[2-J-2-02] Investigation of in-home monitoring methods for forensic outpatients treated under the Medical Treatment and Supervision Act
Medical Treatment and Supervision Act, forensic mental health, designated hospitals for outpatient care
The Medical Treatment and Supervision Act stipulates that forensic psychiatric patients must be treated at a designated hospital, including outpatient treatments. It is important for the outpatients to keep self-monitoring, such as taking appropriate medications, maintaining a lifestyle rhythm, and knowing worsened conditions early. A previous study in the U.S. reported the possibility of detecting condition change of inpatients who are dangerous to themselves or others by using a dedicated app on a mobile device that records voice, movement using an accelerometer, and location using bluetooth. However, to our knowledge, there is no similar study for outpatients treated under the Act in Japan. In this study, we enumerated various requirements for observing patients with the risk of re-offending, and investigated, compared, and examined the devices and mechanisms that can be used for them. Observation requirements include 1) physical condition, 2) activity/sleep condition, 3) mental condition, and 4) taking medicine. It also needs to be minimally invasive to reduce the patient's sense of being "monitored". To monitor a patient’s conditions, wearable devices, mobile terminals, cameras, microphones, and various other sensors can be used, including heart rate, body temperature, oxygen saturation, electrocardiogram, voice, environmental sounds, amount of exercise, body position (standing, sitting, lying down), position, acceleration, symptoms peculiar to mental illness (repetitive movements, tremors, sudden vocalizations, etc.), sleep, snoring, eating, medication, and excretion were investigated and examined. Furthermore, we created a device that can monitor medication and activity, conducted an operation test, and verified the obtained data. Future work includes testing the device on healthy subjects to confirm its usefulness.