Japan Suicide

Japan Suicide Reports

Mondays see most suicides; men tend to pick 5 a.m., women noon

"Mondays had the most suicides in Japan in 2003, with the most common hour being around 5 a.m. for men and around noon for women, an analysis by the Ministry of Health, Labor and Welfare showed Friday...

The ministry said men tended to commit suicide in the early morning, apparently wanting to avoid being noticed by others, while women did so around noon when they were alone at home after their families had gone to work or school.

It said it intends to use the analysis results to map out suicide prevention measures.

The ministry said 73 percent of those who committed suicide were men.

Mondays had the most suicides, with an average of 80.7 males and 27.3 females killing themselves, while Saturday had the fewest, with an average of 53.3 males and 21.2 females.

By hour, 6.2 percent of men committed suicide between 5 and 6 a.m., while 5.6 percent of women committed suicide between noon and 1 p.m.

By month, April had the highest daily rate of suicides, with 103.2 people killing themselves per day, and May the second-highest, with an average of 100.3 people killing themselves daily.

By age bracket, males in their 50s were the largest group of people committing suicide.

Death by hanging was the most common method, but group suicide through gas inhalation also increased, with 3,538 people involved, up by 2,024 from 2002.

Japan has seen a series of incidents in which strangers got together through the Internet and committed suicide in a group, typically using charcoal stoves inside sealed environments, including vehicles.

By prefecture, Akita had the highest suicide rate for both men and women, while Kanagawa had the lowest for men and Saga the lowest for women.

The National Police Agency earlier said in a similar study on suicides that over a quarter of the suicides in 2003 are believed to have stemmed from economic difficulties." ...

The Japan Times, January 29th, 2005

Good to see an article that focuses more on the detailed analysis of both individual and group suicides in Japan, rather than the majority of the more sensational and sometimes hysterical articles towards the end of 2004, which focused almost solely on so called "internet suicide pacts", "internet suicide groups" and even in one case, "internet suicide clubs" (based only on the self styled name of one suicidal individual's homepage).

It is worth noting that The National Police Agency statistics show that group suicide through gas inhalation also increased, with 3,538 people involved. The term group suicide here includes many different situations where people have died together, from a couple who had a chicken farm where a case of asian bird flu was reported, to businessmen whose company went bankrupt committing suicide together in hotel rooms.

The official statistics for the total number of people who actually died in group suicides where the victims made initial contact through "internet suicide sites" have yet to be released for 2004, but is estimated by one expert psychiatrist in the field to be "less than 50" in total. The National Police Agency last reported statistic was for 2003, when a total of 34 people died in group suicides after it seems they made initial contact through the internet.

A lack of in depth background research by some sections of the press and other media in both Japan and in countries abroad, and, in some cases of reports in English, actual errors and a seeming lack of confirming the reliability of the statistics from the original sources in Japanese, may have been one of the factors focusing attention away from the underlying economical and psychological causes of suicide in Japan.

I would urge the more responsible reporters and journalists who will be reporting to take greater care in 2005 and in the future in the reporting of suicide in 2004 (and in the reporting of all other mental health care related issues in Japan) yet to be released later this year. Responsible media reporting could help more to focus on all of the central crucial issues related to suicide prevention, and discourage those less caring members of their craft from sensationalizing and even encouraging the use of the way a relatively low number of unemployed, distressed, depressed and hopeless people lost their lives in 2003 and 2004 - Timi

Abuse of Elders

Efforts under way to stem abuse of elderly

"While Japan's aging population is usually talked of in terms of rising welfare expenditures and the financial burden it will impose on future generations, recently a new problem has emerged: abuse of the elderly.

Lawyers and other experts handling the issue say that compared with child or spouse abuse, abuse of the elderly tends to take longer to surface, in part because the elderly feel responsible when the violence is inflicted by their offspring, and also because the government and local administrators have so far failed to address the problem.

The Japan Federation of Bar Associations submitted a proposal to the Health, Labor and Welfare Ministry in October with an eye to obliging authorities to get tough on abuse.

Its 54-page recommendation refers to the need to help not only victims but also the perpetrators -- in most cases, a member of the victims' family experiencing mental, physical and economic hardship as a result of caring for their elderly relative.

The nationwide lawyer group has already briefed ministry and local government officials and called on them to establish a law -- along the lines of the Child Abuse Prevention Law instituted in 2000 and the Domestic Violence Prevention Law in 2001 -- to crack down on elder abuse.

