Suicide and Depression

Building a suicide safety net

"Every year, slightly more than 30,000 people kill themselves in Japan. Compared with other countries, the situation is particularly grim. The nation's suicide rate, calculated in terms of the number of suicides per 100,000 people, stands at 25.3 -- compared with 38.7 in Russia, 17.5 in France, 13.5 in Germany, 11.7 in Canada, 10.4 in the United States, 7.5 in Britain and 7.1 in Italy. Japan's figure is the 10th highest in the world and the worst among developed countries.
Last year, the government established a joint committee comprising officials from government ministries and agencies concerned to work out "comprehensive measures" to combat the problem. This rather belated move is welcome. The government now regards suicide as something society as a whole must deal with, rather than an individual problem only.

The year 1998 was a turning point in Japan's suicide toll. Through 1997, the number of suicides was slightly less than 25,000 annually. The number jumped from 24,391 in 1997 to 32,863 in 1998. Since then, the number has hovered around that level. The number of suicides by males greatly increased -- from 16,416 in 1997 to 23,013 in 1998. The number of suicides by females rose from 7,975 to 9,850 in the same period. In 2004, Japan recorded 32,325 suicides -- 23,272 by males and 9,053 by females. It is said that for every suicide, there are about 10 attempted suicides.
Suicide is the No. 1 cause of death among males in their 20s and 30s. The suicide rate is especially high among males over the age of 40. According to the National Police Agency's statistics, health problems were responsible for 14,786 suicides and financial problems triggered another 7,947 suicides in 2004. Family problems were behind about 3,000 suicides and work-related problems caused about 2,000 suicides.

Statistics alone do not paint a full picture of the problem. Additional factors behind suicides include overwork and unemployment due to the prolonged economic slump, the aging of the population and health problems, including mental diseases. The joint committee will analyze details related to the suicide problem from both medical and social angles as well as push for the implementation of many kinds of measures to help prevent suicides.

The committee aims to reduce the number of suicides to about 25,000 a year from the current level in 10 years. An encouraging sign for the committee's efforts is the fact that Finland, which saw its suicide rate climb from 15.5 in 1950 to 30.3 in 1990, succeeded in reducing the suicide rate by 20 percent in six years and 30 percent in 12 years (from 1990) through its National Suicide Prevention Project, which began in 1986..."

"A study group of the Health, Welfare and Labor Ministry has found that about 70 percent of those who committed or attempted suicide had not talked with anyone about their problems beforehand. The joint committee can get a cue from the experience in Akita Prefecture. A list of contact numbers for counseling on a wide range of matters including not only medical and mental-health services but also bankruptcy, domestic violence and nursing care of aged people was distributed to every household in the municipalities concerned.

Another study shows that three-quarters of people who contemplate suicide have mental disorders and that about a half of these people are suffering from depression. But three-quarters of those experiencing depression are not receiving medical treatment. Efforts should be made to strengthen cooperation among volunteers, medical experts and municipal workers in improving and expanding counseling networks at workplaces, schools and community facilities -- the main pillar of the joint committee's measures. Helping people suffering from depression, including intervention when necessary, should become an important part of the services.

Volunteer organizations giving advice to suicidal people or helping bereaved families of suicide victims should receive public financial support. If local governments set a numerical target for reducing suicides from area to area, their efforts would become more credible."


The Japan Times, Feb. 25, 2006

An interesting report in that it highlights the fact that, whatever the officially stated reason for suicide in Japan, "three-quarters of people who contemplate suicide have mental disorders and that about a half of these people are suffering from depression. But three-quarters of those experiencing depression are not receiving medical treatment." Depession unrecognissed and untreated can very often lead people to become suicidal, whatever their circumstances. Further and greater efforts to both provide deeper public understanding about depression and also encourage people to seek medical treatment and professional mental health counseling, will be necessary if any significant reduction in the unnessaryily high suicide rate in Japan. - Timi

Pachinko Addicts

Pachinko addicts to get counseling net

Japan's nationwide pachinko industry organization is poised to set up a consultation network for pachinko addicts, officials said.

The association known as Zennichi Yuren will set up the "Recovery Support Network" in April to help those who cannot quit playing pachinko and the families of addicts. This is the first time that the industry has launched a project to support pachinko addicts.

The move comes as a growing number of young children are dying in cars where their parents leave them to play pachinko.

