Analysis of Local Authorities Providing Mental Health Consultation: Towards Establishing a Community-Based Integrated Mental Health Care System.

Background: Since 2017, Japan has been establishing a community-based integrated mental health care system, which includes first-line consultations provided by local authorities (i.e., municipalities). This study aimed to (1) investigate factors related to the challenge municipalities encounter when providing mental health consultations, and (2) identify collaboration patterns between municipalities and public health agencies.

Methods: Data were obtained from a nationwide municipal survey and publicly available government statistics. Municipal staff difficulty in providing mental health consultations was measured using a four-point scale, and its association with local psychiatric and social care resources and collaboration activities across local institutions was examined by ordinal logistic regression analysis. Latent class analysis was also conducted based on how the municipality collaborated with public health agencies.

Results: Lower difficulty providing mental health consultations was associated with the existence of municipally established public health centres (OR 0.22, 95% CI 0.09 to 0.53, p = 0.001), which minimises the organisational barrier between the two entities, and frequent meetings with local service providers (OR 0.65, 95% CI 0.44 to 0.96, p = 0.032). Variables indicating local psychiatric and social care resources showed no significant associations. Municipalities were classified into four latent classes based on collaboration patterns: Overall frequent (18.1%), Overall infrequent (22.0%), Frequent for individual support (49.1%), and Infrequent for individual support (10.8%).

Conclusions: The difficulty faced by local authorities in providing mental health consultations may be reduced by fostering collaboration with other institutions, specifically public health agencies, and by hosting frequent meetings with local service providers.