Reform of "hogosha" system and psychiatric practice in Japan

In this paper, the author examines the current working and drawbacks of the "hogosha" system as set out in the Mental Health Law of 1988, and goes on to suggest a plan for reform. Critics point to two main problems with the current system. One is that the hogosha's powers infringe on the patient's human rights. The other is that the system places too heavy a burden on hogoshas in its efforts to protect the community from the patient. The author argues that the hogosha should retain the power to consent for admission for medical care and custody, but other responsibilities should be reduced. The author stresses that local mayors must be prepared to take their responsibilities seriously when they assume the role of the hogosha.