Overview of the Japanese mental health services through legislation, policies and recent initiatives: a narrative review.
In Japan, mental health legislation and policies have evolved, and mental health services have progressively developed in the post-World War II era. This review introduces two essential laws: the Act on Mental Health and Welfare for Persons with Mental Disorders or Disabilities and the Act on Providing Comprehensive Support for the Daily Life and Life in Society of Persons with Disabilities. It also outlines the changes in mental health policy over the past decades, beginning with the Vision for the Reform of Mental Health and Medical Welfare of 2004, which advocated for a 'transition from hospital-centered care to community-centered care'. The article further presents current practices in mental health-related areas under the community-based integrated care system that also addresses mental disorders-the latest approach to the care of individuals with mental disorders. The changes in the past few decades aimed at promoting community-based care. As a result, while outpatient and home-based services have flourished, the number of psychiatric beds remains high, which is a persisting challenge. Finally, the article discusses the impact of COVID-19 on mental health and mental health services, a policy shift and the necessity of considering mental health in related policies raised by the pandemic in Japan.