Abstract: | In the catchment area of Matsumoto Public Health Center in Japan, 44 schizophrenic patients admitted between April 1992 and March 1997 under the national policy Involuntary Hospitalization Ordered by Prefectural Governor (IHOPG) were compared with 61 schizophrenic patients admitted under another policy, Hospitalization for Medical Care and Protection (HMCP), during the same period. The socioeconomic and familial factors that led patients to IHOPG were evaluated in detail. The results revealed the following characteristics of IHOPG patients as opposed to HMCP patients: (i) their morbidity was of longer duration; (ii) they were more likely to live in a densely populated area; (iii) they were less likely to be financially self-sufficient; (iv) prior to admission they were more likely than HMCP patients to have avoided psychiatric examination and to have refused to take medication, and most had received no treatment before their hospitalization under IHOPG; (v) their relationships with family members were more likely to be poor; and (vi) the family was less likely to have cooperated with treatment or to have solved the patient's problematic behaviors. This investigation and the ensuing discussion revealed that a patient's schizophrenia-based danger to hurt self or others, which is an essential impetus for admission to IHOPG, does not arise suddenly but rather stems from multiple factors developing over time. |