MENU

Stigma on Mental Illness in Japan

CAUSES, CONSEQUENCES, AND POSSIBLE SOLUTIONS 

#FORAHEALTHIERJAPAN

 

BACKGROUND & WHY I CHOSE THIS TOPIC:

In Japan, the stigma on mental health is a large problem that obstructs access to and development of proper mental health care. When researching, I found that up to 50% of the individuals suffering from mental illness would rather stay silent about their sickness and more than 40% suffer from negative social impacts as a result of their illness. Almost two-thirds of those suffering refrain from seeking psychiatric help due to this stigmatization — a huge problem when considering how prevalent issues related to mental health are in Japan. Several other studies I found have confirmed that general stigmatization of mental illness is greater here than in other countries. I’d like to explore why widespread stigma still exists in such a highly developed and prosperous nation like that of Japan, the consequences that result from it, and possible solutions to the challenges my home country faces.

When given the option of what topic to choose for this catalyst conference, I knew I wanted to keep it close to home as my main purpose was to help those directly around me. Furthermore, one of the biggest motives for me joining “Abnormal Psychology” in the first place was my desire to learn more about the many unspoken issues (such as mental health) in Japan, so this conference was the perfect opportunity to explore that topic in depth. I recognized that mental illness was a big issue in my home country early on, long before taking this course, but didn’t know why so many were affected or why so few sought proper help. In the United States, for example, while stigma still exists surrounding mental health, there are so many different treatment options and places/people to go for help. In Japan, unfortunately, mental health care lags behind the US (and many other countries) and people have a more backward/negative view of the mentally ill. I wished to understand the underlying causes of stigma, the bleak consequences of it, and possible interventions to help reduce this mindset #ForAHealthierJapan.

 

Do you recognize stigma around mental illness where you live?

Yes
No

 

PROJECT LAYOUT: 

In order to address stigma on mental illness in Japan, this paper will explore:

  • The nature and characteristics of stigma (causes, consequences)
  • Existing successful interventions aimed at reducing stigma

Firstly, both individual and community level causes of stigma will be assessed in more detail. Secondly, current successful interventions to reduce stigma will be explored and evaluated on their potential. Finally, based on the accumulated evidence, a conclusion will determine what needs to be done in order to change this stigmatization. This will then give insights in and provide suggestions for how stigmatization in Japan can best be addressed.

 


 

IDENTIFIED CAUSES OF MENTAL-HEALTH RELATED STIGMA:

In order to determine what causes mental health-related stigma in Japan, both individual and community level factors of stigma are explored in this section. I first researched the individual-level factors such as lack of education, negative attitudes, prejudice, and discrimination. Then, I addressed the community level factors of stigma in Japan and reviewed both separately.

Individual-Level Factors:

Japanese society has various conceptions of mental illness that differ from other widely­-held conceptions. For instance, common causes of mental illness are considered psychosocial factors including:

  • Weakness of character
  • Loss of willpower or being a generally nervous person

This also means Japanese society considers it shameful to have a mental illness since it is thought that the individual is responsible for developing it on their own. This shame is an important cause of stigma in Japan and leads to an increased social distance between the mentally ill and the general population.

Watch this video as a preview to better understand just how the Japanese deal with mental illness, specifically depression,  which signals a cause of stigma and “backward” mindset regarding mental health.

 

1. Lack of Education Regarding Mental Illness

Particular conceptions of mental illness in Japan might be brought about by a lack of education on mental illness. Statistics show that:

  • The Japanese consider recovery from mental illness unlikely (Only 5% believe that mentally ill people can recover from
    their illness)
  • Japanese society doesn’t consider biomedical treatment as viable options helpful for the mentally ill (respectively only 30-41% and 54-67% regarded antipsychotics and psychotherapy as useful to patients)

There thus seems to be general mistrust in biomedical medicine, stemming from lack of knowledge and awareness.

In addition, Japanese society considers it the task of the family of the mentally ill to take care of these patients; studies show that the most commonly considered suitable help for mental illness are friends or family (70-72%). This contrasts with countries that have adopted a biomedical view on mental illness, where psychiatric treatment or other professional care is often considered the norm and best approach. In Japan, less than 50% of respondents regarded psychiatrists as suitable caretakers of the mentally ill, reducing the overall likelihood of them seeking professional help.

