It has now been 25 years since the Ministry of Health, Labour and Welfare started collecting statistics on the number of child abuse cases in Japan, which have continued to rise unabated to approximately 100 times their initial figure 25 years ago. A large percentage of these cases involve abuse committed by a guardian with mental illness. In annual reviews of deaths due to abuse, the nature of the guardian's mental illness and the conditions in which the child is being raised are not shared with psychiatrists and child guidance centers. The result is that many cases of child death are reported without there having been a proper assessment or response.
 Japan's enactment of the Child Abuse Prevention Law in 2000 represented the first time that the four types of child abuse―physical abuse, sexual abuse, neglect, and emotional abuse-were stipulated by law. Moreover, the law stipulated the obligation to report any suspicion of child abuse, and the obligation for health professionals and others to attempt to identify child abuse as early as possible. It also stipulates the need to prioritize confidentiality of reporting, so authorities do not divulge the identity of the reporting party.
 Child guidance centers are established based on the Child Welfare Law. These centers handle all types of counseling for persons under the age of 18 years, and currently assume the main role in responding to child abuse cases. The centers receive reports of child abuse and undertake the necessary investigations before deciding on the measures to be taken, and information provided by medical institutions plays a crucial role these decisions. This is because many abused children are living at home under the supervision of a guardian. The Child Abuse Prevention Law was amended in 2016 to stipulate that medical institutions and other organizations can provide information on guardians.
 The cooperation of psychiatrists is essential for prevention, early detection, and appropriate intervention in cases of child abuse by guardians with a mental illness. It is therefore of paramount importance to enlist the cooperation of psychiatrists in order to understand the causes of child abuse and the obligation to report, diagnose, and support guardians who commit child abuse, and to provide information. We would like to seek the cooperation of psychiatrists to advise on ways to identify worsening symptoms and provide the necessary support for guardians who are raising children while dealing with a mental illness.
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