{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:09:36Z","timestamp":1790356176700,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","award":["24 ri 005"],"award-info":[{"award-number":["24 ri 005"]}],"id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","award":["24A1014"],"award-info":[{"award-number":["24A1014"]}],"id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PCN Reports"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The prevalence of mental health issues among children and adolescents in Japan is rising, including school refusal, suicide, and neurodevelopmental disorders. In response, the Ministry of Health, Labour, and Welfare (MHLW) introduced insurance incentives in 2014 to expand access to outpatient psychiatric services for Japanese youth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study analyzed data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan from fiscal years 2016 to 2022. Outpatient psychotherapy claims under the newly introduced insurance categories were analyzed by year, age group, sex, and prefecture. National trends and regional disparities were assessed using linear regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nationwide outpatient psychotherapy claims nearly doubled, from 521.0 per 10,000 youth in fiscal year 2015 to 1034.5 in fiscal year 2022 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The increase was most pronounced among adolescent girls. By fiscal year 2022, 94% of prefectures had implemented the policy. Some regions, such as Tokushima and Yamanashi, experienced more than a threefold increase. Nevertheless, regional disparities between prefectures remained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The MHLW's insurance reforms significantly increased access to psychiatric care for children and adolescents across Japan. The combined impact of national financial incentives and local medical subsidies likely contributed to increased service utilization, given the reduction in additional costs for families. Ongoing policy efforts are needed to ensure equitable access and high\u2010quality care nationwide.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pcn5.70131","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T04:29:52Z","timestamp":1749702592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Does the Japanese insurance system increase outpatient psychiatric treatment for children and adolescents? A retrospective study using open data from the national claims database for 2016 to 2022"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1145-9971","authenticated-orcid":false,"given":"Masahide","family":"Usami","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, National Kohnodai Medical Center Japan Institute for Health Security Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, National Kohnodai Medical Center Japan Institute for Health Security Chiba Japan"},{"name":"Department of Psychiatry and Behavioral Sciences Institute of Science Tokyo Graduate School Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Fukuoka University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saori","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Child Psychiatry Ehime University Graduate School of Medicine Toon City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Ito","sequence":"additional","affiliation":[{"name":"National Center for Cognitive Behavior Therapy and Research National Center of Neurology and Psychiatry Kodaira Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-4945","authenticated-orcid":false,"given":"Katsunaka","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Tokai University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3434-6280","authenticated-orcid":false,"given":"Noa","family":"Tsujii","sequence":"additional","affiliation":[{"name":"Department of Child Mental Health and Development Toyama University Hospital Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Satake","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, National Kohnodai Medical Center Japan Institute for Health Security Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","first-page":"135","article-title":"Current status of child and adolescent psychiatry in Japan","volume":"112","author":"Setsuie M","year":"2010","journal-title":"Psychiat Neurol Jap"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.35772\/ghmo.2023.01016"},{"issue":"4","key":"e_1_2_12_4_1","first-page":"465","article-title":"Psychiatric care for children under the COVID\u201019 pandemic","volume":"63","author":"Usami M","year":"2022","journal-title":"JPN J Child Adolesc Psychiatry"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1359872"},{"key":"e_1_2_12_6_1","first-page":"46","article-title":"Annual prevalence and incidence of attention\u2010deficit\/hyperactivity disorder diagnoses among children and adolescents in Japan based on claims data from the National Database of Health Insurance Claims (NDB)","volume":"16","author":"Sasayama D","year":"2022","journal-title":"Child Adolesc Psychiatry Ment Health"},{"key":"e_1_2_12_7_1","unstructured":"Ministry of Internal Affairs. Administrative Evaluation and Monitoring of Support for People with Neurodevelopmental Disabilities;2017.https:\/\/www.soumu.go.jp\/main_content\/000458776.pdf"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.12800"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.12248"},{"key":"e_1_2_12_10_1","volume-title":"NDB Open Data","author":"Ministry of Health Labour and Welfare","year":"2024"},{"key":"e_1_2_12_11_1","unstructured":"Ministry of Internal Affairs. Population Projections;2024.https:\/\/www.stat.go.jp\/english\/index.html"},{"key":"e_1_2_12_12_1","unstructured":"Japanese Council of Child and Adolescent Mental Institution\u3001Stady meeting of Japan organization of Child\u2010Adolescent Psychiatric institution No.52 (2023) Japanese Council of Child and Adolescent Mental Institution."},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pcn5.70107"}],"container-title":["Psychiatry and Clinical Neurosciences Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pcn5.70131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T12:55:55Z","timestamp":1750942555000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pcn5.70131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/pcn5.70131"],"URL":"https:\/\/doi.org\/10.1002\/pcn5.70131","archive":["Portico"],"relation":{},"ISSN":["2769-2558","2769-2558"],"issn-type":[{"value":"2769-2558","type":"print"},{"value":"2769-2558","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2025-04-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70131"}}