Purpose: Over the years, the problems of shortage and geographical maldistribution of physicians have remained major social issues in Japan, but few studies have quantitatively analyzed them in regard to psychiatrists. The purpose of the current study was to conduct a time-based analysis of these issues in psychiatry.
 Method: The analysis covered the period from 2000 to 2018. (1) Using the newspaper article database (Nikkei telecom 21), we analyzed the number of articles highlighting psychiatrist shortage. (2) We searched through the "Survey of Physicians, Dentists, and Pharmacists" to inquire about the supply of psychiatrists and analyze changes in their actual number, sex, age composition, and place of work. (3) With respect to the demand for psychiatrists, data from the "Patient Survey" were used to examine changes in both the number of outpatients and the total number of inpatient hospital stays per year due to mental illness. (4) In order to investigate geographical distribution, we drew on the reaggregated dataset of "Survey of Physicians, Dentists, and Pharmacists" and compared the number of psychiatrists per 100,000 population in 344 secondary medical areas (SMAs) where each prefectural government was required to provide general medical care and supplies.
 Results: (1) The number of articles related to the shortage and growth rate of psychiatrists was lower than that for other specialist physicians. (2) The number of psychiatrists had increased by 1.44 times from 11,063 in 2000 to 15,925 in 2018. The percentages of females, those aged 60 and over, and the overall psychiatrists working at clinics appeared to have changed from 16.9%, 19.7%, and 14.9% to 22.9%, 28.6%, 25.4%, respectively. (3) The number of outpatients per psychiatrist per year had increased 1.31-fold from 4,028 to 5,396, while the total inpatient hospital stays had decreased by 32% from 12,171 to 8,245 days. (4) The number of SMAs with 1 or more and less than 5 psychiatrists had declined from 77 to 39 areas, whereas the number of SMAs with 10 or more and less than 15 had risen from 79 to 124 areas.
 Discussion: The results of this study indicate that the shortage and uneven distribution of psychiatrists tend to improve, which seems to be different from what the medical staff working in clinical settings actually feel. It may be due to the shortage of psychiatrists in specialized fields such as emergency, children, judiciary, or general hospitals, as well as the shortage of psychiatrists in settings other than medical facilities, such as child consultation centers and nursing homes. However, this study took account of only Japanese official statistics, so new surveys are required to support the findings obtained herein. Furthermore, it is urgent to create a new system that solves the problems of organizational and structural distribution of psychiatrists with the aim of enhancing the satisfaction of stakeholders.
 Authors' abstract