 

2. Prejudice and Negative Attitude towards Mental Illness

In addition to misconceptions being caused by lack of education, negative attitudes against mental illness are also often caused by ignorance among Japanese society. Negative attitudes can also emanate from misconceptions, and often lead to prejudice and increased social distance. 

Consequences of negative attitudes and prejudice toward mentally ill:

  • Loss of social opportunity
  • Economic inequality
  • Housing discrimination
  • Low quality of life

One research article I read raised the statistic that 77% of mental health professionals believed that “it was dangerous for mentally ill people to live by themselves.” This clearly shows negative attitudes towards the mentally ill, even by professionals, who think of them as far less capable than a “normal” person.

 

3. Discrimination of the Mentally Ill

Discrimination occurs when stigma is acted upon in behavior, such as exclusion or rejection.

Statistics of discrimination:

  • 62.6% of Japanese respondents indicated they agreed that an individual suffering from chronic schizophrenia would be discriminated against by their community
  • 27.2% of Japanese said people who have depression would be discriminated against
  • 72% indicated they felt the need to conceal their diagnosis (this can be seen as a consequence of anticipated discrimination)
  • Only 20% of mental health professionals believed that people with mental illness should live in a community without being hospitalized
  • 61% of people said they would never employ someone with a mental illness

Both anticipated and negative discrimination of individuals with a mental illness can additionally lead to low rates of help-seeking, diminished access to care, treatment gap, poverty and social marginalization.

 

Community Level Factors that Influence Stigma on Mental Health:

Along with individual factors, stigma is often influenced by community-level factors such as the norms of asocial unit or society. An example of stigmatization on a community level is the shared belief that an individual must act as is deemed socially appropriate by their social community. Japanese culture is generally known for its high value of conformity within society. Having a mental illness is considered deviation from the norm and is therefore not publicly accepted.  Moreover, Japanese culture knows a distinction between “Honne,” which refers to someone’s real opinions or feelings, and “Tatemae,” which refers to feelings that are publicly expressed. The Japanese have always been known to keep these different types of feelings separate, which sometimes leads to portraying the opinions that are publically accepted as opposed to opinions of their own. This is the reason for Japan’s preference of conformity which leads to increased stigmatization of mental illness.

 


 

CHALLENGE:

My topic is challenging because while Japan clearly is in dire need of a solution concerning reduced stigma on mental illness, the “culture of shame” is embedded within society and directly challenging historically built ideas and customs is hard. Furthermore, I found that mental illness stigma is stronger amongst older people rather than younger people, but since Japan is ruled by the old, their opinions count more and perception never changes. Additionally, since the Japanese value conformity and Japan itself is a collectivist country, each person is expected to be functional members of society and anybody who needs additional help or makes others uncomfortable is automatically stigmatized. The mentally ill in Japan, unlike other countries, are discriminated against to the highest degree as they aren’t seen as socially valuable. Opportunities for them to get help, get a job or do anything meaningful with their lives don’t arise easily and they are left feeling alone and isolated in a society that doesn’t accept them.

Listen to this Brian Lehrer talk about 30 Issues If You Needed Mental Healthcare in Japan to get a better sense of the challenges in addressing this problem.

 


 

SUCCESSFUL INTERVENTIONS/SOLUTIONS:

Based on the evaluated causes and consequences of stigma on mental health in Japan, it seems that interventions targeting education, attitudes, prejudice, discrimination, and contact between the mentally ill and general population would be most fruitful. More specifically, awareness campaigns, specifically within schools, to improve knowledge about mental illness seems to be missing in Japanese society. The government should work to make mental health a mandatory class within Japanese public schools so kids can start learning about and build empathy from a young age. Public awareness programs and campaigns to promote knowledge of mental illness seem also successful in addressing the lack of education, removing misconceptions, and decreasing negative attitudes towards mental illness. TELL, with a mission statement of “dedicated to providing effective support and counseling services to Japan’s international community and its increasing mental health needs,” does a good job spreading awareness and acting as care providers. More organizations like this should go and visit schools to spread awareness and promote active participation in shattering the stigma surrounding mental health.

