The New Emergency System for
Mental Illness in TokyoJapanese Association of Mental HealthServices（NPO）
Mental Health & Welfare Section, TOKYO
Metropolitan Government
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

The system consists of twosubsystems
Subsystem Ⅰ
The system for the person who is under theprotection of the police because of the obvious
possibility that he/she would hurt
himself/herself or others because of his/hermental disorder

Subsystem Ⅱ
The system for the person who needs medicalcare and protection, and is thought not to havea clear possibility of the condition as describedto the aboveTOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Subsystem Ⅰ consists of
1. Four metropolitan general hospitals
with 16 beds
2. The information center called
Himawari with 2 clerks

TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Subsystem Ⅱ consists of1.

Two private hospitals with 3 beds open 5pm to9am
2. One private mental clinic open 5pm to 10pm
3. One general hospital for the psychosomatically complicated open 5pm to 9am
4. Ｍｅｔｒｏｐｏｌｉｔａｎ Ｅｍｅｒｇｅｎｃｙ Ｉｎｆｒｏｍａｔｉｏｎ
Ｃｅｎｔｅｒ ｆｏｒ ｔｈｅ Ｍｅｎｔａｌ Ｉｌｌｎｅｓｓ (ＭＥＩＣＭＩ)
with two or three para-medical staff

TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭInstitutions participating
Subsystem Ⅱ
1. The private mental clinics participating insubsystem Ⅱ are the members of the Tokyo
Association of the Mental Clinics
2. The private mental hospitals participating insubsystem Ⅱ are the members of the Tokyo
Association of the mental hospitals
3. The general hospitals participating insubsystem Ⅱ are miscellaneous.for example,several Metropolitan hospitals, severalhospitals attached to the medical universities,
etc.
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Subsystem Ⅰ

TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Subsystem Ⅰ
Number of the emergency cases of mental illness dealt with by the4 metropolitan general hospitals at night and on holidays
2500
urgent involuntary
hospitalization
hospitalizationconsented by the family
total emergent cases

2000

1500

1000

500

0
'02

'01

'00

'99

'98

'97

'96

'95

'94

'93

'92

'91

'90

'89

'88

'87

'86

'85

'84

'83

'82

'81

'80

'79

'78

TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Male/Female ratio of the patients acceptedby Subsystem Ⅰ
N= 2 3 4 7

41%
59%

malefemale（’02-Sep to ‘03- Mar）
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Subsystem ⅡTOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Number of the cases telephoned toＭＥＩＣＭＩ（’02-Sep to ‘03- Mar）
SepOctNovDecJanFeb

Mar Total

Number of the cases

831945889

941904727959 6196

cases triaged asout-patients

111091623

131092cases triaged as inpatients

19191619222427146

cases triaged as thepsycho- somaticallycomplicated

223

20

3

315

TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Who made the emergency call to Metropolitan
Emergency Information Center for Mental
Illness(MEICMI)?
N＝538413220 298133

237He/She by him/herself
Family member who lives with the patient
Family member who does not live with the patient

67

Family member uncertain about living with him/her
Other acquaintance

328
151

Police298
2611

255
258

Emergency staff of the Fire Department
Psychiatric institution (public)
Psychiatric institution (private)
Medical institution (general hospital & clinic)
Other public institution

1001

Rehabilitation facilities
Institution for the welfare of the aged people
Others
Uncertain（’02-Sep to ‘03- Mar）

TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Where is the patient?
in his/her own housein his/her acquaintance house

N＝5384on the street

89101
233
1553

At the police station
In the ambulance car678

Admitted to the physical hospital
Admitted to the psychiatric hospital

2243684

162
68

Out-patient of the medical hospital or clinic
Out-patient of the psychiatric hospital or clinic

77

Others
Uncertain（’02-Sep to ‘03- Mar）
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Male/Female ratio of the patients accepted byMEICMI
N＝5384

7%
40%

male
female53%

uncertain（’02-Sep to ‘03- Mar）
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Distribution of the Age of the patients phoned toMEICMI
uncertain
70～
60～uncertain
femalemaleage

