Past Issues

After the Meiji Revolution in 1867, Japan adopted Western medicine and hospital system. Japan enacted the first mental health legislation “the Home Custody
Act of Mental Patients” in 1900. The complicated legal and forensic “the Soma
event” triggered the enactment of this legislature. The law was public securityoriented to hide vagrancy of mental patients. Family was made responsible for the
care of a member who became mentally sick. The law enabled the home custody
of mental patients for half a century. “The Mental Hygiene Law“ was enacted in
1950 after World War II under the occupation of Allied Forces. The law prohibited
the home custody and promoted the building of psychiatric hospitals. This policy
resulted in the mushrooming of private psychiatric hospitals from 1960’s. This
hospital-centered mental health system was strengthened after an attack by a
schizophrenic patient to an American ambassador to Japan in 1964. Recommendations by World Health Organization consultants to promote community-based psychiatry in 1968 were just ignored. The tide changed when a scandal of private
mental hospital (the Utsunomiya Hospital event) became known to international
organizations. After the visit of International Jurist Organization and World Psychiatric Organization, Japanese government made a major revision in the Mental
Hygiene Law. This amendment resulted in the enactment of the 1987 “Mental
Health Law,” to promote community-based psychiatry and to protect the human
rights of inpatients. In 1995, the Mental Health Law was further amended to “Mental Health and Welfare Law” to include social and welfare services. After Ikeda
Primary School event, the Medical Treatment and Supervision Act was enacted in
2003 to treat and care mental patients who committed serious crimes. The overview of mental health legislation shows the important rôle played by social events
and scandals to shape mental health laws in Japan.