[Background and Methodology] Emergency psychiatric care in Japan is mainly provided by specialist psychiatric hospitals. As a result, there is a long-standing problem of a lack of medical equipment and staff for the treatment of any physical complications. The outbreak of coronavirus disease (COVID-19) reconfirmed the lack of capacity to deal with any physical complications in emergency psychiatric care. The purpose of this study was to support the business continuity of emergency psychiatric care by surveying medical facilities, their policies, and the conditions for dealing with COVID-19 patients in October 2021 at facilities that charge for emergency psychiatric admission (179 facilities).
 [Results] The response rate was 61.5% (110/179 facilities) and 88.2% (97/110 facilities) were specialist psychiatric hospitals. Even before the COVID-19 pandemic, 46.4% (51/110 facilities) of the facilities did not accept patients with physical complications. About half of the facilities surveyed did not have portable X-ray equipment, the capacity for blood gas testing, or other equipment necessary to respond to infectious diseases. As a policy, 31.8% (35/110 facilities) were willing to accept COVID-19 patients, but, in practice, only 20.9% (23/110 facilities) had admitted such patients. The surveyed facilities experienced ward closures, outpatient department closures, and COVID-19 outbreaks among staff and patients, as well as 5.9 and 5.5% decreases in hospital admissions and total outpatient visits, respectively, in FY2020 (April 2020 to March 2021), compared with FY2018.
 [Discussion] The survey results indicate that challenges remain regarding emergency psychiatric medicine's ability to respond to physical disease complications, including COVID-19. In particular, the survey revealed a lack of necessary medical facilities and human resources. The presence of COVID-19-positive patients varied among facilities, and only a few facilities actually had a record of admitting such patients. It is necessary to ensure the business continuity of the entire emergency psychiatric care system while continuing to adapt to local conditions.
 Authors' abstract