Internet Suicide Prevention

Halting Internet-assisted suicide

"The number of cases in which people solicit others on the Internet to commit group suicide is on the rise. To deal with this, a panel of learned people set up by the National Police Agency has called on Internet providers to disclose the names, addresses and birth dates of people sending such messages.

This information is necessary because people who give notice of suicide on the Internet cannot be protected unless they are identified. However, the police will be required to tighten procedures to prevent abuse, and the provider business as a whole, in order to protect human life, will have to be thoroughly prepared to disclose customer information as much as possible despite the obvious conflict with the principle of guarding the confidentiality of communications.

According to the NPA, the number of people committing suicide in Japan reached more than 34,000 the year before last, surpassing 30,000 for the six consecutive year. Last year there were 55 Internet suicides involving 19 cases. Although this number is very small compared with the total suicide toll, the phenomenon is peculiar in that complete strangers with different motivations are getting together over the Internet to plan their deaths together.

For this reason, it may be difficult even for the people closest to a troubled person to detect any signs of a suicide wish. The justification for having a bulletin board operator or provider furnish police with customer information is that the only lead to a potential suicide may be a message posted on an Internet bulletin board. There have been cases in which a person on the verge of death has been saved through the cooperation of a provider, but there have also been many cases in which providers have refused to give information....

... In Japan, it would seem wiser to choose a path by which businesses voluntarily cooperate in preventing Internet-assisted suicide.

Police protection is important for treating the symptoms of someone contemplating suicide, but it is also important that the Internet community itself try to settle the problem of providing a venue for suicide. The number of Web sites that lend an ear to the stories and thoughts of people who are considering suicide must increase. Such people should be urged to spill out their true feelings. People having difficulty dealing with their worries might be encouraged, first of all, to connect to these sites and get advice.

Above all, we must try to ameliorate the factors that are isolating young people from their workplaces, families and schools and thus driving them to the Internet. In other words, we must promote the building of an environment that they can call home."

The Japan Times, May 29, 2005

Amagasaki

Amagasaki witnesses struggle with bouts of trauma, stress

"Chiharu Yoshino, a 43-year-old housewife in Amagasaki, Hyogo Prefecture, did not lose any family members or friends in the fatal April 25 train crash in her neighborhood.

People visit the site of the JR West train crash in Amagasaki, Hyogo Prefecture, on Wednesday, a month after the accident.

But she still goes to the accident site daily to pray for the 107 people who died.

"Every day I think I could have done something more to help the passengers suffering from pain. I go there to say sorry to them," Yoshino said.

Yoshino was one of the bystanders who started rescuing passengers when the West Japan Railway Co. train jumped the tracks on the Fukuchiyama Line and crashed into a nine-story condominium building. More than 540 passengers were injured in the accident, which crushed several people in the first two cars.

Yoshino was waiting at a grade crossing on the way to the hospital when she saw the train crash at around 9:18 a.m.... Afterward, she began feeling stressful at crossings and became frightened by crossing bells and ambulance sirens. Now she has trouble falling asleep without sleeping pills.

Yoshino went to doctors for help. But she didn't get the response she expected.

"Some just told me to forget about the accident," she said. "But I can't and I don't think that I should."

About 350 people have called or visited public health centers or welfare offices in Hyogo Prefecture complaining about difficulty sleeping or riding the trains, according to local authorities.

These people include not only passengers from the ill-fated train and their next of kin, but also people who were traumatized after witnessing the accident or helping out with the rescue...

... In Amagasaki alone, 116 people had sought counseling at the local health center as of May 22, according to the Amagasaki Public Health Center.

... As one month has passed since the accident, the number of people seeking help due to heavy symptoms is increasing. We have to be careful about posttraumatic stress disorders," said Michiyuki Suzu, a mental health welfare expert at the local center...

... Yoshiharu Kim, director of the National Center of Neurology and Psychiatry's adult mental health department, said it usually takes a month after a major accident to determine who is recovering from mental shock and who is not.

He said it is important to screen the mental condition of the survivors and people living near the accident site to make sure no one is left to suffer alone.

"To care for the victims means not only to cure the shock of the accident, but to understand what they can't manage now because of the accident," he said. "There must be some people who are unable to do what they used to do, such as taking care of their families."

Yoshino, the Amagasaki housewife, said, "While I have forced myself to appear cheerful in front of my husband and our 18-year-old son, I want to continue praying for the victims so this tragedy will not be forgotten."

