Access to the emergency psychiatry system in Japan

Although the need for an emergency psychiatry system is increasing in Japan because of a shift to providing psychiatric care from hospitalization to community-based services, little attention is being given to what the general population expects from the health care system. To ascertain the expectations of the general population about how emergency psychiatric cases should be handled, the authors distributed a questionnaire to 1000 people containing 12 characteristic psychiatric emergency cases. The results showed that most expected psychiatric care to be rendered in a general hospital. This was different from the opinion held by most mental health professionals who felt that mental health hospitals should be the core hospitals of emergency psychiatry. Although there was a higher expectation for police officers or paramedics to provide emergent psychiatric care, the general population expected less from public health centers which now provide mental health service in the community. To connect emergency psychiatry with the community, the general hospital must play a larger role in the system through training programs for general hospital psychiatrists as well as nonpsychiatrist professionals, paramedics, and police officers.