presentation for Current issues in Japan

1. MENTAL HEALTH ISSUES
IN JAPAN
and Introduction to
MONGOLIA’s MENTAL
ISSUES by
PUREVDORJ DORJSEMBE

2. Context presentation
■ Stigma related to mental health issues
– Misleading causes of mental illness
– Lack of national campaigns
– Social value of institutionalism and conformity
Source: Ministry of Health, Labour and Welfare (1987)

3. Context presentation
■ Availability and quality of treatments
– “Megadose culture in psychiatric care”
– Insufficient resources
Source: World Health Organization (2015)

4. Context presentation
Source: World Health Organization (2015)

5. Youth issues
■ Causes of youth related suicides
– Stress
– Poor grades
– Bullying
– Romantic relationships
– Issues at home

6. Source: https://www.japantimes.co.jp/news/2017/09/09/national/social-issues/confronting-youth-suicide-seeking-ways-stop-young-people-taking-lives/
Youth issues

7. Youth issues
■ School problematic, spike at the beginning of terms
Source: http://www.bbc.com/news/world-33362387/

8. Youth issues
■ Persistent problem
Source: Factors Affecting Unhappiness at School among Japanese Adolescents: An Epidemiological Study

9. Youth issues
■ Case of hikikomori, shut-in syndrome
– Social reaction (society’s pressures)
– Psychological pathology
Source: http://www.bbc.com/news/magazine-23182523

10. Occupational health issues
■ Financial difficulties second most common motive, but fewer suicides from economic
distress in recent development
■ Collapse of Japan’s bubble economy associated with 10,400 more suicides in 1998
compared to 1997
Source: https://www.economist.com/blogs/graphicdetail/2017/06/daily-chart-20

11. Occupational health issues
■ Impact of occupational factors on mood disorder and suicide
Source: https://www.economist.com/blogs/graphicdetail/2017/06/daily-chart-20

12. Occupational health issues
■ Karoshi (death from overwork) & karojisatsu (suicide from overwork)
Source: http://www.ilo.org/safework/info/publications/WCMS_211571/lang--en/index.htm

13. Occupational health issues
■ Psychosocial hazards at work:
– Long work hours
– Heavy workloads
– Employment insecurity
– Routine and repetitive tasks
– Interpersonal conflicts
– Inadequate rewards
– 25% of Japanese companies have employees working more than 80 hours
overtime a month
– 12% have employees working more than 100 hours a month

14. Elderly and isolation related issues
■ Change of family composition
■ Migration of young people to urban areas
■ Changes in the mindset towards family of the Japanese
■ Feelings of loneliness and shame
■ Lack of psychological help

15. Elderly and isolation related issues
■ Lack of social support crucial for depression, especially in rural areas
■ Sleep disturbance crucial for people in Urban areas
■ Living alone as a risk factor for depression amongst the elderly
■ Financial strain and unemployment in both areas as risk factors

16. Elderly and isolation related issues
Source: Abe et al. 2012

17. Elderly and isolation related issues
Source: Abe et al. 2012

18. Elderly and isolation related issues
Source: Abe et al. 2012

19. Countermeasures
■ Mental health system reforms
– Shift from mental hospitals to rehabilitation centers
– Deinstitutionalization; treatments oriented towards a more human approach
– Japanese government programs: changing the names of illnesses
■ Youth
– Efforts to reduce suicide rate by 30% by 2026
– School counselling in all elementary and junior schools
by 2019
– Anti-bullying and –harassment education in early education
– 24 hour helpline
■ Hikikomori
– "reorganising" the relationship between the patient
and his parent
Source: https://www.japantimes.co.jp/news/2017/09/09/national/social-issues/confronting-youth-suicide-seeking-ways-stop-young-people-taking-lives/#.Wh924LSFifU

20. Countermeasures
■ Middle aged and large public programs
– Educational programs towards mental illness for industrial workers and
government employees
– Suicide prevention act of 2006, Jisatsu taisaku kihon hou
– General Principles of Suicide Prevention Policy of 2007; intensifying of research
on suicide, the implementation of caretaking facilities
– Decrease in suicides for the seventh consecutive year
■ Overtime working issues
– Lower the allowed overtime working limit
(currently it is allowed 45 hours/month)
– Fine the companies if their workers exceed the limit

21. Countermeasures
■ Elderly and isolation
– Community-based research on depression and suicide, Oyama et al. (2006)
– Establishment of more facilities for general health care, with a special focus on
people over 65 years
– Such programs could be more effective for men if they considered mental health
problems that could be often seen with this population, like alcohol abuse, Ono
et al. (2013)

22. Mental health issues
in MONGOLIA
■ Mental health is not so popular subject (more western problem)
■ Mental health problems are getting on debate subjects lately

23. Main issues
■ Alcoholism
■ Divorce
■ Violence

24. Countermeasures
■ To create jobs for people working in mental health
■ Trained psychologists
■ Doctors and nurses to know mental health problems when they see them
■ Open mental health services and let people know it that its okay to ask