50～
40～
30～
20～
16～19～150200

400600
number of patients

8001000（’02-Sep to ‘03- Mar）

TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Incidence of patients as to age and sex
total
70～

uncertain
female
male

60～

age

50～
40～
30～
20～
16～19～1501020

30

4050

60

70

80

number of patients per 100,000（’02-Sep to ‘03- Mar）
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Distribution of the type of disorder according to theinformation from patient or his/her family (Male)F2: Schizophrenia

Uncertain

F3: Mood disorder70～

F4: Neurotic disorder60～

F5: Eating disorder / sleeping
disorderF6: Personality disorder

age

50～

F0: Dementia

40～

F1: Mental and behavioral disorders
due to psychoactive substance use
F7/8: Mental retardation

30～
20～

F9: Behavioral and emotional
disorders
G4: Epilepsy

16～19
～15

Others

0%

20%

40%

60%

80%

100%

Unspecified（’02-Sep to ‘03- Mar）
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Distribution of the type of disorder according to theinformation from patient or his/her family (Female)
F2: Schizophrenia
Uncertain

F3: Mood disorder70～

F4: Neurotic disorder60～

F5: Eating disorder / sleeping
disorderF6: Personality disorder

age

50～

F0: Dementia

40～

F1: Mental and behavioral disorders
due to psychoactive substance use
F7/8: Mental retardation

30～
20～

F9: Behavioral and emotional
disorders
G4: Epilepsy

16～19
～15

Others
0%

20%

40%

60%

80%

100%

Unspecified（’02-Sep to ‘03- Mar）
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

What MEICMI did for the emergency phone calls

13211881 12730

Listening and giving advice
Introduction of medical facilities

193

Introduction of counseling facilities

511

Advice to call police2794

Advice to call fire department
Advice by the triage-doctor

1398

Triaged as the primary emergent case
Triaged as the secondary emergent case
Triaged as the psycho somatically complicated

N＝5384（’02-Sep to ‘03- Mar）
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Major reason for phone call to MEICMI

N＝5384

Disorder of consciousness

72

Paranoid-hallucinatory state/strange behavior

51340
457

Excitement/distraction
Epileptic seizure

191431

Anxiety and depression
Eating disorder / sleeping disorder

1010

Attempted suicide / desire to suicide
Violence
Running out of medicine

1175

460
75

Side effect of medicine
Request to introduce medical facilities
Request to get consultation

3793164

Others（’02-Sep to ‘03- Mar）
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Measure of transportation
Public transportation facilities

N＝238

9

By car
By taxi

7358

21101867

Ambulance of the fire
department
Patrol car of the police
department
Ambulance of the privatetransportation company
Others（’02-Sep to ‘03- Mar）
TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

What decision was made finally for the patient being
triaged and brought to the mental clinic, mental
hospital or facility for the psycho somaticallyOut-patientscomplicatedVoluntary admission

Triaged as the psycho somaticallycomplicatedInvoluntary Admission(withthe consent by the family)
Cancel for getting therapy

Triaged as the secondary emergent
case

Triaged as the primary emergent case02040（’02-Sep to ‘03- Mar）

60

80

100

120140TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ

Distribution of diagnoses of patients being triaged as
out-patient, in-patient or psycho-somatically
F2: SchizophreniacomplicatedF3: Mood disorder
F4: Neurotic disorder

Triaged as thepsycho-somaticallycomplicatedF5: Eating disorder / sleeping
disorderF6: Personality disorder
F0: Dementia

Triaged as thesecondary
emergent case

F1: Mental and behavioral disorders
due to psychoactive substance use
F7/8: Mental retardation

Triaged as theprimary emergentcase

F9: Behavioral and emotional
disorders
G4: Epilepsy
Others

020

40

60

80

100120140
Unspecified

N＝238（’02-Sep to ‘03- Mar）

TOKYO Metropolitan Government/ ＮＰＯ-ＪＡＭ