Presentation Information
[O-15-03]Bridging Institutional Gaps in Psychiatric Emergency Care for Immigrants: A Frontline Psychiatrist’s Perspective from a Case of Severe Mental Illness
*Yumiko TAKAHASHI (Chiba Emergency and Psychiatric Medical Center(Japan))
Keywords:
Immigrant mental health,Multilingual support,NGO collaboration
Background:
Japan is one of the world’s fastest-aging societies and has adopted a de facto immigration policy since the 2020s. However, institutional frameworks supporting immigrants, especially with regard to language, healthcare and welfare, remain underdeveloped. The psychiatric care system is particularly fragile for immigrants with severe mental health conditions, often relying on ad hoc responses.
Method:
We present a case study of a foreign resident with severe mental illness to highlight systemic gaps. Patient consent was obtained in accordance with the guidelines of the Japanese Society of Psychiatry and Neurology .
Results:
The patient was a foreign woman in her 50s who had lived in Japan for 30 years. She spoke minimal Japanese and was socially isolated, except for her Japanese husband. She developed chronic, untreated schizophrenia which went unnoticed for years. Following her husband's death, local administrative agencies repeatedly encouraged her to seek care, but she refused. Her condition deteriorated, ultimately resulting in emergency psychiatric hospitalization — the first instance of medical intervention. However, discharge was obstructed by legal and institutional barriers, including her visa status, lack of a guarantor and lack of secured housing. Efforts by the multidisciplinary hospital team alone were insufficient. However, with support from International Social Service Japan (ISSJ), essential services such as multilingual communication, identity verification, family contact and travel coordination were provided, enabling her to be safely repatriated.
Discussion:
This case highlights the essential role of NGOs such as ISSJ in providing services that Japan’s healthcare and welfare systems currently lack, especially for immigrant psychiatric patients. Notably, these ISSJ services were provided voluntarily, without any governmental funding or institutional support. Moving forward, Japan must strengthen its institutional capacity for multicultural and multilingual support and establish formal funding and policy frameworks to support NGOs. Collaborative efforts between medical institutions, administrative bodies, and NPOs will be critical to ensuring sustainable and equitable psychiatric care for all immigrants.
Japan is one of the world’s fastest-aging societies and has adopted a de facto immigration policy since the 2020s. However, institutional frameworks supporting immigrants, especially with regard to language, healthcare and welfare, remain underdeveloped. The psychiatric care system is particularly fragile for immigrants with severe mental health conditions, often relying on ad hoc responses.
Method:
We present a case study of a foreign resident with severe mental illness to highlight systemic gaps. Patient consent was obtained in accordance with the guidelines of the Japanese Society of Psychiatry and Neurology .
Results:
The patient was a foreign woman in her 50s who had lived in Japan for 30 years. She spoke minimal Japanese and was socially isolated, except for her Japanese husband. She developed chronic, untreated schizophrenia which went unnoticed for years. Following her husband's death, local administrative agencies repeatedly encouraged her to seek care, but she refused. Her condition deteriorated, ultimately resulting in emergency psychiatric hospitalization — the first instance of medical intervention. However, discharge was obstructed by legal and institutional barriers, including her visa status, lack of a guarantor and lack of secured housing. Efforts by the multidisciplinary hospital team alone were insufficient. However, with support from International Social Service Japan (ISSJ), essential services such as multilingual communication, identity verification, family contact and travel coordination were provided, enabling her to be safely repatriated.
Discussion:
This case highlights the essential role of NGOs such as ISSJ in providing services that Japan’s healthcare and welfare systems currently lack, especially for immigrant psychiatric patients. Notably, these ISSJ services were provided voluntarily, without any governmental funding or institutional support. Moving forward, Japan must strengthen its institutional capacity for multicultural and multilingual support and establish formal funding and policy frameworks to support NGOs. Collaborative efforts between medical institutions, administrative bodies, and NPOs will be critical to ensuring sustainable and equitable psychiatric care for all immigrants.