Psychiatrist Naoyuki Nishimura, who is active in treating drug addicts, will head the network that will comprise lawyers who are providing counseling for alcoholics and drug addicts as well as counselors.
Zennichi Yuren is expected to provide 100 million yen to support the network's activities over the next five years.

In a survey conducted recently by the industry association, about 30 percent of customers at pachinko parlors said they are afraid that they are addicts.
Some of these addicts are heavily indebted while others even abuse their family members, industry sources said.

Mainichi News, February 24, 2006

Aum Shinrikyo

Report on Aum founder's mental fitness due shortly

"The stalled appeals trial of the cult leader accused of masterminding the deadly sarin-gas attacks in Tokyo is about to reach a crucial stage.

If a court-initiated psychiatric evaluation finds 50-year-old Chizuo Matsumoto is fit to stand trial, his death sentence could move a step toward finalization depending on how his lawyers respond.

The evaluation is due to be released this month, sources said.

But if Matsumoto, founder of Aum Shinrikyo, is deemed mentally unfit, the appeals trial will be suspended.

The evaluation was initiated by the Tokyo High Court in September after Matsumoto's appeal stalled because defense lawyers claimed their client was unable even to communicate.

In February 2004, the Tokyo District Court sentenced Matsumoto to death on murder and other charges. He was found guilty of masterminding the 1995 sarin attacks on the Tokyo subway system that left 12 dead as well as other crimes by his disciples.

Aum Shinrikyo now calls itself Aleph.

After it reviews the report and hears from the defense team and prosecutors, the high court will decide if Matsumoto is fit to continue his appeal.

If he is found fit, the defense team must give the Tokyo High Court a crucial document it has withheld since August--a summary of its reasons for appealing.

Matsumoto's attorneys have said they cannot prepare the summary because their client could not communicate with them.

If the defense still refuses to produce that paper, the court could dismiss the appeal.

A dismissal could lead to the death sentence becoming final, although the defense may file an objection.

If the defense team hands in the summary, the hearings will resume, unless the court rejects the paper for missing the August deadline.

In that situation, the case would likely go on to the Supreme Court. But then, Matsumoto's lawyers would have to change tactics, as the trial would move forward on the premise that Matsumoto is mentally competent.

Presiding Judge Masaru Suda agreed to the psychiatric test in order to move the stalled process forward.

In December 2004, Suda took the rare step of meeting Matsumoto in person. The judge found him capable of understanding him.

The court's evaluation has been conducted by a court-appointed psychiatrist. The same doctor in a previous case found another defendant, who is now on death row, to be mentally competent.

Because they fear the psychiatrist could decide against them, defense lawyers offered him assessments by other experts in support of their position, sources said..."

International Herald Ttribune /Asahi News, February 17, 2006

Gambling Addiction

High stakes

"It took mounting debts to 25 financial institutions, failure at university and finally the tears of his wife before a Tokyo man finally got help for his problem.

The man, now in his 40s, was addicted to gambling, a social ill that only recently has received wide recognition in Japan.

Although no official statistics exist for gambling addiction in Japan, estimates range from 1 million to 1.5 million people, including 70 to 80 percent gripped by the lure of pachinko machines..."

"... Psychiatrist Masando Iwasaki, who heads the Iwasaki Mental Clinic in Fujisawa, Kanagawa Prefecture, said the evils of gambling are finally being addressed in Japan.

"Partly because the addiction problem has come to be discussed openly in Japan, it has become a prominent problem," Iwasaki said. "Patients have doubled in the last five years..."

"Experts say that attending self-help groups is the most effective way to recover.

Gamblers Anonymous Japan, for example, was established 16 years ago and now has 43 groups around the nation.

Anyone can attend the groups' meetings, and addicts can remain anonymous. They talk about their experiences but do not criticize each other as long as they have the intention to quit.

"Loneliness and anxiety are at the root of this affliction, and anyone can become an addict in this society of diluted communication with real people because of collapsed family ties and the wide-spread use of the Internet," said Taizo Kato, professor of psychology at Waseda University.

"There are concerns that patients will increase in the future," he said..."

International Herald Tribune/Asahi Newspaper, February 11, 2006

Self-injury

Self-injury phenomenon emerging at Japanese schools

"Wrist-cutting and other forms of self-injury are surfacing as problems at schools, a survey by the National Center of Neurology and Psychiatry's National Institute of Mental Health has found.

Wrist-cutting had been cited as a problem at Japanese junior high schools and high schools in the past, but the survey is the first to back up such fears.
The survey was conducted on 126 second-year students at a girls' high school in Kanagawa Prefecture, and 477 second- and third-year students at a public junior high school in the same prefecture.

