Presentation Information
[O-15-04]Bridging Institutional Gaps in Psychiatric Emergency Care for Immigrants: A Frontline Psychiatrist’s Perspective from a Case of Severe Mental Illness
*Yumiko TAKAHASHI1, Kayuki KONDO4, Hironori IWASAKI3, Hina SHIRASAKI1, Miyu NOMURA1, Takayuki ABE1, Mieko ISHIKAWA4, Shimpei HANAOKA1,2 (1.Chiba Emergency and Psychiatric Medical Center(Japan), 2.Division of Health Policy and Health Toho University Faculty of Medicine Service Research, Department of Social Medicine(Japan), 3.Chiba Pediatric Hospital(Japan), 4.International Social Service Japan (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 in language, healthcare, and welfare—remain underdeveloped. Psychiatric care is particularly fragile for immigrants with severe mental illness, often relying on ad hoc responses.
Method:
We present a case of a foreign resident with chronic psychosis 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 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. Her chronic schizophrenia went untreated and unnoticed for years. After her husband’s death, local authorities urged her to seek care, but she refused. Her condition deteriorated, leading to emergency psychiatric hospitalization—her first contact with medical services. Discharge planning was hindered by visa-related concerns, lack of a guarantor, and absence of housing. Despite efforts, the hospital team could not secure discharge. With support from International Social Service Japan (ISSJ), multilingual communication, identity verification, family contact, and travel coordination were achieved, enabling safe repatriation.
Discussion:
This case underscores the essential role of NGOs like ISSJ in filling critical gaps left by Japan’s healthcare and welfare systems, particularly for immigrant psychiatric patients. These services were provided voluntarily, without government funding or institutional support. As Japan’s society becomes increasingly multicultural, formal policies and funding mechanisms must be established to institutionalize multilingual and culturally competent care. Sustained collaboration among hospitals, government agencies, and NPOs will be crucial for building an inclusive and equitable psychiatric care system.
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 in language, healthcare, and welfare—remain underdeveloped. Psychiatric care is particularly fragile for immigrants with severe mental illness, often relying on ad hoc responses.
Method:
We present a case of a foreign resident with chronic psychosis 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 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. Her chronic schizophrenia went untreated and unnoticed for years. After her husband’s death, local authorities urged her to seek care, but she refused. Her condition deteriorated, leading to emergency psychiatric hospitalization—her first contact with medical services. Discharge planning was hindered by visa-related concerns, lack of a guarantor, and absence of housing. Despite efforts, the hospital team could not secure discharge. With support from International Social Service Japan (ISSJ), multilingual communication, identity verification, family contact, and travel coordination were achieved, enabling safe repatriation.
Discussion:
This case underscores the essential role of NGOs like ISSJ in filling critical gaps left by Japan’s healthcare and welfare systems, particularly for immigrant psychiatric patients. These services were provided voluntarily, without government funding or institutional support. As Japan’s society becomes increasingly multicultural, formal policies and funding mechanisms must be established to institutionalize multilingual and culturally competent care. Sustained collaboration among hospitals, government agencies, and NPOs will be crucial for building an inclusive and equitable psychiatric care system.