We retrieved cases from the medical litigation case database created by the law department at the Hamamatsu University School of Medicine. The cases were between 1999 and 2018. From this database, we analyzed 21 cases of suicide by patients with psychiatric disorders. Of the 21 cases, ten occurred during hospitalization of the patient, nine occurred during outpatient care visits, and two occurred during overnight stays during hospitalization. Furthermore, twelve patients were diagnosed with depression, being the most common diagnosis, followed by schizophrenia in eight.
 Of ten suicide cases that occurred during the patient's hospitalization, the court ruled in favor of the patient in three. However, two of the cases were settled with small amounts of 1.25 million yen and 250 thousand yen, respectively. Negligence was argued in nine of ten cases, and the predictability of suicide was argued in eight.
 The court acknowledged that the predictability of suicide has to be "not just the general possibility, but the specific danger of the patient doing so".
 Regarding negligence, the obligation of the medical staff to make rounds was argued. Normally, the staff is required to make rounds every hour, but they need to be performed more frequently under special circumstances such as after a recent attempted suicide, for patients with dysphagia, or during sedation by injection of drugs.
 Of nine suicide cases that occurred during the outpatient care visits, the court ruled in favor of the patient in only one. Moreover, this case was unique in that the aftercare provided by the medical institution was deemed particularly malicious. Such behaviors included tampering with the patient records. Eight of nine cases argued over prescriptions, and four argued over the predictability of suicide.
 As for the cases that occurred during outpatient care visits, the court acknowledged that medical institutions should take measures for voluntary admission only after finding "a definite possibility and danger of the patient attempting suicide again."
 After analyzing the court cases of suicide by patients with psychiatric disorders, we concluded that the court understood the uniqueness of the psychiatric department and made reasonable rulings.
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