 


 

WHAT CAN YOU DO?

Here are 9 simple steps that you can take to reduce stigma around mental health:

  1. Talk openly about mental health
  2. Educate yourself and others
  3. Be conscious of language
  4. Encourage equality between physical and mental illness
  5. Show compassion for those with mental illness
  6. Choose empowerment over shame
  7. Be honest about treatment
  8. Let the media know when they’re being stigmatizing
  9. Don’t harbor self-stigma

On top of these actions, you can try to push for a club at your school dedicating to mental health. At my school, I am a part of mental health awareness club called Piece of Mind, dedicated “to spread awareness about different mental illnesses in order to build compassion for those who go through it.” Our efforts include trying to create a safe space for students who are going through mental health struggles and provide stress-relief activities for high schoolers. During our meetings, we talk about different mental illnesses and what we can do as a club to reduce the stigma around them. We also fundraise through bake sales and events to donate to mental health organizations like TELL mentioned above. Be the change you want to see and create a club for yourself and others! #EndTheStigma

 


 

CONCLUSION

In Japan, there is a great need to reduce stigma on mental illness and increase awareness among the population since individuals with mental illness greatly suffer from the consequences. Increasing education, reducing negative attitudes and discrimination, as well as better facilitating contact through the implementation of deinstitutionalization should be achieved in order to reduce stigmatization in Japanese society.

 


SOURCES CITED:

Bauer, Dennis. “New Documentary Explores Taboo Subject of Mental Illness in Japan.” Japan Today, © Japan Today, 22 Mar. 2009, japantoday.com/category/features/new-documentary-explores-taboo-subject-of-mental-illness-in-japan.

Greenstein, Laura. “9 Ways To Fight Mental Health Stigma.” National Alliance on Mental Illness, 11 Oct. 2017, www.nami.org/blogs/nami-blog/october-2017/9-ways-to-fight-mental-health-stigma.

“Mental Health.” Japan Healthcare Info, japanhealthinfo.com/mental-health/.

Taplin, Ruth, and Sandra J Lawman. “Mental Health Care in Japan.” Japan Society of the UK, 26 Apr. 2013, www.japansociety.org.uk/29943/mental-health-care-in-japan/.

PHOTO CREDITS:

https://www.pinterest.com/djacademe/groups-networks-organizations/

https://www.emaze.com/@AIWFFLZL/Eight-Eyes-

https://ameblo.jp/ryumiyata1960703/entry-12243931012.html

http://fatherknowsbooks.com/?tag=dad

Share this project
COMMENTS: 17
  1. April 26, 2018 by Ella.Durbin

    Rikako,
    Your project topic brings up an issue that I haven’t thought much about so thank you for bringing awareness and light to it. You had really strong statistics that really pushed me to want to make a change. It’s interesting because in Seattle, where I am from, if someone was discriminated against because of a mental illness, there’d be a huge uproar and it would be absolutely unacceptable. It’s shocking to me that such a high percentage of people would discriminate and decline to employ someone with a mental illness. Overall you had a great topic and I think you made a super important impact on this topics urgency for change!

    • April 28, 2018 by Rikako.Kent

      Thanks Ella! It really is a locational and cultural problem that Japan has such negative attitudes towards mental health, and they should really take after other countries in how to treat their mentally ill population. Thanks again for reading and commenting!

  2. April 27, 2018 by brendan.sarsfield

    I was impressed by not only your content and the strength of your communication in sharing this issue, one which affects so many people here in Japan ….and elsewhere in the world, but also your strong layout and visual presentation –

    Your page design is crisp, well structured and thoughtful – it helps provide a mature and professional looking context for your clear engagement and passion for the subject.

    Thanks !! – I’m going to recommend my students visit your site !!

    • April 28, 2018 by Rikako.Kent

      Mr. Sarsfield, thank you so much for reading! I definitely put emphasis on the designing aspect of the project. Your sharing would be greatly appreciated!

