This paper outlines the overall system of patient advocates for persons admitted to psychiatric hospitals and other facilities, who are external parties responsible for visiting facilities and protecting the rights of admitted patients. It also aims to clarify the role of peer supporters within that system. Patient advocates have taken on multiple different lineages, and have therefore come to be interpreted differently by different proponents. This paper details both the lineage of legal models based on the principles for the protection of persons with mental disorders and the improvement of mental healthcare, as well as the lineage of social models that follow from the Convention on the Rights of Persons with Disabilities. It points out that in Japan, since patient advocates have come to be accepted based on the legal model perspective, discussion based on the social model perspective has been scarce. This is followed by a description of the governmental review process in respect of the introduction of a formal patient advocate system. The issues raised in the report of the working group on the future of mental healthcare and welfare (February 2017) are effectively being reconsidered, and it has been made clear that the patient advocate system is being transitioned to one based on the defense of rights. Moreover, the author proposes an overall vision of the introduction of a patient advocate system that details its functions, roles, targets, actors, implementation framework, funding, and similar. Finally, with respect to the utilization of peer support, the paper points out several gaps that cannot be overlooked between the image of peer supporters imagined by governmental policy on national peer support professional skills evaluation and the lineage of peer supporters who work at Centers for Mental Health and Human Rights. Peer supporters who work at Centers for Mental Health and Human Rights make up a large majority of those affiliated with a peer supporter group. Through the above, this paper allows the overall picture of the patient advocate system and the role of peer supporters within that system to be clarified.
 Author's abstract