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RIGHTS-JAPAN: Recognition of Mental Health Issues Comes Slowly
By Suvendrini Kakuchi
TOKYO, Oct 2 (IPS) - For more than 30 years, Sue Nagahama has battled
depression. ''It took me years to find a doctor I could trust,'' said the
57-year-old single mother.
Misunderstood by her relatives - they called her lazy when her chronic
depression forced Nagahama to give up her jobs - she yearns for kindness
and care.
She is unlikely to find either. Nagahama says that depression is the
''worst'' treated condition in Japan. Unemployed today, she lives with a
man who repeatedly asks her to leave his house. ''I want to get away but I
am too scared to live alone,'' she explained. ''When I tell this to my
doctor, he just increases my medication.''
Nagahama's condition typifies that of the depressive and mentally
handicapped in Japan.
More than 330,000 patients languish in psychiatric
hospitals, the biggest such population among developed countries. Yet Japan
does not have laws that ensure this population housing and jobs, as is the
case with the physically disabled.
Hiroko Mizushima, psychiatrist and member of Japan's Diet or parliament,
has long advocated policies that aim at helping such patients lead normal
lives. She has called for emergency treatment facilities, rehabilitation
programmes, and jobs that accommodate their special needs.
''Mentally handicapped people can contribute to society given better
support,'' she said. ''Japan must move away from focusing policies on the
negative aspects of mental illnesses.''
In fact, it is the lack of family or welfare support - not medical
reasons - that keeps 72,000 people with psychiatric conditions in
institutions, according to the Health and Welfare Ministry.
Even so, a mounting concern for counsellors and advocates working for
the rights of the mentally handicapped is a law endorsed in July 2003 by
the Diet which paves the way to forcibly hospitalising mentally disabled
lawbreakers.
The law is to come into force in spring 2004 and will give courts the
authority to decide whether such people should be hospitalised or require
regular clinical attention.
It is unfortunately a recent spate of crimes committed by troubled
youth, coming on top of media reports on the increasing number of
stress-related deaths, that has highlighted the issue.
Lawyer Kazuo Satomi, who defends troubled clients, has criticised the
new law. He argued that it is a huge blow to the rights of the mentally
handicapped, who already have to deal the perception that they are social
burden and are best dealt with by sequestering them from the community at
large.
''By especially singling out people with mental disorders they are seen
as potential criminals,'' he said.
Japan has long ignored its mentally handicapped, and crime-related
incidents involving them tend to be seen by the authorities only as
law-and-order problems, not as indicators of social trauma.
A recent example of this attitude is the decision taken on Sep. 29 by
the Nagasaki Family Court to send a 12-year-old boy to a special security
facility for juvenile criminals.
The boy killed a four-year-old after stripping him naked and mutilating
him with a pair of scissors in July. The 12-year-old was examined by
psychiatrists who diagnosed him as suffering from a mental disorder that
makes it difficult for him to interact with people. Reports also stated
that he suffered from mental stress at school.
Critics also point out the new law was passed to appease an angry public
following the fatal stabbing in Osaka of eight children by Mamoru Takuma in
June 2001.
Having also injured 15 others, Takuma was sentenced to death on
Aug. 28 on the grounds that he knew he was committing a crime despite a
psychiatric evaluation that showed he had an extremely rare personality
disorder.
The defendant's lawyer, Shigeki Totani, had argued against the verdict
by presenting documents which showed that Takuma had been a victim of
psychological problems as a child and had been treated at more than 17
hospitals.
Satomi the lawyer, who is also a director of the advocacy group, Osaka
Mental Treatment Human Rights Centre, said the shows the lack of
understanding for the mentally sick in Japan. ''There was no public debate
on the issues surrounding Takuma's background or mental status,'' he said.
Satomi's group - set up a decade ago - helps an average of 150 callers
every month through telephone counselling. The group also visits patients
in psychiatric hospitals, and seeks new programmes to help lead patients
back towards a normal life, rather than keep them locked up.
Signs of new thinking are slowly emerging.
The Health and Welfare Ministry will from April 2004 start a new section
devoted to mental health and has launched new studies on depression.
Activists see these as signs of long-awaited improvement.
Some doctors are now beginning to study patients' personal backgrounds
as a prelude to diagnosing psychiatric illnesses, which was not commonly
done earlier.
Confronting the scale of the problem will take dedication and the
willingness to tackle it head-on. Kenichi Takase, one of two counsellors
with Tokyo's Stress Care Centre, the first to be set up by the government
last year, says depression is rampant among male employees who work too
hard and take few vacations.
Takase develops slower schedules - working one or two days a week - to
encourage employees who have been hospitalised to return to normal life.
An encouraging sign is that the government is planning to set up six
more such centres in the country to help depressed workers as, according to
National Police Agency statistics, over 5 percent of the 31,042 suicides
recorded in 2001 are thought to be work-related. (END/2003)
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