Psychiatry is an essential part of emergency medicine. However, unless there is a nearby psychiatrist available for consultation, connecting emergency medical care to psychiatric care is challenging due to differences between the two medical care systems.
 The psychiatric emergency medical care system divides emergencies into two types: hard emergencies, which are triggered by a police officer's report of a patient; and soft emergencies, which are not triggered by a police officer's report. In hard emergencies, which are equivalent to tertiary psychiatric emergencies, the decision to treat a patient is often left to the police officer's discretion. Depending on the decision of the police officer, the patient may not be connected to psychiatric care, which is a major difference from general emergency medical care. On the other hand, soft emergencies are equivalent to primary and secondary psychiatric emergencies. They are similar to general emergency medical care as patients can be seen at their request; however, the number of psychiatric facilities that provide such care is small and patients may not receive useful advice from the psychiatric emergency information center, which serves as a consultation service for psychiatric emergencies. As a result, many patients with soft emergencies visit general emergency medical facilities where psychiatrists are not available, placing a burden on general emergency medical facilities.
 In this article, we discuss the problems of hard and soft emergencies, and propose that the psychiatric emergency medical care system be converted to an ER-type emergency system that treats patients regardless of their level of urgency or severity of illness. In addition, we suggest the importance of information exchange between the psychiatry department and the emergency department, since both departments have different views on the decision to accept a patient from the telephone call to the direct consultation, the handling of suicide attempts and self-injury, the timing of consultation in case of overdose, and the need for multiple medications in the case of an emergency.
 It is necessary to modify the psychiatric emergency care system to facilitate access to medical care for psychiatric emergency patients and to seek better collaboration between psychiatry and emergency departments.
 Author's abstract