The Japan Times: May 28, 2005

Smoking

Getting doctors off the habit

"In 1992, a group of antismoking doctors and dentists started a campaign to ban smoking at medical and public health facilities and to promote antismoking education for students and the public at large. However, I have yet to see antismoking posters at dental clinics and hospitals. Health professionals should play a more active role in tobacco control.

According to the Japan Nursing Association, 24.5 percent of the nation's female nurses smoke, double the rate for women in general. This rate perhaps reflects a strong sense of gender equality among female professionals, but it is nevertheless disturbing. The association is pushing a campaign to reduce the level of workplace smoking among nurses to zero immediately, and to halve the percentage of nurses who smoke anywhere by 2006. The campaign is welcome.

The government, regrettably, is indifferent to measures to protect minors from the ills of smoking. More than 20 percent of first-year junior high male students have smoking experience. For second-year male high school students, the rate rises to more than 50 percent.

Most underage smokers (more than 70 percent of third-year student-smokers) obtain cigarettes from vending machines. The 1900 Japanese law prohibiting underage smoking is rarely enforced. This is a serious problem, since smoking is often linked to juvenile delinquency...

...The nation's future depends on healthy children. For starters, the Finance Ministry and the tobacco industry should abolish tobacco vending machines. School physicians should make more efforts to prevent underage smoking... "

The Japan Times: May 23, 2005

Self-Defense Force Suicides

Record number of SDF members committed suicide in fiscal 2004

"A record 94 Self-Defense Force (SDF) members committed suicide in fiscal 2004, surpassing the previously record of 78 in 2002, according to Defense Agency statistics a Diet politician obtained.

Tomoko Abe, a House of Representatives member from the Social Democratic Party, learned of the figure while investigating one particular suicide case.

Agency statistics show that 64 members from the Ground SDF committed suicide in fiscal 2004, followed by 16 from the Maritime SDF and 14 from the Air SDF...

... We guess that they committed suicide over family troubles or due to illness, but we don't know why the number was so high," a Defense Agency official said.

The number of SDF members who committed suicide stood at 73 in fiscal 2000, followed by 59 in 2001, 78 in 2002, and 75 in 2003.

Military affairs journalist Isaku Okabe said that mental care programs for SDF members should be considered."


Mainichi Shimbun, Japan, May 20, 2005

Sexless Marriages

Japan's sexless marriages are turning it into the land of rising celibacy

A recent survey by Japan's health ministry found that as many as one third of marriages in Japan are sexless. The problem is now so widespread that the government fears it is contributing to the dramatic plunge in Japan's birthrate.

Researchers admit that the phenomenon is poorly understood and has various causes. But they stress that sexlessness is not only found in couples whose relationships have broken down and are headed for divorce. Mr Yamada, a Tokyo office worker in his 30s, is among those who loves his wife and has no intention of separating, even if he is dissatisfied with the lack of intimacy.

"I wouldn't say my marriage is unhappy but the better part of two years is a long time to go without," he says.

Sex experts say there is a high correlation between sexlessness and poor communication on such crucial subjects such as contraception and sexual likes and dislikes. Mr Yamada says he has not discussed sex with his wife in the last year and, for that reason, asked that his real name not be used.

The term "sexless", adopted from English, first began to be used in Japan in the early 1990s. But now it is instantly recognizable to Japanese and widely discussed in the media. There are books on the subject and numerous websites, including heartbreaking blogs, while letters on the subject fill agony columns.

One woman writes: "I have been married for a year but we have had sex just a handful of times. I know my husband feels stress at work and don't want to bother him. But I sometimes doubt he really loves me."

News Telegraph, 20 May, 2005

Sexless Marriages

Japan's sexless marriages are turning it into the land of rising celibacy

A recent survey by Japan's health ministry found that as many as one third of marriages in Japan are sexless. The problem is now so widespread that the government fears it is contributing to the dramatic plunge in Japan's birthrate.

Researchers admit that the phenomenon is poorly understood and has various causes. But they stress that sexlessness is not only found in couples whose relationships have broken down and are headed for divorce. Mr Yamada, a Tokyo office worker in his 30s, is among those who loves his wife and has no intention of separating, even if he is dissatisfied with the lack of intimacy.

"I wouldn't say my marriage is unhappy but the better part of two years is a long time to go without," he says.

Sex experts say there is a high correlation between sexlessness and poor communication on such crucial subjects such as contraception and sexual likes and dislikes. Mr Yamada says he has not discussed sex with his wife in the last year and, for that reason, asked that his real name not be used.