According to a nationwide poll taken by the Institute for Health Economies and Policy on behalf of the welfare ministry and released in April -- Japan's first survey of elder abuse -- 11 percent of those responding who have suffered abuse have been in a life-threatening situation.

Sons were responsible for the abuse in 32 percent of the cases, followed by daughters-in-law and spouses, each at 20 percent. About 64 percent of the cases involved mental abuse, including yelling or willful neglect, 52 percent involved denying meals or other forms of care and 50 percent included beating people or tying them to their bed.

The average age of the victims was 81.6, with women accounting for 76 percent of the total. The survey covered 1,991 abused seniors as reported by licensed care managers, including doctors, nurses and other health-care professionals..."

The Japan Times, January 6, 2005

Sex Abuse Support Group

Japan's Battlers of Sex Abuse Confront Culture, Law

... Yanagishita left home with her two children one winter November morning two years ago, fearing for her life. "My husband expected me to be his slave and I thought I had to comply because that's what is expected from women. After therapy I realized how stupid I had been," she said.

Yanagishita discovered the counseling services offered by JUST, Japanese Union for Survivors of Trauma, a nongovernmental organization offering support for women who have been raped or sexually abused. The group, which began operating in 1997, this year became the first organization in Japan to offer an advocacy service for victims of sexual violence. The Tokyo-based group offers a telephone hotline, group and individual counseling and works with public-welfare officials to take abused women to doctors, hospitals and lawyers.

"When a Japanese woman is raped or sexually abused, most often she has no one to help her. The role of the advocate is especially important against this social backdrop," said Yanagishita, now a counselor for JUST.

Among the annual 140 phone calls fielded by JUST are shocking revelations of women breaking almost 30 years of silence to talk about rape or other sexual violence.

"A woman in her 50s wept as she recalled been raped by her father when she was a teen-ager," said Yanagishita. "By talking to me, she said she found some release for the first time in her life."

Working on the basis of strict anonymity for their clients, JUST counselors say several middle-aged callers have talked of recurring nightmares, long depression and of not seeking help for fear of being exposed.

Figures compiled by the National Police Agency indicate that 2,238 cases of rape, or 10 percent of all serious crimes, were reported in Japan in 2001. If numbers for indecent assault are included--such as attempted rape, groping or harassment--the cases of sexual abuse rise to 43 percent of the total...

... After intense lobbying by feminists, Japan passed the Law for Prevention of Spousal Violence and Protection of Victims in October 2001. Under the law, hitting a woman can lead to jail terms of up to a year or a $10,000 fine. Advocates say the law was the first recognition of domestic violence as a crime, instead of a private domestic matter. The law also recognizes sexual abuse as an aspect of domestic violence, but stops short of calling it spousal rape, a disappointment for activists.

... Still Sumita, also a committee member for the Council for Gender Equality at the Prime Minister's Office, said there have been some startling signs of encouragement in recent years. For example, the National Police Agency established a special rape unit in 2000 that employs female policewomen to help victims...

... The gains, however, have exposed a new problem for advocates. "There is a backlash from older men, especially powerful male politicians who are now saying the issue of sexual rights endangers marital harmony and causes social breakdown. But we are determined to fight on," said lawyer Sumita...

Women's eNews, January 23, 2005


Well written and well researched article on the the excellent work of the Japanese Union for Survivors of Trauma, and also detailing improvements being made in both the social awareness and advocacy and legal protection the victims of rape, sexual abuse, domestic violence and spousal rape. Read the article in full at the link above.

Sex Abuse

Japan's Battlers of Sex Abuse Confront Culture, Law

... Yanagishita left home with her two children one winter November morning two years ago, fearing for her life. "My husband expected me to be his slave and I thought I had to comply because that's what is expected from women. After therapy I realized how stupid I had been," she said.

Yanagishita discovered the counseling services offered by JUST, Japanese Union for Survivors of Trauma, a nongovernmental organization offering support for women who have been raped or sexually abused. The group, which began operating in 1997, this year became the first organization in Japan to offer an advocacy service for victims of sexual violence. The Tokyo-based group offers a telephone hotline, group and individual counseling and works with public-welfare officials to take abused women to doctors, hospitals and lawyers.

"When a Japanese woman is raped or sexually abused, most often she has no one to help her. The role of the advocate is especially important against this social backdrop," said Yanagishita, now a counselor for JUST.

Among the annual 140 phone calls fielded by JUST are shocking revelations of women breaking almost 30 years of silence to talk about rape or other sexual violence.

