Suicide prevention is a significant clinical issue for psychiatric practice. Compared to stand-alone outpatient clinics, outpatient departments at psychiatric hospitals tend to play a major role in follow-up after discharge and in facilitating access of unstable patients to crisis intervention by hospitalization. These needs are generally severe and unstable, particularly for patients at high risk of suicide. Given this background, "Coordination and Continuity of Care" and "Integration into Primary Care through Shared Care" are universal principals in care and treatment in community mental health. A second feature of psychiatric hospitals is their need to organize themselves to provide quality-assured continuous health service. Furthermore, the multifunctional aspects of this care incorporate the need for "Comprehensiveness", "Integration into the General Health System" and "Multi-sectoral Linkages"
 For more than 20 years, Numazu Chuo Hospital has been a regional hub in the provision of hospital-based emergency psychiatric services managed by the local government. In this role, we frequently experience clients at high suicide risk. Our inpatient registry shows that 10% of newly admitted patients exhibit self-harm and 8% have attempted suicide. Suicide ideation is observed in 30% of newly admitted patients, of which about half are mild cases and half are severe. It is difficult to determine whether this frequency is high or low because of limited data resources.
 Not only in suicide prevention but in all clinical areas, practice reflects the basic principles of the organization. Our shared goal is the implementation of community mental health and suicide prevention. Realizing that the strategy of suicide prevention requires the integration of sympathy into the clinical context and standardized procedures, and a humanistic understanding and acquisition of standardized intervention skills is essential. Strengthening the organization's ability to improve staff skills, achieve commonality of processes and procedures, and conduct damage control in the case of unpredictable incidents. Such incidents are sometimes unavoidable in the clinical care of patients at high suicide risk.
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