Pathway to psychiatric care in Japan: A multicenter observational study

Daisuke Fujisawa, Naoki Hashimoto, Yayoi Masamune-Koizumi, Kotaro Otsuka, Masaru Tateno, Gaku Okugawa, Atsuo Nakagawa, Ryoko Sato, Toshiaki Kikuchi, Eita Tonai, Kosuke Yoshida, Takatoshi Mori, Hidehiko Takahashi, Soichiro Sato, Hiroyasu Igimi, Yoshibumi Waseda, Takefumi Ueno, Ippei Morokuma, Katsuyoshi Takahashi, Norman Sartorius

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)


Background: This study examines pathways to psychiatric care in Japan using the same method as the collaborative study carried out in 1991 under the auspices of the World Health Organization. Methods: Thirteen psychiatric facilities in Japan were involved. Of the 228 patients who contacted psychiatric facilities with any psychiatric illness, eighty four visiting psychiatric facilities for the first time were enrolled. Pathways to psychiatric care, delays from the onset of illness to treatment prior to reaching psychiatrists were surveyed. Results: Thirty three patients (39.4%) directly accessed mental health professionals, 32 patients (38.1%) reached them via general hospital, and 13 patients (15.5%) via private practitioners. The patients who consulted mental health professionals as their first carers took a longer time before consulting psychiatrists than the patients who consulted non-mental health professionals as their first carers. The patients who presented somatic symptoms as their main problem experienced longer delay from the onset of illness to psychiatric care than the patients who complained about depressive or anxiety symptoms. Prior to the visit to mental health professionals, patients were rarely informed about their diagnosis and did not receive appropriate treatments from their physicians. Private practitioners were more likely to prescribe psychotropics than physicians in general hospitals, but were less likely to inform their patients of their diagnosis. Conclusion: This first pathway to psychiatric care study in Japan demonstrated that referral pathway in Japan heavily relies on medical resources. The study indicates possible fields and gives indications, underlining the importance of improving skills and knowledge that will facilitate the recognition of psychiatric disorders presenting with somatic and depressive symptoms in the general health care system and by private practitioners.

Original languageEnglish
Article number14
JournalInternational Journal of Mental Health Systems
Publication statusPublished - 2008 Sept 26

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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