The term "sexless", adopted from English, first began to be used in Japan in the early 1990s. But now it is instantly recognizable to Japanese and widely discussed in the media. There are books on the subject and numerous websites, including heartbreaking blogs, while letters on the subject fill agony columns.

One woman writes: "I have been married for a year but we have had sex just a handful of times. I know my husband feels stress at work and don't want to bother him. But I sometimes doubt he really loves me."

News Telegraph, 20 May, 2005

Depression

Medical world fights stigma of depression

"A psychiatrist practicing in Tokyo found out the hard way.

Diagnosing a patient in her 20s as suffering from depression, the doctor last fall reported the finding to the woman's employer, recommending she be given two weeks' leave.

The woman was given a pink slip instead.

Doctors report that they are treating more cases of depression as companies restructure amid uncertain economic conditions, leaving many employees worried about their futures.

That, in turn, is causing greater stress in the workplace.

In fact, many patients ask doctors to keep their diagnosis secret for fear they might lose their jobs or any chance of promotion.

Their fears seem well grounded since many companies are unwilling to allow people with depression to return to work unless they are "completely cured."

A health ministry survey in 2003 of 389 leading manufacturers found that only 26 percent operated rehabilitation programs to ease the transition back to the workplace for such employees.

Thus, doctors find they must fight social prejudice and often uncaring corporations in shielding their patients.

As it is, most doctors go along with their patients' wishes, according to a survey on mental health by Kansai Rosai Hospital in Hyogo Prefecture.

Polling 3,000 psychosomatic and psychiatric doctors nationwide in February 2004, the survey found that 92 percent of the 846 who responded often write up a "softer diagnosis but not to the point that it is false."

Instead of straightforwardly listing depression or melancholia, many doctors report that their patients are "in a dispirited state,'' "suffering from mental and physical fatigue" or "in a psychosomatic state.''

The health ministry seems to take no issue with this as long as a doctor's certificate is not outrightly deceptive..."

International Herald Tribune/Asahi, May 19, 2005

Domestic Violence Victims Self Support

Victims hide from abusive spouses but lose ID papers

For years, a woman in her 60s living in the Kanto region has always worn a hat and a surgical mask whenever she ventures outside. It is just one line of defense to prevent her abusive husband or his friends from finding out where she lives.

"I had lost my self-confidence because my husband used to say everything that was wrong was my fault, and then he'd hit me,'' she recalled. "I couldn't think or act on my own."

Like many other abused spouses, the woman has found ways to remain hidden from her husband-but at a price.

A revised law on preventing domestic violence took effect last December, requiring the central and local governments to help battered victims get back on their feet.

But one of the biggest problems that still needs to be fully worked out concerns the identities of victims.

Abused spouses often flee their homes without official documents that state who they are. They also refuse to register a change of address with ward and other offices to keep their whereabouts concealed.

They seldom have health insurance coverage because the family health certificates remain at home. Many abused women are even afraid to use insurance certificates issued in the name of their husbands out of fear of being located.

The central government has acknowledged this problem, and some prefectures and municipalities have started taking measures.

But for now, abused wives not only live in fear, they also face tough times trying to start a new life without the proper forms of identification...

... Kazuko Hirakawa, who runs FTC Shelter, a Tokyo support organization for victims of domestic violence, said the legal revisions are "a step forward" but further measures are required.

"Public support for victims until now focused on securing the safety of the victims, but care for their becoming self-supportive has lagged behind," she said.

Hirakawa cited the need for facilities where victims can receive mental care as well as job training after they leave protective shelters. She also said guarantors should be provided for victims looking for housing.

The central government's basic plan on the issue says support should focus on helping domestic abuse victims become self-reliant.

The basic plan proposes local governments give special consideration to battered victims applying for public housing. It also calls for allowing national health insurance coverage for spouses who flee a violent household if they provide certification as a battered victim from women's counseling centers or other authorities.

Under the revised law, abusive spouses have limited access to resident registers kept by local governments if police or other officials recommend such restrictions.

The revised law also calls for prefectural governments to compile support measures. Most prefectures are expected to complete their plans by the end of the current fiscal year.

Tottori Prefecture is leading the pack. In fact, officials said the Tottori government came up with a support plan for victims last December.

"We wanted to set an example for other governments," said an official.

The prefecture has offered rent subsidies for abuse victims and provided interpreters for foreign victims. The prefecture also helps with child-care and transportation costs when abused spouses look for jobs..."