"A woman in her 50s wept as she recalled been raped by her father when she was a teen-ager," said Yanagishita. "By talking to me, she said she found some release for the first time in her life."

Working on the basis of strict anonymity for their clients, JUST counselors say several middle-aged callers have talked of recurring nightmares, long depression and of not seeking help for fear of being exposed.

Figures compiled by the National Police Agency indicate that 2,238 cases of rape, or 10 percent of all serious crimes, were reported in Japan in 2001. If numbers for indecent assault are included--such as attempted rape, groping or harassment--the cases of sexual abuse rise to 43 percent of the total...

... After intense lobbying by feminists, Japan passed the Law for Prevention of Spousal Violence and Protection of Victims in October 2001. Under the law, hitting a woman can lead to jail terms of up to a year or a $10,000 fine. Advocates say the law was the first recognition of domestic violence as a crime, instead of a private domestic matter. The law also recognizes sexual abuse as an aspect of domestic violence, but stops short of calling it spousal rape, a disappointment for activists.

... Still Sumita, also a committee member for the Council for Gender Equality at the Prime Minister's Office, said there have been some startling signs of encouragement in recent years. For example, the National Police Agency established a special rape unit in 2000 that employs female policewomen to help victims...

... The gains, however, have exposed a new problem for advocates. "There is a backlash from older men, especially powerful male politicians who are now saying the issue of sexual rights endangers marital harmony and causes social breakdown. But we are determined to fight on," said lawyer Sumita...

Women's eNews, January 23, 2005


Well written and well researched article on the the excellent work of the Japanese Union for Survivors of Trauma, and also detailing improvements being made in both the social awareness and advocacy and legal protection the victims of rape, sexual abuse, domestic violence and spousal rape. Read the article in full at the link above.

Japan Smokers High Suicide Rate

Heavy smokers more likely to commit suicide

Middle-aged and elderly men who smoke heavily are more likely to commit suicide, a major survey by the Ministry of Health, Labor and Welfare has found.

In an epidemiological survey conducted by a research team at the ministry, it was found that the rate of suicide among middle-aged and elderly men was linked to the number of cigarettes they smoked.

"We have to pay more attention to smokers' mental health," a representative of the research team said. The results will be announced at a meeting of the Japan Epidemiological Association in Otsu on Friday ...

Mainichi Shimbun, Japan, January 18, 2005

Hanshin Quake Psychological Effects

Great Hanshin Earthquake - 10 years on and many people still suffer the psychological effects.

10 years on, residents still feel effects of Hanshin quake

A total of 65 percent of people in areas hit badly by the Great Hanshin Earthquake in January 1995 feel that the disaster-stricken areas are now "restored," but 64 percent say effects of the quake remain, a Mainichi survey has shown.

The survey, conducted last month, asked people in three areas hit badly by the earthquake on whether they thought the affected areas had been restored, what influence the quake had on them, and whether their memories of it had faded.

When asked, "Is your area restored?" a total of 65 percent of the respondents answered "yes," greatly exceeding the 27 percent who said "no."

At the same time, however, many people said the effects of the quake, that registered 7.3 on the open-ended Richter scale, remain. When questioned what part of their lives were still affected by the earthquake, with multiple answers permitted, 30 percent said "the family budget," followed by "mental health" (21 percent), "physical condition" (19 percent), and "work" (18 percent).

When asked whether their memories of the earthquake had faded, 65 percent answered in the affirmative. A total of 64 percent said they were satisfied with their current lifestyles.

However, the effects of the temblor still weighed heavily on others.

"My old-age life has collapsed from its very foundations," one 66-year-old respondent said. Another 53-year-old woman said, "The town has been restored, but I am living in grief," while a 68-year-old man said, "Life is much harder than before the quake. I don't feel any restoration at all." ...

Mainichi Shimbun, Japan, January 17, 2005

Kobe Earthquake Students Psychological Care to End

Psychological care to end for students

The Hyogo prefectural board of education will no longer assign teachers, specializing in the psychological care of children affected by the Great Hanshin Earthquake, to primary and middle schools in the prefecture after fiscal 2004 ends on March 31.

Concern has been expressed over the decision as some students are still struggling with psychological problems brought on by the quake.

The decision was made due to the board's financial difficulties. Other teachers will try to fill the roles of the specialists, although 1,337 students in the prefecture still need some special psychological care, according to a survey conducted last year.