25. References
Abe, Yasuhisa, Noboru Fujise, Ryuta Fukunaga and Manabu Ikeda
2012 „Comparisons of the prevalence of and risk factors for elderly depression between urban and rural populations in Japan”, International
Psychogeriatrics 24/8,1235‒1241. DOI:10.1017/S1041610212000099.
Bradbury W.
2014, Japan: A Haven For the Psychologically Troubled, article written for The Japanese Times, (checked 27/11/2017)
https://www.japantimes.co.jp/community/2014/05/28/voices/japan-haven-psychologically-troubled/
Kingston J.
2012, “Shedding light on problems with Japan’s psychiatric care”, The Japan’s time (online), found at
https://www.japantimes.co.jp/culture/2012/11/25/books/book-reviews/shedding-light-on-problems-with-japans-psychiatric-care/#.Whu5cbSFifU
Kremer W., Hammond C.
2013, “Hikikomori: Why are so many Japanese men refusing to leave their rooms?“, BBC magazine (online), found at
http://www.bbc.com/news/magazine-23182523
Kunihiko Asai
1991,“Mental Health Services in Japan”, Journal of Sociology and Social Welfare, Vol. 18 No.2, 1991, found at
http://www.npo-jam.org/en/pdf/en_asai_007.pdf
Kyodo
2017, “Nearly a quarter of Japanese have considered suicide, government survey says”, The Japan Times (online), found at
https://www.japantimes.co.jp/news/2017/03/21/national/nearly-quarter-japanese-considered-suicide-government-survey-says/#.WhqLDLb5wxe
Inagaki, Kazuyuki
2010 “Income inequality and the suicide rate in Japan: Evidence from cointegration and LA-VAR”, Journal of Applied Economics 13/1, 113‒133.

26. References
Lu S.
2015, The Mystery Behind Japan’s High Suicide Rates Among Kids, article written for the Wilson Quarterly, (checked 27/11/2017) fount at
https://wilsonquarterly.com/stories/the-mystery-behind-japans-high-suicide-rates-among-kids/
Masami Ito
2017, Confronting Youth Suicide: Seeking Ways to Stop Young People From Taking Their Own Lives, article written for The Japanese
Times, (checked 27/11/2017) https://www.japantimes.co.jp/news/2017/09/09/national/social-issues/confronting-youth-suicide-seeking-ways-stop-
young-people-taking-lives/
Norasakkunkit V., Gulati N. (Gonzaga University)
2014, Mental Illness and the Marginalization of Youth in Post-Industrial Japan, published in Cultural sociology of mental illness: An A-to-Z
guide. (Vol. 10 pp. 433-435), Thousand Oaks, CA: SAGE Publications (checked 27/11/2017)
(https://www.researchgate.net/publication/265382428_Norasakkunkit_V_Gulati_N_2014_Japan_In_A_Scull_Ed_Cultural_sociology_of_mental_illn
ess_An_A-to-Z_guide_Vol_10_pp_433-435_Thousand_Oaks_CA_SAGE_Publications_Inc_doi_httpdxdoiorg1041359781483346342n159)
Ono, Yutaka, Akio Sakai, Kotaro Otsuka, Hidenori Uda, Hirofumi Oyama, Naoki Ishizuka, Shuichi Awata, Yasushi Ishida, Hiroto Iwasa, Yuichi
Kamei, Yutaka Motohashi, Jun Nakamura, Nobuyuki Nishi, Naoki Watanabe, Toshihiko Yotsumoto, Atsuo Nakagawa, Yuriko Suzuki, Miyuki
Tajima, Eriko Tanaka, Hironori Sakai und Naohiro Yonemoto
2013 „Effectiveness of a multimodal community intervention program to prevent suicide and suicide attempts: A quasi-experimental study”, PloS
ONE 8/10, e74902. DOI: 10.1371/journal.pone.0074902.
Oyama, Hirofumi, Masahiro Goto, Motoi Fujita, Hiroshi Shibuya and Tomoe Sakshita
2006 „Preventing elderly suicide through primary care by community-based screening fpr depression in rural Japan”, Crisis 27/2, 58–65. DOI:
10.1027/0227-5910.27.2.58.
Rupert Wingfield-Hayes
2015, “Why does Japan have such a high suicide rate?”, BBC News (online), found at http://www.bbc.com/news/world-33362387

27. References
Saint Arnault D.
2015, The SAGE Handbook of Modern Japanese Studies, SAGE editions (edited by James Babb), London, pp 334-348.
Schaede, Ulrike
2013 „Sunshine and suicide in Japan: revisiting the relevance of economic determinants of suicide”, Contemporary Japan 25/2, 105–126. DOI:
10.1515/cj-2013-0006.
Shuntaro Ando MD, MScPH, Sosei Yamaguchi PhD, Yuta Aoki MD, Graham Thornicroft MD, PhD
2013, “Review of mental-health-related stigma in Japan”, Psychiatry and Clinical Neurosciences Volume 67, Issue 7, Pages 471–482, found at
http://onlinelibrary.wiley.com/doi/10.1111/pcn.12086/full
Takeshima, Tadashi, Takashi Yamauchi, Masatoshi Inagaki, Manami Kodaka, Toshihiko Matsumoto, Kenji Kawano, Yotarō Katsumata, Maiko
Fujimori, Ayaka Hisanaga und Yoshitomo Takahashi
2015 „Suicide prevention strategies in Japan: A 15-year review (1998–2013)”, Journal of Public Health Policy 36, 52–66. DOI: 10.1057/jphp.2014.42.
Traphagan, John W.
2010 „Intergenerational ambivalence, power, and perceptions of elder suicide in rural Japan”; Journal of Intergenerational Relationships 8/1, 21–
37. DOI: 10.1080/15350770903520643.