  3. April 27, 2018 by CC Yin

    Rikako, I love your project! I think you do a great job of empathizing with non-western cultures and you provide so much information, people don’t really need to have any background information to understand your project.

    • April 28, 2018 by Rikako.Kent

      Thank you CC Yin! I hope it was an interesting read and you learned a little more about Japan and it’s mental health problems.

  4. April 28, 2018 by Tobi Howe

    Rikako, amazing project in addressing the stigma surrounding mental illness in Japan. From your background information to possible solution sets, the project was well-researched and clearly writ for anyone to understand. The designing and layout approach was also cool and it was pleasing to look at. Overall, awesome job!

    • April 29, 2018 by Rikako.Kent

      Tobi! Thanks for your nice comment 🙂

  5. April 28, 2018 by Zain.Palanpur

    This presentation was really well done. I think you did a great job putting it together and flowed really well. I found the way you broke up the causes of mental health section into the three factors. You do a good job of explaining/defining the problem and use strong data to supplement your argument. Finally, I think the “what can you do?” section was a great last touch in offering your audience some tools they can use to positively impact the problem stigmas on mental health. Awesome project!

    • April 29, 2018 by Rikako.Kent

      Zain, thank you for taking the time to view my presentation! The “What can you do?” section was the most vital piece of the presentation because it is the change stimulator. Thanks again!

  6. April 29, 2018 by Rory Smith

    Rikako,
    Thank you for a comprehensive, engaging presentation on mental health stigma in your community. In my school and hometown in North Carolina, mental health is spoken about fairly openly and the biomedical approach is relied on heavily, so it was interesting to see how this varies in other parts of the world. Your analysis on the factors that impact stigma were very thought-provoking, and I appreciated your incorporation of the narrative (in the video) which added the empathy aspect to your presentation. In the future, I will strive to incorporate your 9 stigma-reducing steps into my daily behavior. I can tell that you put a lot of effort and thought into this presentation, and I commend you for a job well done! I have loved hearing your thoughts about mental health this semester in Ab Psych and wish you the best of luck in spreading this information to your community!

    • April 30, 2018 by Rikako.Kent

      Rory, thank you for taking the time to view my project! I really hope my community and Japan as a country can learn from places like the US in how to deal with mental health issues. Throughout this semester, your comments also stood out to me for how in-depth and thoughtful they were. I’ve enjoyed being in an online class with you and thanks again for commenting 🙂

  7. April 29, 2018 by Aidan.Pak

    Wonderful site and presentation. I believe that a similar culture to the one you are experiencing in Japan is present in the one that I live in. Mental health is a serious issue that are generation needs to step up and solve, and I think that you did a great job at identifying the roots of the issue, and then giving a series of good solutions that aim at solving the issue.

    • April 30, 2018 by Rikako.Kent

      Aidan, thank you for your comment! It’s crazy to think that in some countries there is hardly any stigma surrounding mental illnesses but in others, it is blatantly obvious that there is. My goal is to abolish any kind of negative feeling or unknowingness about the topic so people can live happy and healthy lives. Thank you again for taking the time to view my presentation.

  8. May 01, 2018 by Anderson Page

    Hi Rikako,

    Great project! You did a nice job of researching all different aspects of your topic and presenting a clear, thorough explanation of an issue that definitely needs attention. This is definitely a relevant issue, as every culture seems to have its own way of ignoring or disadvantaging the mentally ill. I really enjoyed the many different examples of how people can be stigmatized, as well as the steps we can take to prevent it.

    • May 01, 2018 by Rikako.Kent

      Anderson, thank you for your kind comment! I agree with your point about different cultures having different ways of dealing with or handling the mentally ill population. I hope to see a change in Japan’s mindset for sure. Thanks again!

  9. May 13, 2018 by Max.Ting

    Rikako, this is a great presentation! It’s extremely well structured and layout makes all the content easy to follow. It’s interesting to see the contrast between how mental illness is perceived in Japan vs. in the States. In the social sphere in Japan, the fact that one would get discriminated against because of a mental illness or even denied/ excluded from society shows the dire state of mental health in Japan.

Sorry, the comment form is closed at this time.

Sorry, the comment form is closed at this time.