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これまでの研究や政策立案では、薬物依存の課題を抱える刑事施設等出所者を対象とした地域生活定着支援センターにおける支援の現状と課題については明らかにされていない。そこで、本稿では、地域生活定着支援センター職員に対するインタビュー調査をまとめることによって、薬物依存の課題を抱える刑事施設等出所者の地域支援に関する課題を明らかにする。インタビュー調査の結果、地域生活定着支援センターにおいて、薬物依存の課題を抱える刑事施設等出所者の支援においては、その対象者をいかに「生活者」として把握していけるかが鍵を握ることが明らかになった。実践的な課題として、地域生活定着支援センターと精神保健福祉センターの連携が、学術的な課題として、地域生活定着支援センターを利用し、社会福祉サービスの活用によって地域生活を営んでいる当事者の事例の縦断的な検討が明らかになった。

本稿の目的と関心は，全国的にも高い評価を受ける北海道帯広・十勝圏域の精神保健医療福祉実践を概観するとともに，その歴史的事項の整理を行いながらわが国の精神保健福祉士のあり様について試論を述べることにある。この実践を検討する際には，諸家が「オープンシステム」を評価していることに注目するべきである。それは，「どこの病院の患者であろうと利用できる。誰が創ろうと地域に創られた資源は，医療機関も同様に住民が自由に活用できることが当たり前であり，社会資源は社会の共有資源であることを基本として相互に利用しあうこととなった」というものである。諸家の記録を検討すると，これらの実践では，当事者が置かれている環境へのきわめて素朴な疑問から関係者が様々な連携・協働の下にシステムを構築してきたことが明らかであった。この点の重要性を精神保健福祉士は再認識すべきであると考えられた。, This study has the objective and interest of outlining mental health welfare practices in Obihiro and Tokachi districts of Hokkaido, which are highly esteemed nationwide, with presentation of the author’s opinions of how psychiatric welfare workers should fulfill their duties by summarizing related historical information. In examining this practice, it is noteworthy that many experts appreciate the “open system.” According to the system, “Any patient of any hospital can use it. No matter who creates it, the resource created at a community, including healthcare facilities, should be used naturally and freely by residents. Therefore, social resources have been used communally on the premise that they should be shared as social resources.” Examination of records by the experts revealed that the people involved have created a system with various cooperation and collaboration from simple problem consciousness they have of the environment in which patients are placed. The author infers that psychiatric social workers should recognize the importance of this point.

The purpose of this study was to explore and make it clear the current trends and issues of home-basedrehabilitation（HBR）that the rehabilitation therapists practicing in the field. Investigators carried out semi-structuredinterviews targeting the four reha-therapists who provided HBR services．Interview of about 30 minutes per person wasperformed and created the verbatim records．Two researchers examined categories and their relevance by conducting thecoding through discussion based on the verbatim records．As a result, ① users are passive, and have needs such as to bereleased from the body functional training and pain．This makes a contrast against the user image which reha-therapists haveexpected．And this is causing a gap between the support and needs．② Therapists try to get an understanding of the user，but it is difficult．③ Awareness of users are born from their experience at hospital and lack of well-recognized method by caremanager．④ Reha-therapists are lobbying for care manager to let users understand the service．But it is not really workingand still is an issue．⑤ Understanding for HBR is different by care manager, and it has become clear that there remains aproblem in the well-known method to the users．In the background of this structure, the stage of rehabilitation is converted tolife model support model from a medical model is due to transition from hospital to home, it is suggested that it is affected．