International Herald Tribune/Asahi, May 18, 2005

Blind Psychiatrist

Shortsighted system sabotages dream of aspiring blind psychiatrist

"HITACHINAKA, Ibaraki -- Japan's second blind person to pass the state examination for medical practitioners has been blocked from legally required clinical training.
Mainichi Shimbun

Akihiro Osato talks to a Mainichi reporter.

No hospital is prepared to accept him as a trainee because the volume of clinical training that medical practitioners are supposed to undergo has significantly increased since last year.

Under the Medical Practitioners Law, doctors are required to undergo at least two years of clinical training at medical institutions before qualifying to work as medical practitioners.

"My dream of becoming a psychiatrist will never come true if the situation remains as it is," said the man, 50-year-old Akihiro Osato of Hitachinaka, Ibaraki Prefecture. "My success in the state examination will be meaningless unless I'm allowed to undergo clinical training. The government should take steps to do something to rectify the situation."

The Health, Labor and Welfare Ministry is set to consider ways to open the way for him to take clinical training..."

Mainichi Shimbun, Japan, May 13, 2005

Sexless couples

Sexless marriages caught up in battle of words

"Recently released Health, Labor and Welfare Ministry statistics, which show 32 percent of married couples in Japan tend to be sexless, has sparked controversy over the definition of the term, rather than the figure itself.

The Japan Society of Sexual Science (JSSS) defines a sexless marriage as a couple's lack of sex for one month or longer without a special reason such as the delivery of a baby.

Discussions on sexlessness began in Japan in 1991 when Teruo Abe, vice president of the JSSS, noticed that the number of married couples not engaging in sex had been rapidly growing since the late 1980s. He presented the result of his survey at a society session.

At the time, some experts pointed out that one month was too short a period as a definition for sexlessness. However, although Abe conducted a similar survey after changing the definition to three months, the results proved to be almost the same.

JSSS President Genichi Nozue said the society set the period at one month because treatment for sexlessness should be provided as soon as possible.

He explained that it is necessary to examine the psychological backgrounds of sexless couples, such as relations between themselves and their relations with colleagues at their workplaces, in addition to their physical condition..."

Mainichi Shimbun, Japan, May 17, 2005

Professionals Licence

Mental health professionals' license plans to be merged

"Two groups of Diet members working separately to create laws for national licensing of mental health professionals have begun talks aimed at unifying their bills.

Takeo Kawamura, former education, science and technology minister, and Ichiro Kamoshita, chairman of the Health, Labor and Welfare Committee of the House of Representatives, who lead the two groups, have held talks since late April to reach a consensus on the issue.

A multiparty group of lawmakers with interests in health and welfare planned to pass a bill to license psychologists who treat patients in hospitals, while another group with educational interests had proposed licensing those engaged in counselling clients at schools and health centers. Both groups wanted their bills passed in the current Diet session.

Psychologists provide mental health services at medical and educational institutions. The moves were prompted by a recent increase in demand for mental health services to help growing numbers of suicidal and depressed patients.

The need for quick and proper mental health services also was highlighted after disasters such as the Niigata Prefecture Chuetsu Earthquake. But there is no national licensing system for mental health counselors. Though the job title 'clinical psychologist' is well known in Japan, it is awarded by a private foundation, the Japanese Certification Board for Clinical Psychologists.

The group of lawmakers with interests in health and welfare wants licensing only for psychologists working at medical institutions..."

The Yomiuri Shimbun, May 17, 2005

Stress

"KEEPING STRESS IN THE FAMILY"

Fetuses found to inherit mother's trauma

"Stress can motivate us, but it can also get us down. And though it might just make us feel blue, it can also kill us. It depresses levels of sex hormones and people stressed by deadlines are more likely to suffer heart attacks.

In Japan, karoshi (death by overwork) is said to claim 10,000 lives each year. Meanwhile in Britain last November, the Trades Union Congress, the national trades union organization, released data showing that stress costs the economy £7 billion a year.

With all the understandably negative reports about the effects of stress, it's easy to overlook the fact that the stress response is beneficial. And, like everything else to do with our bodies, the way they work and the way we behave, the stress response evolved through natural selection.

The stress hormone cortisol causes a rise in blood pressure and blood glucose levels. This is useful when an organism faces possible danger or loss of resources. It prepares us for "fight or flight," or -- in the modern world -- it helps us, say, to get a column written in time or to get through a public speaking engagement.

Cortisol is secreted when there are special opportunities as well as potential dangers. But when there are extreme dangers, cortisol levels can actually fall, because so much of it is used up. One of the consequences is a depressed immune system.