The teachers specializing in psychological care have been posted to schools in six cities and two towns in the prefecture since fiscal 1995. From fiscal 1996 to 2000, 207 teachers were assigned. Since fiscal 2001, the teachers have been gradually reduced. Fifty-five teachers are currently active.

... According to last year's survey, five students said they had been buried alive in the earthquake, and 10 students said they had problems related to the earthquake.

The teacher said that although some of their problems appeared to have been resolved, the students had not completely overcome their psychological trouble.

One primary school teacher is worried that his students will suffer flashbacks of the earthquake because of video footage of the recent Indian Ocean tsunami.

A total of 224 primary and middle school students suffered flashbacks after an earthquake in the western part of Tottori Prefecture in October 2000 and an earthquake in Hiroshima and Ehime prefectures in March 2001.

He said, "I believe parents will worry once the specialized teachers end their work."

Yomiuri Shimbun, January, 15 2005

Internet Suicide Pacts

Improve online content to stop suicide pacts

Point of View": Dr Takeshi Tamura

"Suicide pacts carried out among young people who meet via the Internet are occurring frequently. A chain reaction seems to be at work, as attested by the common use of rentan charcoal stoves in sealed-up cars. It is reasonable to assume they imitated earlier cases reported by the media.

... Suicides can be prevented with proper support. By the very nature of the Internet, on which anyone is free to express themselves, it is impossible to completely regulate sites that provide suicide-related information. We should improve Internet content so society can support Web sites that discourage and help prevent suicidal behavior instead of encouraging it.

Web sites that are currently blamed for triggering suicide pacts are run by individuals. In many cases, the operators themselves have a hidden impulse to kill themselves. They want to come in contact with others who share the same feelings and believe they are not alone. Reading the entries, I see many cases that suggest people who give vent to their bottled-up pain find solace because they feel others understand them. However, one false step could turn the sites into a service to arrange suicide pacts between strangers. They are too dangerous.

What is needed to prevent Internet-suicide pacts are safe forums where people can fully express their true feelings and turn despair into hope. For that, well-meaning mediation by people who understand suicidal psychology and the characteristics of Net communication are needed.

Such services can be provided by public organizations with experts or private ones supported by volunteers.

In Britain, the Samaritans started an Internet service to help the suicidal, depressed and distressed in 1994. Although it is not directly aimed at preventing suicides, in Japan, too, such organizations as NHK and the Bureau of Citizens and Cultural Affairs of the Tokyo metropolitan government are offering Internet counseling for people who withdraw from family, school and friends.

... Most Internet-suicide pacts are carried out by young people because most computer users are young. But less than 50 people a year kill themselves that way.

With so few cases, it is meaningless to point out the immaturity and problematic behavior of young people today. Suicide cases among older people far outnumber those among the younger generation. Suicides have increased in Japan in recent years.

Now more than 30,000 people commit suicide in Japan each year.

We must not view suicide as a ``special problem that only affects psychologically weak people.'' It is a tragedy that can happen to anyone.

Suicide prevention is a problem that must be tackled by society as a whole."

International Herald Tribune/Asahi Newspaper: January 11, 2005

First rate article written by Dr Dr Takeshi Tamura, an expert psychiatrist in this field, who has been supervisor of the Tokyo Government's Internet counseling service provided since 1997 through the Bureau of Citizens and Cultural Affairs. One of the very few well informed, thoughtful and accurate articles currently available in English suicide in Japan. It contains reliable information those who may have met through the internet, which according to official stastistics was 34 people of the total record number of over 34,000 people who committed suicide in Japan in 2003. In comparison to the overall figure there is a relatively low number of group suicides in Japan (less than 2% of the total number suicides). Some of the more sensational media reports in 2004 have referred to group suicides in which the people may have originally met through internet web sites as "internet suicide pacts" in Japan. - Timi

Earthquake Tsunami Trauma

Long Sustained Mental Health Care Needs for Children and the Elderly for Earthquake and Tsunami Trauma Victims

Scars remain a decade after Japan's Kobe earthquake

The 7.3-magnitude earthquake hit western Japan at 5:46 a.m. on Jan. 17, 1995, killing 6,433 people, forcing more than 300,000 to take refuge, destroying homes, factories, roads and railways. Total damage was estimated at 10 trillion yen ($96 billion).

A decade later, Kobe is again a glittering modern city of more than 1.5 million people.

But scars remain, especially among the poor, the elderly and the children who were hardest hit when the disaster stuck.

The same is all certain to be true for victims of the tsunami, which ravaged the weak and the poor most of all.

