Mental Health Japan

The burning and the haunting: how for some the nightmare of Hiroshima will never end

Despite the line, “In Japan, where discussing mental illness is taboo”, this is overall a well research and sincere article based on a BBC television report marking the sixty years anniversary of the atomic destruction of Hiroshima. The idea that talking about mental illness is taboo in Japan often still appears in English media reports on Japan, even though, for example, depression (”utsubyou”, anxiety disorders “fuanshou”, PTSD and trauma (”torauma”) are health problems that are regularly discussed on television and in daily newspaper and popular magazines.

The most impressive point this article drives home is that nuclear weapons are terrible weapons that continue to corrode and effect the mental and phsyical health of the civilians of the cities that are vicitm to these weapons for generations after they explode and destroy without mercy. – Timi

Survivors describe the horrors of August 6 1945 and the scars that remain

“The nightmares that have stayed with her are understandable, but probably the mildest manifestation of the physical and mental scars that remain with many of those who survived. Some hibakusha have only started to talk publicly about their experiences in the last decade. Although they now receive special state welfare provision and much public attention, for many years after the war they were stigmatised. Women, in particular, found it hard to marry.

“They used to call women like me a ‘pikadon girl’ or an ‘atomic girl’,” said Kinuko Laskey, who was 16 when she was caught in the blast. “They would say, you don’t know what sort of a baby she will give birth to. Others said that the radiation could be genetically transmitted or was even contagious.”

Mrs Laskey attempted suicide several times before marrying a Canadian serviceman and emigrating to Vancouver. The explosion split open one of her eyes and drove hundreds of shards of glass into her body. For a whole year her mother covered up reflective surfaces, including pans, to prevent her daughter from seeing her disfigurement. By the time of her death last year, she had had numerous operations that had eventually made the visible damage almost indiscernible.

Flashbacks, hyper-vigilance and poor sleep have been reported among hibakusha. Many survivors become very anxious when talking about their experiences, as if they are stepping back into the horrors they are describing.

In Japan, where discussing mental illness is taboo, both doctors and survivors play down the possibility that some victims of Hiroshima might still be suffering from post-traumatic stress disorder, emphasising instead the desolation caused by losing loved ones and the anticipatory fear of radiation-related illness…”

The Guardian, Saturday August 6, 2005

Comfort Women May Forgive but Not Forget

“For a decade now, Song Shin Do, 84, the only Korean former comfort woman who lives in Japan, has refused monetary compensation but fought bitterly for an apology from the Japanese government, taking every defeat handed down at the courts with a poignant stoicism that has won her grudging admiration.

But today, Song, a small wizened woman with a sharp tongue, says she is ready to call it quits, exhausted from the long-drawn-out lawsuits that have rejected her strongest wish — to be able to die satisfied that there is repentance and that what they did to her will never be repeated.
Song said she was duped into becoming a sex slave when she was 16 years old to serve the Japanese Imperial army that colonised the Korean peninsula and most of Asia in the early 20th century.
”I was raped repeatedly by Japanese soldiers daily and was told I was serving the country. No woman should experience such a life again,” she told a public gathering late last month.
Activists supporting hundreds of aging sex slaves like Song explain the elusive wish for a sincere apology from the Japanese government must be viewed, not as an act of the past, but a deep blow to their struggle to pressure militaries to respect the right of women to be protected from violence during wars and conflicts.
”Song and other former comfort women are a powerful symbol of how women have been butchered by militarism in the past and which continues today in conflicts across the globe,” said Mina Watanabe, curator of the newly- opened Women’s Active Museum on War and Peace.
The museum is a heroic effort undertaken by women’s groups and international pacifists to leave a record of the cruel comfort women system and other human rights violations committed in post world war conflicts around the world.
Watanabe explained that the museum has a wide collection of testimonies of former sex slaves and is a crucial landmark in highlighting the vulnerability of women in armed conflicts and current sexual trafficking.It provides evidence to support the urgent need for better laws to punish acts of violence against women and develop a system where victims can be cared for by governments…”

Inter Press Service News Agency, Tokyo, 6 August, 2005

Community the key to preventing suicides

Worth reading the whole of this excellent and informative article by Professor Yutaka Motohashi, professor of Public Health at Akita University. The article places emphasis on the need for funds for suicide prevention programs, not just for research programs on the suicide. The majority of the suicides reflected in the high annual suicide rates are preventable and many of these needless deaths could be prevented if there is a stronger resolve in the political and social will to do so. – Timi

“… It is said that suicide and unemployment rates are commensurate. That connection is certainly evident in low-income prefectures.

In 2000, the Akita prefectural government embarked on an extensive program that targeted suicide prevention. The mainstay of the program placed emphasis on primary prevention through public health activities by improving health standards of both individuals and the wider community.

A noteworthy aspect of the program is that it chose not to center around the typical secondary mode of prevention-the early discovery and treatment of depression.

The prefectural government established venues in local communities equipped to provide health education and advice. Residents are able to participate as they wish.

