Methods: We selected participants from the mentally disabled patients who routinely visit the department of psychiatry of the medical institutions in cooperation with the persons in charge of psychiatric day care and outpatient department. We told these patients that their participation is voluntary and that their privacy is protected orally and in writing, and we then obtained the written consents from 6 patients. We qualitatively and inductively analyzed the interview results using Grounded Theory Approach of Strauss Corbin by collating the concept of resilience defined by Bonano and the central concept of PTSD advocated by Judith L. Herman.
Results: We extracted the following 8 categories concerning the anteroposterior episodes of the daily life experiences of the mentally disabled patients and the process of how they begin to visit medical institutions. [First morbid experiences and their surrounding environment], [Awareness of the need of hospital visit], [First treatment acceptance], [Change of the treatment regimens], [Change of the sense of values], [Change of their courses], [Acquisition of knowledge and skills] and [Actions to gain qualifications and work opportunities]. For most of the patients, the first morbid experiences and their surrounding environment promoted the awareness of the need of hospital visit, leading to the first treatment acceptance. However, the patients experienced the changes of treatment regimens including the changes of hospitals and doctors due to the distrust of medical institutions, poor sense of therapeutic effects and suffering adverse events. Afterwards, the patients met new people such as reliable health and medical welfare experts and friends with mental illness. In addition, the patients experienced various life events such as romance and marriage. As a result, the patients achieved the changes of the sense of values and their courses on the basis of disability acceptance that comprehensively includes self-understanding, self-acceptance and social acceptance. And although the patients have the feelings of insufficiency and anxiety for the current situation, the patients also achieved mental health restoration.
Conclusion: Therefore, the patients were able to pursue the stability and growth even more, acquire knowledge and skills, gain qualifications, take aggressive actions seeking work opportunities, and hope for the future. However, there were some patients who have problems with the ability to receive interest from others, to maintain it and to continue to have confidence in others. For such patients, it was difficult to change the sense of values and their courses.