The government-sanctioned involuntary hospitalization system (IHS) has not been sufficiently reviewed even though the Act on Mental Health and Welfare for the Mentally Disabled has been repeatedly revised. However, the massacre at the Sagamihara handicapped facility in 2016 led to a motion to review the IHS. "Special Committee on Law Related to Mental Health and Welfare of the Person with Mental Disorder", currently "Committee on Law Related to Mental Health and Welfare of the Person with Mental Disorder", of the Japanese Society of Psychiatry and Neurology conducted a questionnaire survey on IHS for selected members. The effective response rate was 29.8%.
 Approximately 30% of designated psychiatrists (DPs) who responded to this survey felt that the medical examination for government-sanctioned involuntary hospitalization was a burden. Most DPs noted that "fear of self-injury or other harm" was likely in the near future, and 45% of DPs felt that they were expected to be able to judge the necessity of government-sanctioned involuntary hospitalization. Few DPs selected government-sanctioned involuntary hospitalization in cases that met the requirements for both government-sanctioned involuntary hospitalization and medically necessitated family/proxy-consented hospitalization. Only a quarter of DPs felt that IHS offered appropriate medical service without prevention of treatment, implying that medical services during IHS are limited.
 Many DPs consider cooperation with the public health center and family to be important for supporting patients in government-sanctioned involuntary hospitalization, but conferences for patient support after discharge were held more often than necessary in all cases. Moreover, DPs did not discuss home-visit instruction or welfare service for individuals with disabilities upon withdrawal notification from government-sanctioned involuntary hospitalization. There were varying opinions on the necessity of subject reviews for IHS applications, criteria for designated hospitals, and improvement of skills by professionals involved in IHS.
 As clinical psychiatrists noted many problems in the present IHS, it is necessary to discuss the entire psychiatric hospitalization system from a wide point of view.
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