Cortisol levels can also fall if stress is chronic, drawn out, relentless. This was the kind of stress experienced by Yuji Uendan, a 23-year-old temporary staff agency employee who worked 9 3/4 hour shifts at a Nikon Corp. plant in Kumagaya, Saitama Prefecture, for 15 days in a row before committing suicide in March 1999. A Tokyo District Court ruling in March 2005 ordered Nikon and Atesuto (formerly Nekusuta), the Nagoya-based agency, to pay Uendan's mother 24.8 million yen compensation for her son's karoshi, in what is believed to be the country's first such ruling related to a temp service worker...

... It used to be thought that reduced cortisol levels could be explained by mostly environmental factors, such as the stress of living with a parent who is depressed or anxious. That was how researchers explained the low cortisol levels in the adult children of Holocaust survivors: The children had heard stories of how their parents suffered, and became traumatized themselves.

But after 9/11, researchers at Mount Sinai School of Medicine in New York City saw a different pattern. The scientists studied 38 women who were pregnant and witnessed the attacks on the World Trade Center. Those women in the sample who developed post-traumatic stress disorder (PTSD) symptoms in response to 9/11 had lower cortisol levels than the women who did not develop PTSD.

Such a result was what the scientists expected.

However, about one year after birth, the babies of mothers who had developed PTSD symptoms had significantly lower cortisol levels compared to those in babies of mothers who developed only minimal symptoms. .

"The findings suggest that mechanisms for transgenerational transmission of biologic effects of trauma may have to do with very early parent-child attachments," said Mount Sinai's Rachel Yehuda, "and possibly even in utero effects related to cortisol programming."

In other words, the reduced cortisol in babies seems to be a "transmitted" biological trait -- traumatized mothers may have passed on potential mental illness to their unborn children..."

The Japan Times, May 12, 2005

Child Abuse Deaths

Care centers aware of abuse in most cases of child deaths

"A government research panel investigating cases of child abuse resulting in death has revealed that in most cases local child consultation offices and public heath centers were aware of the abuse but failed to stop it.

The Ministry of Health, Labor and Welfare panel investigated the involvement of child consultation offices and health centers in the 24 cases of child abuse that caused 25 children to die between July and December 2003.

Officials said on Thursday that those offices were involved in 21 of the cases but failed to take proper measures to prevent the deaths.

Child consultation offices knew of the abuse in 12 of the cases, but those in charge failed to collect detailed information or were slow to intervene, as they wanted to avoid creating friction with parents, ministry officials said.

In three other cases, health center and related organization officials suspected child abuse but didn't take their suspicions seriously, failing to report the cases to child consultation centers.

In six other cases, officials failed to detect evidence of abuse even though they carried out checkups on the children concerned.

The 25 children who died from child abuse were all less than 6 years old and 44 percent of them were aged less than 12 months. Mothers were the fatal abusers in 50.1 percent of the cases, while fathers fatally abused their children in 30 percent of the cases.Attacks to the head or face resulted in death in 42 percent of the cases.

"If you detect injuries to the head or face of infants, you should suspect potentially fatal abuse," a panel member said, urging health centers and child consultation offices to be more involved in communications with parents."

A government research panel investigating cases of child abuse resulting in death has revealed that in most cases local child consultation offices and public heath centers were aware of the abuse but failed to stop it.

The Ministry of Health, Labor and Welfare panel investigated the involvement of child consultation offices and health centers in the 24 cases of child abuse that caused 25 children to die between July and December 2003.

Officials said on Thursday that those offices were involved in 21 of the cases but failed to take proper measures to prevent the deaths.

Child consultation offices knew of the abuse in 12 of the cases, but those in charge failed to collect detailed information or were slow to intervene, as they wanted to avoid creating friction with parents, ministry officials said.

In three other cases, health center and related organization officials suspected child abuse but didn't take their suspicions seriously, failing to report the cases to child consultation centers.

In six other cases, officials failed to detect evidence of abuse even though they carried out checkups on the children concerned.

The 25 children who died from child abuse were all less than 6 years old and 44 percent of them were aged less than 12 months. Mothers were the fatal abusers in 50.1 percent of the cases, while fathers fatally abused their children in 30 percent of the cases. Attacks to the head or face resulted in death in 42 percent of the cases.

"If you detect injuries to the head or face of infants, you should suspect potentially fatal abuse," a panel member said, urging health centers and child consultation offices to be more involved in communications with parents.