In fiscal 2001, the prefectural government designated six towns as a model area and urged them to come up with primary ways of preventing suicide.

Today, these six towns have very active “community advisers,” all local citizens who listen to concerns expressed by others. They also set up venues where residents can get together to discuss their interpersonal problems.

In 2001, these six towns had a combined 30 suicides. In 2004, that figure dropped to 13.

No other town recorded a similar decline, which suggests the prevention program was working.

There are those who point out that while this remedy may work for rural communities, it would not apply to cities.

But the “Akita model” is not an atypical case.

There is no difference between rural and urban communities in that they all contain people who are suffering and want to live but need help in seeking assistance.

The issue is how to create a support network that fits and meets the needs of individual localities.

The essence of what was achieved in the rural communities can be applied in various ways in cities. Cities, for example, could be divided into clear-cut areas that have assigned health workers who diligently establish themselves in their assigned areas. The areas could also draw on the power of local people to help bring down suicide rates.

The central government, meanwhile, should provide the necessary powers to local governments to help them implement measures that fit the local situation. Preventing suicides is a matter of “local autonomy.”

Presently, the Ministry of Health, Labor and Welfare has placed suicide prevention research as the centerpiece of its prevention programs. In my view, it is actual prevention activities that need to be urgently put in place, not research.

To begin with, perhaps the government should help the other prefectures to establish prevention programs on a par with Akita’s. But rather than force the same set of activities onto the various prefectures, it should allocate funds that local governments can use at their discretion. The annual budget for Akita’s suicide prevention program comes to just under 10 million yen. If the central government allocated 10 million yen to each prefecture, it would add up to only 470 million yen.

Could the government not add this to the health ministry’s annual suicide prevention budget of 855 million yen?

If only the government would continue to earmark this additional amount until 2010, the year by which its target of reducing suicides by 30 percent is supposed to be reached.

There are still many prefectures that have not undertaken any kind of suicide prevention measures. But if they are given funds, they surely will take action.

Suicides are like automobile accidents in that they are by and large “avoidable deaths.”

A public outcry arose in the 1970s over what was termed traffic warfare. Since then, traffic fatalities have been significantly reduced. The traffic safety activities that were enforced involved the central government, local authorities, schools and workplaces. They would also serve as an effective model for suicide prevention activities.”

International Herald Tribune/Asahi Newspaper, August 3, 2005

Homemakers furious over taxing ‘parasite wives’ remark

As many women in Japan, both single and married, are showing more independence and determination to chose for themselves the life and lifestyle they wish to lead. At such times in the development of any modern equalitarian society, it is not unusual for chauvinistic sterotypical rants and criticism to ensue for a while, and in so doing reveal sexist distain for women’s intellects and fear of women exercise greater power and control in their lives. The following extract is taken from an article from Aera, revealing on such group of ranters… parasite is a subjective word and often to be found in the eye of the beholder… – Timi

“As full-time housewives, many women don’t do any work at all. They don’t bear children either, as opposed to the working women who want to have children but don’t. So these women just lounge around their homes, and are no different from the ‘parasite singles’ who sponge off their parents. Call them ‘parasite wives’ if you will. They’ve got money and time on their hands.”

These politically incorrect remarks were voiced last month during the 32nd meeting of an advisory subcommittee formed to reconsider Japan’s system of individual taxation in the 21st century. The committee, composed of 26 academics, bankers, authors and other upstanding citizens, had begun its deliberations two years ago…

…”To bear children or not is a matter of values,” says Rika Nogi, 41, a professional translator. “Many of these housewives are active in the school PTAs or community volunteer activities.”
“Up to now, women have practically never been able to choose their own lifestyles,” says Masami Ohinata, professor of development psychology at Keisen Women’s University. “The whole notion of fulltime housewives was part of a national strategy to keep women at home during the era of rapid economy growth, to enable the men to work all-out.”

Aera, by way of Wai Wai section of Mainichi Newspaper, July 30, 2005

Government moves to cut high suicide rate

“The government is planning coordinated suicide prevention efforts that will cross boundaries at ministries and agencies, officials said.

The move will come in response to a resolution by an Upper House panel on health, labor and welfare expected Tuesday calling for steps aimed at curtailing the high suicide rate.

The steps will include setting up a liaison council within the Cabinet Secretariat and a suicide prevention center at a health ministry affiliate.

The new system will also invite local authorities and nonprofit organizations to join suicide prevention efforts to build nationwide networks.

According to Ministry of Health, Labor and Welfare statistics, 30,227 people killed themselves in 2004, passing the 30,000 mark for a second year in a row. Suicide was the sixth-largest cause of death that year.

But according to National Police Agency statistics, the number of suicides has remained above 30,000 for seven years.

The health ministry aims to reduce suicides to 22,000 or less by 2010. The ministry, along with other government entities, has taken separate countermeasures, but they have been deemed ineffective, say officials.

They are especially alarmed by an increase in suicides among middle-aged people, especially men between the ages of 50 and 54.

Also disturbing is a recent trend toward group suicides by people who make contact through suicide Web sites.

