<p>This article examines the role of psychiatric care in the passage of unstably documented migrants and asylum seekers in Japan from detention-bound, dispossessed non-citizens with no recognized voice to medically certified claimants whose documented distress opens legal pathways to social protection. Psychiatric care is the only medical welfare provision in Japan for those without residential registry, who are required to verify severe mental illnesses to maintain provisional release permits (PRPs) that may defer detention and potential forced repatriation. Drawing on multisited ethnography through 18 months of fieldwork in Hanami Clinic—a neighborhood-based psychiatric clinic—and Tsunagi Shelter—a refuge for individuals lacking formal registration—I explore the intersection of clinical intervention, legal procedures, and everyday experiences of mental illness. Through these psychiatric care practices, multi-ethnic PRP holders cultivate new ways to articulate their detention experience and legal predicament, discursively broadening narratives about their psychological distress along with its potential for documentability. My argument is that psychiatric medicalization is helping create an important conceptual space for psychiatric legitimization of access to basic rights. Through its constitutive role in legal documentation and PRP justification, psychiatric mediation provides new discourses that legitimize moral claims to legal resolution.</p>