On February 17, 2023, the Mental Health and Disability Health Division, Department of Health and Welfare for Persons with Disabilities, Social Welfare and War Victims’ Relief Bureau, Ministry of Health, Labour and Welfare (MHLW) issued an administrative communication entitled “Guidance and Supervision for Suspected Abuse Cases in Psychiatric Hospitals (Recirculation)” to the departments (bureaus) in charge of mental health and welfare in each prefecture and designated city.

This administrative communication is in response to a case of suspected abuse that occurred in a psychiatric hospital in Tokyo and is in line with the “Thorough Guidance and Supervision of Psychiatric Hospitals” (Notification issued on March 3, 1998, as Disability No. 113, Health Policy No. 232, Medical Affairs No. 176, Social/Relief No. 491, under the Director-General of Department of Health and Welfare for Persons with Disabilities, Minister’s Secretariat, Ministry of Health and Welfare, and the Director-General of the Health Policy Bureau, Ministry of Health and Welfare, the Director-General of the Pharmaceutical Safety Bureau of the Ministry of Health and Welfare and the Director-General of Social Welfare and War Victims’ Relief Bureau of the Ministry of Health and Welfare). In addition, this administrative communication requests the following points to implement the appropriate guidance and supervision for preventing abuse, early detection, and recurrence of abuse.

1. If abuse against a patient is suspected according to the contents of a discharge request or a request from the patient for an improvement of treatment, or information provided by an external party to the prefectural government, the appropriate guidance and supervision should be implemented, including collecting the necessary information and providing on-site guidance.
2. When collecting information, the appropriate data should be collected, e.g., not only from the hospital staff but from inpatients as well who should be carefully interviewed.
3. In urgent cases of strong suspicion of abuse against inpatients, on-site guidance may be given to the psychiatric hospital concerned without being limited by a notification period. In addition, even if a discharge request or a request for improved treatment is pending, on-site guidance may be carried out without waiting for the result of the review by the Psychiatric Review Board. In such cases, on-site guidance should be conducted promptly without hesitation.

The notification can be found below:
https://www.mhlw.go.jp/content/12200000/001060191.pdf