Abstract
“At-Risk Mental State, ARMS” is the term given to the psychotic-onset risk state. It seems to be mild and is difficult to distinguish from common depression without careful observation. Many patients visit a mental clinic complaining of insomnia, anxiety and depression. The concrete medical care regarding ARMS are not prevailed in over 6000 mental clinics in Japan. Then we present three patients of ARMS and two patients who do not meet the criteria of ARMS from Ginza Taimei Clinic. Mental clinics are “gate-keepers” of psychiatric medicine. They can contribute to ARMS treatment and early intervention. Mental clinics can initiate medical care even at night or on holidays, near the station or far away in town. In case of need of advanced or emergency care, psychiatrists refer patients to university or specialty hospitals. For remaining updated on the latest, the clinic staff attend academic conferences and build relationships with the staff of university and specialty hospitals. The most important role of a psychiatrist is not diagnosis, or “labeling”, but assistance, or ”empathy.“
