Poster 22

[P-22-03] Involuntary Psychiatric Admission in East Asia: A Case-Vignette-Based Comparative Analysis in Japan, South Korea, and Taiwan

*Kei Kobayashi^1,2, Eisuke Sakakibara¹, Shinsuke Kondo¹, Kanna Sugiura², Keijin Yamamura³, Kaori Usui², Mayui Nara², Satoe Takashima², Asami Matsunaga^2,4, Chiyo Fujii², Kiyoto Kasai¹, Toshiya Murai³ (1.Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo(Japan), 2.Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry(Japan), 3.Department of Psychiatry, Graduate School of Medicine, Kyoto University(Japan), 4.Department of Mental Health and Psychiatric Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University(Japan))

Keywords:

Involuntary admission,East Asia,Cross-national comparison,Convention on the Rights of Persons with Disabilities (CRPD)

In recent years, discussions on Japan’s mental health care system have been advancing, influenced by multiple factors including the ratification of the Convention on the Rights of Persons with Disabilities (CRPD) and its subsequent Concluding Observations. A 2022 report by the Ministry of Health, Labour and Welfare emphasized the need to establish a seamless, community-based support system that enables individuals with mental health challenges to live safely in their communities aligned with their preferences and needs. The report also called for revisions to both inpatient and community care, including a review of "Involuntary Hospitalization for Medical Care and Protection (Iryo-hogo)" from a rights-protection perspective. Key areas for consideration included the legitimacy of non-consensual admission, the family burden, and cross-national comparisons. As part of a government-funded study, we examined legal and procedural frameworks for involuntary psychiatric admission across seven regions: Japan, South Korea, Taiwan, England, France, Germany, and three Canadian provinces. This poster focuses on the East Asian context, comparing Japan, South Korea, and Taiwan—three jurisdictions with distinct yet regionally situated mental health systems. We used carefully structured case vignettes based on challenging situations for Japanese clinicians, aiming to explore how similar cases might be approached under differing legal and clinical frameworks. To understand how decisions regarding involuntary admission are made and implemented, we conducted interviews with clinicians involved in these processes across each setting’s mental health system. Our findings reveal both jurisdiction-specific differences as well as shared challenges in balancing patient rights, safety, and care delivery. This poster aims to inform ongoing international discussions on mental health system design, with reference to the evolving expectations outlined in the CRPD.