Tackling Japan’s Complex Mental Health Puzzle

Updated: Jan 18

My Body My Pilates is one organisation that supports mental health in Japan

There have been encouragingly positive strides made in recent years in the area of mental health all around the world as the topic continues to be highlighted as an increasingly problematic issue.

Charity foundations, professional support networks, actions by celebrities in the sports and entertainment worlds are just a handful of examples of efforts in not only helping understand the issue better but making significant headway it how best to treat those suffering.

However, there are still certain countries where mental health, sadly, remains a stigma and consequently a big problem. Japan is one such country where the topic is a pressing issue, though the perception and handling of it still lags behind when compared to efforts in other nations.

According to the Japan Health Policy Now, although the number is trending downwards, Japan has the most people hospitalised in psychiatric wards on a per capita basis in the world. Figures from 2017 show that an estimated 4.193 million people in Japan were living with mental health issues, a number that continued to grow. Shockingly, the number of people living with mental health issues in Japan is greater than the number of people who have been diagnosed with cancer, stroke, acute myocardial infarction, and diabetes combined.

Exhausted, stressed and lonely

There are a myriad of factors behind these staggering numbers including poor mental health, mental illness, and social and economic pressure and stress factors; Japan is renowned as a country often characterised by extremely hard work ethics, long hours and immense stress. The millions of white collar workers, known as “salary men”, who show overriding loyalty and commitment to the corporation within which they are employed are often overworked to the point of exhaustion, are stressed and very lonely.

Additionally, there are factors such as natural disasters like the 2011 Great East Japan Earthquake and Tsunami in Tōhoku that devastated the country and left over 20,000 dead; likewise, major events such as Japan’s property and stock market crash of the early 1990s, and the global financial crisis of 2008.

Similarly, the COVID-19 pandemic hit hard with repeated nationwide lockdowns leading to increased unemployment – in 2020, there was a 34.5% increase in unemployment for women and 31.8% for men, according to statistics provided by the World Economic Forum.

COVID-19 also resulted in the Tokyo 2020 Olympics proceeding minus the fanfare that millions of Japanese had been looking forward to for years – whereas it was certainly a symbol of triumph in many respects, it had the feeling of a somewhat hollow experience, played out in front of empty stadia and without the carnival atmosphere that had been promised. This, of course, resulted in a major shortfall economically as the subsequent boost to the economy that tourists and visitors would have certainly created was absent. Tokyoites felt like a kid at Christmas who had been promised his wishlist of toys only to wake up on Christmas morning to find that his sack from Santa was empty. And with a downturn in the economy comes a further increase in mental stress and health.



One major hurdle is the fact that mental health has long been regarded as a stigma in Japanese culture. Japanese society has conditioned its citizens to believe that a mental health disorder is shameful and signifies a lack of willpower, says Eliza Kirk in a Borgen project report on the topic. In her June 2018 study on the perception of mental illness in Japan, more than 80% of Japanese participants believed that treatment could cure depressive disorder or schizophrenia but stigma toward people with schizophrenia was still quite apparent. As a result of Japan’s collectively held stigma, persons affected by mental illness often do not seek treatment.

This oppressive stigma has resulted in many Japanese people not believing that mental illnesses require professional treatment with almost two-thirds of sufferers never seeking help from a health professional and therefore suffering in silence.

This stigma is certainly one of the fundamental contributory factors to the high rate of suicides in Japan. The country reports its numbers at the end of every month and is therefore regarded as providing the most accurate data on the issue globally.

Despite suicide numbers in Japan falling for many years, last year saw an increase for the first time in 11 years, with the impact of the aforementioned COVID-19 pandemic the main factor; in 2020, Japan reported 16.7 suicides per 100,000 inhabitants. In October alone, it recorded 2,100 suicide-related deaths.

Help is at hand...

However, sustained efforts are constantly being made to address mental health issues and reverse these alarming statistics.

In specifically attempting to combat the stigma against mental illness and schizophrenia, the Japanese Society of Psychiatry and Neurology changed the Japanese name of schizophrenia from seishi buntetsu byo (split-mind disorder) to togo shiccho sho (loss of coordination disorder), reports Kirk. Although Japan has yet to celebrate its success in ending stigma, even minor changes illustrate that the country is evolving to no longer neglect mental