Eight hospitals for 47 prefectures, and a year counted in contacts
- Annual report of a Japanese government scheme, the Eating Disorder Treatment Support Centre Establishment and Operation Project, running since fiscal 2014 on the Mental Health Measures subsidy and written up by the National Center of Neurology and Psychiatry for the Ministry of Health, Labour and Welfare. The document is in Japanese, 192 pages, dated July 2025, covering fiscal 2024 from April 2024 to March 2025. The scheme designates one support hub hospital per participating prefecture plus one national support centre. After eleven years there are eight hub hospitals: Tohoku University Hospital in Miyagi, Dokkyo Medical University Hospital in Tochigi, Tokyo Metropolitan Matsuzawa Hospital, Kanazawa University Hospital in Ishikawa, the University of Fukui Hospital, Kohnodai Hospital in Chiba, Hamamatsu University Hospital in Shizuoka and Kyushu University Hospital in Fukuoka. Two were designated inside the reporting year, Tochigi in April 2024 and Tokyo in July 2024.
- The year's service figure is 2,425 contacts, 2,045 of them first-time, counted across the eight hub hospitals together with the national telephone line that the national centre contracts out to the department of psychosomatic medicine at Kohnodai Hospital. That line has run since January 2022 and takes calls from prefectures with no hub hospital, four days a week, Tuesday to Friday, 9:00 to 15:00. The same report puts the national number of people with an eating disorder at approximately 220,000, an estimate it draws from mental health and welfare statistics based on 2021 national claims data.
- Training is the other counted product. Five courses ran online during the year: two on outpatient treatment for beginners, two on inpatient treatment, and a first paediatric course that drew more than 600 registrants, mostly paediatricians. More than 90% of post-course respondents answered satisfied or very satisfied. One follow-up was carried a year out: 394 past attendees of the outpatient course were sent a questionnaire and 171 replied, on whether they had referred or received a patient, taken a case on, and felt able to work to the guideline. The public information portal recorded around 1.5 million accesses.
- The ministry surveyed all 47 prefectures on whether they would designate a hospital. Eight had done so, five said they intended to, and 34 answered that they had no plan to. Reasons for not designating were collected with multiple answers allowed: funding could not be secured, 16; no medical institution would take it on, 14; no expertise in eating disorders, 8; the national criteria too demanding, 1; other, 20, including seven who said the question had not reached the stage of consideration. Eleven prefectures asked for the preparatory training session to be held in their area. The report states that outpatient waits at existing hub hospitals already run to several months.
Eight hospitals for 47 prefectures. Tohoku University Hospital in Miyagi, Dokkyo Medical University Hospital in Tochigi, Tokyo Metropolitan Matsuzawa Hospital, Kanazawa University Hospital in Ishikawa, the University of Fukui Hospital, Kohnodai Hospital in Chiba, Hamamatsu University Hospital in Shizuoka, Kyushu University Hospital in Fukuoka. Two of those arrived inside the year this report covers, Tochigi in April 2024 and Tokyo in July 2024, which is what gives the Kanto region three. The scheme has been running since fiscal 2014.
How the thing is arranged
The budget line is the Mental Health Measures subsidy. A prefecture designates one hospital, and that hospital picks up four duties written into the ministry's outline: spreading knowledge and technique, training and supporting other institutions in its area, technical support to patients and families, and coordination with the bodies around them, public health centres, schools, local government. Above the eight sits a single national centre, the National Center of Neurology and Psychiatry in Tokyo, which convenes the national council, keeps the information portal and backs the hubs. Participation runs through the prefecture. The Eighth Medical Plan asks each of them to make clear which local institutions can handle eating disorders, and the ministry asks, at the national meeting of welfare division chiefs, that they use this scheme to do it.
What the year is counted in
Contacts and attendance. Across the eight hospitals and the telephone line, 2,425 contacts were logged for the year, 2,045 of them first-time. Five training courses ran online, two for outpatient work, two for inpatient work, one for paediatric practice held for the first time, and the paediatric course drew more than 600 registrants. Over 90% of those who answered afterwards said they were satisfied or very satisfied. The portal took around 1.5 million accesses.
One thing was followed a year out. A questionnaire went to 394 people who had attended the outpatient course, 171 answered, and what it asked about was them: had they referred a patient or received one, had they taken a case on, did they now feel able to work to the guideline. The unit of measurement is the clinician's own account of the clinician.
The denominator sits in the same document. Mental health and welfare statistics built on 2021 claims data put the number of people in Japan with an eating disorder at approximately 220,000. Against that, a year of 2,425 contacts is roughly one per hundred.
Why 34 prefectures are not planning one
The ministry asked all 47. Eight had designated a hospital, five intended to, 34 said they had no plan to. The reasons, multiple answers allowed: funding could not be secured, 16 times; no medical institution would take it on, 14; no expertise in eating disorders, 8; the national criteria too demanding, once. Twenty gave some other answer, seven of them that the matter had not reached the stage of consideration and four that they first needed to know the local scale. Eleven prefectures asked for the preparatory seminar to be held on their own territory. The report reads that as movement, and in the same section notes that appointments at the hubs that do exist already run to a wait of several months.
Reachable from the other 39
Two things, and neither is a local specialist service. The telephone line, in its four-day window from 9:00 to 15:00. And the list of facilities that treat eating disorders, published on the portal and revised this year against what those facilities actually do.
Inside the eight, one patient-level count began this year: the hubs filled in individual record sheets and reported 600 inpatients, 70% of them with under a year between onset and treatment, 32% in their teens or younger. That last figure is the one the report acts on, calling for better inpatient provision for patients in their teens; the paediatric course, prepared the year before, points the same way. Everything else that reaches the national total is a call, a registration or a page view.
The scheme has run since fiscal 2014 and stands at eight designated hospitals across 47 prefectures, and the year it reports is counted in 2,425 contacts, 2,045 of them first-time, set beside a national estimate of approximately 220,000 people with an eating disorder.
The 2,425 is a count of contacts, not of people. It tallies approaches made to eight hospitals and one telephone line over twelve months, one person may approach more than once, and the 2,045 first-time contacts are first for that service rather than first in the illness, so the figure cannot be read as a number of patients reached. Outcomes are missing from the national total but not from the document: individual hub hospitals report their own, and the report's own recommendations cite the Shizuoka hub's data on shorter duration of illness at first presentation, higher body mass index at first presentation, shorter admissions and higher body mass index at discharge, then propose checking whether the same pattern holds at the newer hubs. Nothing in the report carries those hospital figures up into a national outcome measure.