Mental Health Care in Japan Lecture by Yuri Kitamura

Mental Health Care in Japan lecture by Yuri Kitamura

In this lecture, I was introduced to some health statistics of Japan. It was really shocking to see the trends in total fertility rate decreasing and the trends in share of the population over 80 years old increasing, as this means that Japan will rapidly age with fewer children, causing an imbalance in the population pyramid which will affect Japan’s economy and social structure in the future. The reason for the fertility rate declined is because people are starting to marry late or not marry at all. They face many hurdles that discourage them from marrying young and having families — including unstable jobs and low income, as well as various costs associated with giving birth and raising children. I believe that measures to boost the employment stability of young people to steps to support working mothers and child-rearing — should be pursued as necessary investments by the government to help maintain the nation’s social integrity. Another contrasting statistic that was introduced in this lecture was the relatively lower health expenditure of Japan compared to other OECD countries such as the USA, despite a low number of Japanese people reporting themselves to be in good health. However we can also see the health expenditure of Japan increasing due to the rise of the aging population as mentioned above and lifestyle-related diseases including cardiovascular disease. I believe the reason for the contrast is due to the fact that health expenditure were not spent on treating mental-type illnesses, hence we are looking at a nation that are physically healthy, yet are not satisfied with their life and suffer mentally.  

Furthermore, we were introduced to the vision for health care in Japan, whereby Japan wants to build a health care system that is designed for all lifestyles and people- from children to older people, from patients to providers- where individuals feel secure and supported to make the life and work choices that are right for them.  It will be build according to the following principles: fairness, solidarity built on autonomy and shared prosperity for Japan and the world.  They came up with ideas to change the infrastructure of the system- from innovation to health care professionals and many more. For example, focusing on sustainable financing, they want to build establish a financial support mechanism to complement public insurance. These efforts are indeed useful to improve the health care system in Japan and reduce health risk in Japan. However this system in flawed in a way because it does not address mental health as a global health priority, hence not much efforts were taken to develop proper mental health care. Mental and Behavioural Disorders are the leading cause of disability worldwide which quantifies the comparative magnitude of health loss in a society, Japan included. However, I believe that stigma on mental health is a large problem in Japan that obstructs access to and development of proper mental health care. Japanese who are suffering from mental illness rather stay silent about their mental illness and some might suffer negative social impact as a result of mental illness (BBC, 2014). I feel that many Japanese refrain from seeking psychiatric help due to this stigmatization. I think the stigma is caused by both individual and community factors such as lack of education, negative attitudes and discrimination. After discussing these issues with my Japanese friends, I realized that the Japanese society has various conceptions of mental illness that differ from other widely-held conceptions. Japanese society considers it shameful to have a mental illness, since it is thought that the individual is responsible for developing a mental illness. This shame is an important cause of stigma in Japan and leads to increased social distance between the mentally ill and the general population. This social distance, in turn, leads to for instance loss of social opportunity for the mentally ill, economic inequality, housing discrimination and low quality of life. Also, Japanese society does not consider biomedical treatment options helpful for mental illness; and it is believed that it is the task of the family of the mentally ill to take care of these patients. This is in contrast with countries that have adopted a biomedical view on mental illness, where psychiatric treatment or other professional care is often considered the norm. This reduces the likelihood of seeking professional help for those that suffer from mental illness.