The new liaison council in the Cabinet Secretariat will bring together bureau chiefs of the ministries of health and education, the NPA and related entities.

The National Institute of Mental Health of the National Center of Neurology and Psychiatry will host the proposed suicide prevention center.

In addition to research in cooperation with police, schools and nonprofit organizations, the center will train suicide prevention specialists…”

International Herald Tribune/Asahi: July 18,2005

Mental trauma identified in A-bomb victims

“About 90 percent of respondents to an Asahi Shimbun survey conducted prior to the 60th anniversary of the bombings of Hiroshima and Nagasaki also said they continue to worry about their health.

The survey, based on responses from 13,204 hibakusha, found that the more acute the victim’s symptoms were 60 years ago, the greater their continuing anguish.

Those who continue to be haunted by their experiences account for 80 percent of respondents.

In addition, the survey found that 50 percent of respondents blame both the Japanese and U.S. governments for the bombings. Only 28 percent pinned all responsibility on the United States.

Fifty-nine percent feared nuclear weapons would be used again.

Questionnaires were distributed to about 40,000 atomic bomb survivors. With 13,204 people replying, the response rate was about 32 percent.

The average age of the respondents was 72.4. The survey comprised 51 questions covering their physical and mental health, and the state of their current lives. It allowed respondents to select from multiple answers and add comments.

Asked how often they recall their experiences immediately following the bombings, 23 percent said they “often” have such flashbacks and 53 percent indicated that they “sometimes” do.

Nearly 60 percent of those who were under 10 years old at the time of the bombings stated that they “often” or “sometimes” recall such memories.

Among those who experienced acute symptoms immediately after the bombings on Aug. 6 and 9, 1945, and up to the end of that year, 88 percent said they “often” or “sometimes” have flashbacks about their experiences.

In comparison, 71 percent of those who said they did not display acute radiation symptoms after the bombings indicated they often or sometimes have such memories.

Asked whether they worry about their physical health, 45 percent of respondents said they are “always” concerned, while another 45 percent said “sometimes.” … “

International Herald Tribune/Asahi July 18, 2005

Paxil and Luvox: The background and availablity of SSRI anti-depressant medications in Japan.

Drug firms cashing in

“One of the new drugs was British pharmaceutical giant GlaxoSmithKline’s medicine Paxil — a so-called “selective serotonin re-uptake inhibitor” that boosts the presence in the brain of serotonin, a chemical believed to help regulate mood. Sales of Paxil took off, as did those for another SSRI that debuted in 1999 under the names Luvox and Depromel…”

Depression in Japan… “is now being seen as the common and crippling disease it is”

DEPRESSION

The Japan Times, July 10, 2005

A brave attempt to break away from the sterptype, too often portrayed in articles in English, that mental health care and treatment of depression in Japan and public understanding of depression is non-existant because of stigma. – Timi

Roots of abuse borderless: Swedish reporter

“As child abuse increasingly makes headlines in Japan, a Swedish journalist who has made many documentaries on youngsters says there is indeed truth to common findings that many abusive parents were victims of abuse during their own childhood.

In Japan, the number of child abuse consultations at public child counseling centers nationwide reached 32,979 in fiscal 2004, up 24 percent from the previous year, the Health, Labor and Welfare Ministry has reported.

According to Ylva Martens, a producer at public radio broadcaster Swedish Radio, Sweden has also seen a rise in child abuse reports in recent years, although it is unclear whether incidents are really on the rise or merely coming out into the open.

But research has shown many of the parents who abuse their offspring were abused during childhood, she said…”

The Japan Times, June 30, 2005

“SLEEPLESSNESS, IRRITATION MAY BE SYMPTOMS”

General anxiety disorder may be affecting 3% of population

“About 3 percent of Japanese are probably suffering from generalized anxiety disorder, which leads to depression and seriously affects not only those who have it, but also those around them.

Osamu Tajima, a Kyorin University professor, said GAD patients sleep poorly, suffer headaches and become highly sensitive and impatient.

“Naturally, they become irritable, tormenting themselves and troubling those around them,” Tajima said.

GAD used to be called anxiety neurosis and was thought to be a condition that mainly affected highly sensitive and nervous people. Its causes are not fully known, but neither character nor stress is the cause.

“It is supposed that symptoms of anxiety, tension and sleeplessness occur after the brain’s work to adjust anxiety and emotion becomes unbalanced,” Tajima said.

As the number of those suffering from GAD in Japan is not well known, Tajima and other researchers recently carried out an Internet survey covering 24,000 people.

It asked whether they have felt a lack of rest and have worried about something trivial for more than half a year.

They were also asked whether they are suffering from headaches of unknown cause or other pains, whether they cannot fall asleep or sleep well, and about several other symptoms.

As a result, 3.2 percent of the respondents were diagnosed as suffering from GAD. The ratio of men and women was the same. The largest group was those aged 15 to 19, at 4.2 percent. Only 6.8 percent of all the respondents have received hospital treatment, and 83.8 percent have never been treated…”

Japan Times, June 16, 2005