"Those who suffered (in Kobe) most were already worst off economically, and it was hard for them to rebuild their lives. That situation persisted and caused stress and ultimately, health problems," said Hitoshi Kato, director of the Hyogo Institute for Traumatic Stress, set up after the quake.

LONELY ELDERLY, TRAUMATISED CHILDREN

Yoshiko Fujita, 78, also remembers the fires that destroyed her home. "I lived in that house for 20 years, but I didn't have the money to rebuild it," said Fujita as she sat on a park bench.

Fujita now lives in an apartment building in her old neighbourhood, but many aged residents were less fortunate.

"Many elderly, who already had shaky finances, lost everything. They were too old to borrow to rebuild and had to be relocated to public housing," said the Hyogo Institute's Kato.

"Those who were moved far away to new homes suffered stress and were unable to cope with the unfamiliar environment."

When the tsunami struck Indian Ocean coasts, children were among the its biggest victims. UNICEF estimates about 50,000 children died, a third of the total death toll. Tens of thousands were orphaned and are likely to suffer trauma for years.

In Kobe, Tomoyuki Nagake, 17, lost his father to a stress-induced stroke three months after the quake.

"When I lost my dad, I had no one to rely on and I stuck to my mom, developing a kind of mother-complex and was bullied," Nagake said last week at a gathering in Tokyo of orphans from 11 countries.

An estimated 1,300 children in Kobe still require mental care for disorders they suffer as a result of the quake.

Reuters AlertNet 11 Jan 2005

This article in full reviews some of the long term known effects of the 1995 Kobe area earthquake on children and the elderly, and so highlights the need for many years to come for focused and sustained mental health care of the hundreds of thousands of children and elderly people who are currently already suffering the trauma of the Indian Ocean eathquake and tsunami. - Timi

Elderly Abuse

Elderly Abuse

Efforts under way to stem abuse of elderly


Kyodo News

While Japan's aging population is usually talked of in terms of rising welfare expenditures and the financial burden it will impose on future generations, recently a new problem has emerged: abuse of the elderly.

Lawyers and other experts handling the issue say that compared with child or spouse abuse, abuse of the elderly tends to take longer to surface, in part because the elderly feel responsible when the violence is inflicted by their offspring, and also because the government and local administrators have so far failed to address the problem.



The Japan Federation of Bar Associations submitted a proposal to the Health, Labor and Welfare Ministry in October with an eye to obliging authorities to get tough on abuse.

Its 54-page recommendation refers to the need to help not only victims but also the perpetrators -- in most cases, a member of the victims' family experiencing mental, physical and economic hardship as a result of caring for their elderly relative.

The nationwide lawyer group has already briefed ministry and local government officials and called on them to establish a law -- along the lines of the Child Abuse Prevention Law instituted in 2000 and the Domestic Violence Prevention Law in 2001 -- to crack down on elder abuse.

According to a nationwide poll taken by the Institute for Health Economies and Policy on behalf of the welfare ministry and released in April -- Japan's first survey of elder abuse -- 11 percent of those responding who have suffered abuse have been in a life-threatening situation.

Sons were responsible for the abuse in 32 percent of the cases, followed by daughters-in-law and spouses, each at 20 percent. About 64 percent of the cases involved mental abuse, including yelling or willful neglect, 52 percent involved denying meals or other forms of care and 50 percent included beating people or tying them to their bed.

The average age of the victims was 81.6, with women accounting for 76 percent of the total. The survey covered 1,991 abused seniors as reported by licensed care managers, including doctors, nurses and other health-care professionals...

The Japan Times January 6, 2005

Sex Offenders

sex offender recidivism: no systematic correctional programs for sex offenders

Nara girl's murder spotlights sex-crime recidivism

When a 36-year-old man was arrested late last year for the kidnap-murder of a girl in Nara, his criminal past raised a puzzling question in the public mind: How could a repeat offender be allowed to keep on committing the same crime?

The arrest of newspaper deliveryman Kaoru Kobayashi on suspicion of abducting the 7-year-old girl with intent to molest was not his first for sex offenses against children.

In 1989, he was given a suspended sentence for molesting eight young people. In 1991, he was sentenced to three years in prison for the near strangulation of a 5-year-old girl.

Crime experts say the Japanese correctional system is simply not up to the task of dealing with sex offenders, who often repeat their crimes in a pattern of escalating savageness.

Last year saw other repeat offenders carry out crimes.

A 39-year-old man who had served three prison terms for rape and other offenses was indicted in August for kidnapping, raping and killing a teenage girl in Ehime Prefecture.

