Persons with mental disorders are entitled to appropriate treatment for physical comorbidities. However, the measures in place for this in Japan are far from sufficient, with each region operating its own medical-psychiatric treatment system for physical comorbidities in accordance with its particular situation. Tokyo Metropolitan Matsuzawa Hospital began operating its medical psychiatry units (MPU) in 1977. The present report provides current information on the performance of MPU and the challenges they face. The MPU at Matsuzawa Hospital contain 131 beds and received 1,099 patients in 2019. Many patients with dementia or schizophrenia were admitted for recurrent aspiration pneumonia, fractures, and digestive cancer due to aging. However, the bed occupancy rate remains low due to issues related to the economics of health care such as insufficient nursing staff. The medical-psychiatric treatment system for physical comorbidities requires further improvement to guarantee the rights of persons with mental disorders.
 Authors' abstract