Psychiatric emergency service in a university hospital in Japan

From the number of psychiatric hospital beds (30 per 10,000 persons in 1990) and the mean length of the psychiatric patient's hospital stay (441 days in 1996) in Japan, it is evident that psychiatric patients are treated in hospital as a matter of principle in this country. The hospitalization of psychiatric patients is strictly regulated by the Law Concerning Mental Health and Welfare for the Mentally Disabled in Japan. This applies to both involuntary hospitalization (Involuntary Admissions by the Prefectural Governor and Admissions for Medical Care and Custody) and voluntary hospitalization (Voluntary Admissions). Kitasato University Hospital classifies these hospitalizations as "legal" and "medical". It provides emergency psychiatric care for Kanagawa Prefecture. In 1997, 541 psychiatric patients were admitted to this hospital, and their mean stay was 82.8 days. The number of psychiatric patients seen there as outpatients has been increasing steadily; and was an average of 353.7 per day that year. The deinstitutionalization of Japanese psychiatric care can be expected when more institutions provide comprehensive psychiatric care comparable to that of this hospital.