A retrospective study examined factors influencing prolonged evacuation among patients receiving home-visit psychiatric nursing services after the 2024 Noto Peninsula Earthquake in Japan. The study analyzed data from 115 patients, with a mean age of 53.3 years, focusing on demographic, mental health, and living environment factors in relation to evacuation status. Findings indicated a median evacuation duration of 208 days, with an initial shelter stay averaging 2 days. Binomial logistic regression revealed that staying less than 23 days in the initial shelter and using a public shelter were significantly associated with prolonged evacuation. Specifically, the odds of extended evacuation increased for those who stayed in a public shelter compared to other options. Geographic information system analysis illustrated the distances traveled by the most affected individuals, with total evacuation distances reaching up to 884.1 km. These results highlight that initial evacuation decisions and shelter choices can greatly impact the duration of evacuation for patients in home-visit psychiatric care.