The students were asked various questions, such as, "Have you ever injured your body with a knife or pointed object?" Answers were recorded anonymously.
A total of 14.3 percent of the female high school students said they had purposely injured themselves at least once, while 6.3 percent said they had done so at least 10 times.

At the junior high school 9.3 percent of the 238 female students and 8 percent of the 239 male students said they had cut themselves with blades.
In addition 27.7 percent of male junior high and high school students and 12.2 percent of female junior high and high school students said they had smashed their heads or fists against walls or similar objects.

When asked why they had injured themselves, various answers were given, such as to escape feelings of anger or as an expression that they were seeking help.
Some schools are struggling to deal with the problem. Last year, wrist-cutting suddenly began to spread at a public junior high school in the Tokyo metropolitan area. At first the problem was limited to just a few students, but the school later confirmed that at least 20 of the fewer than 200 third-year students at the school had slashed their wrists. School officials said students appeared one after the other at the school nurse's office saying, "I went and cut myself."

A teacher who treated some of the students said there had sometimes been more than one injury at a time.

"There were times when I treated the wrist of one student with one hand while tightly holding the hand of another student. It wasn't limited to just wrists either. A group that cut crosses on the backs of their hands also appeared. All of them seemed to want others to notice their suffering," the teacher said.
Because of the problem, teachers at various junior high schools and high schools have held meetings to help people learn about wrist-cutting. However, those involved have continued to come forward with various worries, saying the number of young people who injure themselves is continuing to increase, but there are no places or time to quietly speak with each of the victims, and that the mental burden on teachers who see students with cut wrists every day is severe. Others wonder how far into households schools should delve when dealing with the problem.

Osamu Mizutani, a 49-year-old teacher who is known to have helped many troubled youths, often receives inquiries from people who have injured themselves. He said in one case all of the members of a junior high school girls' basketball team injured themselves, thinking it was their fault that a teacher had told off one person.

Toshihiko Matsumoto, a doctor at the National Institute of Mental Health, said he has also heard of an increase in the number of people injuring themselves from his colleagues.

"I want people to give (the victims) words of sympathy, such as, 'It's hard for you, isn't it?' or, 'Let me know if you feel like cutting yourself again,' and to give them the chance to express themselves in words and understand their feelings," he said."

Mainichi News, February 6, 2006

Domestic Violence Shelters

A defender for Japan's battered women

"According to a nationwide government survey in 2000, 27.5 percent of Japanese wives said they had been beaten by their husbands, and 4.6 percent of women in another study said spousal abuse had put them in a life-threatening situation. (Estimates of domestic violence against women in the US vary widely, but tend to range from less than 1 percent to a little more than 3 percent, according to the Family Violence Prevention Fund.)

Experts and activists argue, however, that since many Japanese still regard violence against women not as a violation of their human rights but as a "family matter" - a quarrel between husband and wife - the actual number of cases in that country is probably much larger than reported.

In 1996, no publicly funded shelters existed in Japan solely for victims of domestic violence. (They were mandated by law in 2001.) There were probably fewer than 30 privately funded shelters to serve the entire country.

That April, Ueda established a group called Space Enjo (Assistance). She spent 45,000 yen (about $425) of her own retirement money every month to rent a two-room apartment as an emergency shelter for battered women in Osaka, the largest city in western Japan.

Soon she was swamped with pleas for help from victims, and was appalled when some women arrived with black eyes and purplish bruises. She knew then that the situation was more serious than she had thought.

Within two years, lack of shelter space for victims became an issue at Space Enjo. So, in 1998 she rented a second apartment. Then the need for better security became an issue when some husbands tried to get into the shelters. In 2001, Ueda borrowed 24 million yen (about $226,000) from the Government Housing Loan Corp. and from her husband and daughter to purchase a four-room condominium with a state-of-the-art security system.

The three locations can accommodate 10 women (and their children, if necessary) at a time.

Since it opened, Space Enjo has sheltered more than 300 women and children. Victims are of diverse nationalities, with ages varying from 17 to 78. Ueda and other volunteers help the women meet with lawyers, real-estate agents, government employees, and others who can help them. The organization also continues to provide guidance long after the stays end, so victims can learn to become more self-reliant.

Some battered women who come to the shelters have suffered from what Ueda calls a "full course" of domestic violence, in which the husband assaults the wife physically, psychologically, and economically..."

February 04, 2004