Mainichi Shimbun, Japan April 29, 2005

Train Crash PTSD

A well intentioned and concerned report on The Amagasaki Municipal Health Center efforts to encourage people traumatised by the train crash need to consult with mental health care professionals as soon as possible. Some of those sufffering acute stress symptoms are at risk of developing post-traumatic stress disorder (PTSD) - Timi

Train crash trauma victims seeking help only 'tip of the iceberg'

AMAGASAKI, Hyogo -- The Amagasaki Municipal Health Center is encouraging people traumatised by the April 25 train disaster to consult with local health officials, as center officials believe that the large number of requests for consultation so far are only "the tip of the iceberg."

Since the fatal derailment 108 people in Hyogo and Osaka prefectures, including those related to the victims and those with no connection to the accident at all, have filed complaints of mental uneasiness and health problems with local governments. Requests from those not directly involved in the derailment on JR Fukuchiyama Line in Amagasaki indicate that the accident caused anxiety among the public at large.

The Mainichi learned that the Hyogo Institute of Traumatic Stress received 71 requests for consultations while 32 such requests were filed with the Amagasaki Municipal Government. Four other requests have been made to other local governments.

Of the 108 cases, 46 cases involved bereaved families of victims as well as passengers on the train who survived. Other cases included those involved in rescue operations and others who watched reports about the accident on TV.

Many of the cases were from people who showed acute stress symptoms such as headaches, a feeling of nausea and insomnia.

Several people who were in Hyogo Prefecture when the Great Hanshin Earthquake hit the area in January 1995 told the Hyogo Institute of Traumatic Stress that they had flashbacks of the killer quake upon learning of the train accident.

Some of them said they were suffering from exhaustion or couldn't stop shedding tears.

"These are natural reactions for people after seeing a major disaster," an Amagasaki Municipal Health Center official said. "I think these symptoms will disappear in one month."

But officials of the center warned that some people might suffer what is called post-traumatic stress disorder (PTSD) after experiencing these symptoms for a month, encouraging people to consult with health officials.

Mainichi Shimbun, Japan, May 3, 2005

Daycare Centers

Daycare Center lets dementia sufferers stock up on support

"The Monowasure Kafe in Moriyama, Shiga Prefecture, is no ordinary cafe.

The facility is a daycare center whose name translates as "Cafe Forgetful," and those who use it all have one thing in common: They all suffer from mild dementia.

Cafe Forgetful opened last September in a building opposite JR Moriyama Station. It is the fourth daycare center for dementia sufferers operated by the Fujimoto Clinic, which is located in the same building.

Clinic head Naoki Fujimoto, 52, named it in hopes it would become a place where patients could chat about their memory problems over a cup of coffee...

... In Japan, 1.6 million people currently suffer from senile dementia, according to the Ministry of Health, Labor and Welfare. A decade from now, this figure is expected to rise to 2.5 million. The ministry is taking steps to increase the early detection and prevention of the condition.

There is another worrying statistic concerning dementia. In fiscal 1996, a health ministry research group concluded that an estimated 25,000 to 37,000 people between the ages of 18 and 64 suffered from dementia. Some experts argue there are more than 100,000 latent younger sufferers.

The problems dementia causes for younger sufferers and their families are even graver than those it creates among the elderly. Younger sufferers tend to be affected to a greater extent by financial difficulties, for instance, as their symptoms affect them at the height of their careers, often when children are still in school. Another problem is the lack of facilities for younger sufferers and those in the less progressive stages of the disease.

Fujimoto first started consulting people with memory and reasoning problems in 1990 while working at the prefectural-run Shiga Medical Center for Adults.

In 1999, as a pioneer in the field, he set up a clinic for the forgetful and started offering day-care services to support family caregivers and build a local network.

The objective of "Cafe Forgetful," Fujimoto says, is to cater to the needs of people suffering from less serious symptoms in the early stages of dementia as well as relatively young patients. These people tend to hide away at home, reluctant to go to facilities that care mainly for elderly people with serious senile dementia.

Symptoms become aggravated in many of these sufferers because they are secluded and do not receive the reassurance and care they need to make their lives easier.

"They need a place to take part in social activities with others while their symptoms are mild," Fujimoto says.

At "Cafe Forgetful," caregivers take a supporting role to encourage spontaneity on the part of participants...

... The Alzheimer's Association Japan, based in Kyoto, is considering ways to improve support for younger sufferers. Some of the association's branches hold regular meetings with family members of younger sufferers, but there are still very few daycare centers... "

International Herald Tribune/Asahi: May 4,2005