Key Activities The survey showed lower rates of involuntary hospitalization since informed consent was introduced, but it is hard to say that the informed consent system is the direct cause of the fall in long-term hospitalization and deinstitutionalization. It was also found that the amendment to the Mental Health and Welfare Act resulted in more mental health promotion centers, but the number of nursing personnel and mental healthcare specialists is still not enough compared to the number of patients. The survey also showed that the mass media reinforces negative perceptions and prejudices against people with mental disabilities, and such perceptions are more prevalent among older, married, and more educated people. Based on the results of monitoring of the implementation of the 2009 State Report, the Commission will update the report in 2020 and make policy recommendations on additional measures that are necessary to promote the rights of persons with mental disabilities. H. Inspection of Medical System for Persons with Severe Mental Disorders The Commission conducted an inspection of medical services offered to persons with mental disorders, to monitor whether timely treatment is given after the first onset of mental disorders and for severe mental disorders, and whether proper treatment is given to those hospitalized in mental healthcare facilities and other multi-user care facilities. For this purpose, the National Health Information database of the National Health Insurance Service was analyzed and interviews were made with facility personnel, persons with mental disabilities (those with the first onset and those with severe disorders), and their families. In the midst of a shift in global mental health paradigm from custodial care to community care, the mental healthcare in Korea has not moved away from the boundaries of custodial care, and very little information is available on treatments offered in nursing homes for people with mental disorders or facilities for the homeless. The inspection showed that a significant number of people do not receive timely treatment at the first onset of severe mental disorders and many are involuntarily hospitalized, with 24.5% of people with first experience of severe mental illness hospitalized without outpatient care. Even those living in nursing facilities do not get enough care except for short meeting with a part-time doctor. Based on the findings, the Commission will examine institutional and policy improvement proposals and reflect them in the 2020 update to the State Report. 52