Attitudes of Japanese psychiatrists toward forensic mental health as revealed by a national survey

Aim: In Japan, a new comprehensive forensic mental health service was established and enforced in 2005. However, the shortage of psychiatrists dedicated to this service is a problem. Therefore, we investigated the attitudes of general psychiatrists in Japan toward this field in order to develop measures for dealing with this issue. Methods: Questionnaires were sent to 3205 psychiatric facilities in Japan in January 2007. The questions explored the experience of the respondents with forensic evaluations; the respondents' recognition of, experience with, and attitude toward the Medical Treatment and Supervision (MTS) Act; and attitudes toward forensic mental health in general. Results: The data of 1770 respondents were analyzed in this study. Three main findings were obtained: psychiatrists generally had little experience with criminal responsibility evaluations, and a small percentage of psychiatrists tended to have conducted the majority of these evaluations; although psychiatrists widely recognized the enactment of the MTS Act, they were not sufficiently familiar with the details of the MTS Act; and in spite of a reluctance to address forensic mental health issues, the respondents harbored a general interest in these topics. Conclusions: Despite a general interest, general psychiatrists in Japan tend to possess insufficient knowledge of this subspecialty and lack experience in and opportunities to work in this subspecialty. The reluctance of psychiatrists to work in forensic mental health might be partly responsible for this situation. These results suggest that the enrichment of education systems for forensic psychiatry is necessary for the development of forensic psychiatry in Japan.