
E-Newsletter- Issue No. 5 (April, 2014)

 Average time from the date of injury toadmission to support centers: 96 days

From Sidney, Australia

 Average stay in rehabilitation unit: 97 days

Assessing and Measuring Mental Health
Recovery The most frequently provided services inboth inpatient and outpatient settings:
occupational rehabilitation services
 The average time of the inpatient
occupational rehabilitation: 208 minutes aweek for 3 months per person (physicalrehabilitation was 190 minutes/week, speechrehabilitation was 174 minutes/week, andpsychologicalrehabilitation
including
psychologicalassessments
was142minutes/week) Average duration of mainly provided
occupational and speech therapies after
discharge: 80 to 120 minutes per week for 4
to 5 months
 Employment: employed one year after injury(24%). 31% of the participants who wereemployed pre-injury returned to work or
found open employment
 The percentage of participants who havereturned to work: 47 % provided that
performing a household task and studying
are also included in the definition of work
For more information:
 NRCD, Japan. Rehabilitation manual 19:
Guide to Support for Persons with Higher
Brain Dysfunction 1. Tokorozawa.2006.
http://www.rehab.go.jp/english/pdf/E19.pdf
 NRCD, Japan. Rehabilitation manual 22:
Guide to Support for Persons with Higher
Brain Dysfunction 2. Tokorozawa.2008.
http://www.rehab.go.jp/english/pdf/E22.pdf
For further information please contact Ms. Yoko
Nishimura at: nishimura-yoko@rehab.go.jp

Reported by Dr. Nicola Hancock and Dr. Anne
Honey, Centre for Disability Research andPolicy, University of Sydney, Australia
Mental illness is the leading cause of non-fatalburden of disease and injury in Australia (24%).
Around 7 million Australians experience mentalillness during their lifetime, at any point in time
there are around 206,000 Australians withmental illness who experience severe or
profound limitations to their daily activities.
People with lived experience of mental illness
describe recovery not as medically defined cureor amelioration of symptoms, but rather, as aprocess of attaining a meaningful and satisfying
life regardless of the presence or absence ofreoccurring symptoms (e.g., (Anthony, 1993;Bellack, 2006; Davidson & Roe, 2007; Onken,Craig, Ridgeway, Ralph, & Cook, 2007). The goalof recovery is increasingly reflected inAustralian policy (Department of Health andAgeing 2009) and needs to be reflected in thegoals, interventions, and outcomes of services.
To do this, a way of measuring recovery isneeded.
Whilst a plethora of recovery-based
instruments
havebeendeveloped
internationally over the last decade, many ofthese have remained in early stage
development with limited psychometric testingand ongoing development (Burgess, Pirkis,
Coombs & Rosen, 2011). The Recovery
Assessment Scale (RAS) is one of the moredeveloped, evaluated and used of thesemeasures. However, our study, which
xxxxxxxxxxx
Page 7