According to police records, 9.8 percent of those arrested or referred to prosecutors in 2002 on suspicion of rape or molestation had committed similar offenses in the past.

Junko Fujioka, a psychology professor at Osaka University's graduate school who also counsels sex offenders, points to problems in Japan's correctional system, which too often places priority on keeping inmates busy with work.

"(Inmates) often leave prison before their sexual problems are corrected," she says.

According to the Justice Ministry, some prisons do offer counseling to convicted sex offenders. But unlike with drug addicts, whose rate of recidivism is particularly high, there are no systematic correctional programs for sex offenders.

Internation Herald Tribune/Asahi: January 5,2005

Japan Doctors Overwork Suicide

Work redress available for suicide

In a rare move, the government has recognized overwork as the cause of a doctor's suicide, allowing his bereaved family to claim workers' compensation, family members said.

They told a news conference Wednesday that the Tokyo branch of the Fund for Local Government Employees' Accident Compensation conveyed the decision to the family earlier in the day.

The doctor, who held a managerial post at a Tokyo metropolitan hospital in Fuchu, western Tokyo, killed himself in 1999 at age 53.

"I hope this will become an opportunity to improve the severe work conditions at hospitals that drive people to commit suicide and (encourage a rise) in the number of doctors hired," said his 60-year-old wife.


International Herald Tribune/Asahi: December 31, 2004

Causes of Suicide in Japan

PREVENTABLE DEATHS: Japan's suicide rate highest ever despite economic rebound

Japanese are killing themselves at an alarming rate. Last year (2003) more than 34,000 people-up 7.1 percent from the previous year-committed suicide...

Last year suicides by employed workers rose 13.4 percent from the year before, according to the National Police Agency. In human terms, that is 1,004 more preventable deaths. By age, suicides committed by people in their 30s increased by as much as 17 percent...

Fumio Otake, a professor at Osaka University, who is an expert in labor economics, says that overwork has caused many employees to suffer depression. "Companies fired many workers during the recession. And so, when the economy picked up, those still employed had to work much harder," says Otake. "This situation is believed to have caused many mid-career workers to suffer depression and led some to take their lives."

Otake's assumption of much busier workers is backed by the latest employment survey, which is conducted every five years by the Ministry of Internal Affairs and Communications. It states that while 4.09 million employees worked 60 hours a week or more in 1992, the comparative figure was 5.48 million in 2002...

International Health Tribune/Asahi: December 25,2004

Mental Stress

IN PUBLICLY RUN SCHOOLS/Mental stress cited for nearly 50% of teachers on leave

"A record 3,194 public school teachers took sick leave nationwide in fiscal 2003 because of mental problems, accounting for almost half the 6,304 teachers who were off work, education ministry figures show."

The problem of mental health among teachers has been steadily rising for the past decade, according to the Ministry of Education, Culture, Sports, Science and Technology. The 2003 figure represents a 2.7-fold increase from fiscal 1994.

The Sanraku hospital in Tokyo's Ochanomizu area said teachers accounted for 353 newly treated patients in fiscal 2003.

According to hospital officials, many of the new patients were veteran teachers in their 50s who complained they ``couldn't keep up with changes in the workplace.''

The main problem cited was ``guidance counseling'' for their students, followed by ``human relationships in the workplace.''

Kazunori Nakajima, head of the neuropsychiatric department at Sanraku hospital, suggested things could be much grimmer.

"The 3,000 or so patients represent only those teachers with such serious problems," he said. "An increasing number of teachers are being treated on a short-term basis."

Seiji Niu, a physician at the department of psychosomatic internal medicine at the Shojukai Matsuzaki Hospital in Nobeoka, Miyazaki Prefecture, offered this overview of the problem.

"More than 80 percent of the patients are coming down with reactive depression, triggered by overwork,'' Niu said. ``Many teachers are falling apart both mentally and physically from compounded symptoms of autonomic nerve imbalance.''

Niu said he was surprised at how many teachers wait until they are very sick before they seek medical attention.

"They tend to be perfectionist 'all A' teachers. The other problem lies in the Japanese psyche to put the blame on weakness of character, rather than calling it a medical disorder," he said.

Keiko Nagayama, who is in charge of mental health care at the Japan Teachers' Union, points out: "Teachers began taking sick leave for mental problems in droves starting around 2000. It coincides with when the government began implementing a series of educational reforms."

International Herald Tribune/Asahi Shimbun: December 15, 2004