According to official statistics, 21,140 people took their own lives in Japan in 2017. The thought of so many deaths is tragic enough, but it is made even worse when you consider that all of these were preventable.
This month marks the time of year when suicides typically spike across the country. It’s appropriate, then, that March is Suicide Prevention Month in Japan.
To help raise awareness of the issue for this post, I spoke with two experts on the subject: Andrew Grimes, the director of Tokyo Counseling Services, a clinical psychotherapist with over 30 years experience working in Japan, and Samuel Annesley, the executive director of Tokyo English Life Line (TELL), a hotline aimed at helping foreigners in distress in Japan.
I began by asking Annesley why March historically sees such a high number of suicides in Japan. “In Japan, March comes right before the start of the new fiscal and academic year. Anxiety and fear peaks as people worry about starting a new job or going back to school after spring vacation. This can be overwhelming for people and cause them to think about suicide.”
He added that foreigners in Japan are especially at risk given the “lack of immediate family support, fewer social networks and little in terms of support services available in their native language.”
Both Grimes and Annesley share the view that access to such services for foreigners in Japan — especially in more rural areas — is extremely limited.
However, Grimes struck a positive note on the weighty subject when I asked him about the number of patients he has helped through the years. “Suicide numbers shot up in 1998, coinciding with the bursting of Japan’s ‘bubble economy’ the previous year. Since then, we’ve seen an increased number of people seeking counseling and support. There is still a long way to go but certainly there is less stigma around seeking professional help in Japan than there was 20 years ago.”
So, with the parameters and the problem firmly established, what exactly can we do about it? I asked both experts what I should do if I suspect a friend is at risk.
There is still a long way to go but certainly there is less stigma around seeking professional help in Japan than there was 20 years ago.
Annesley set out the following step-by-step plan to help a friend in need:
- Listen carefully to what is troubling them.
- Talk gently about your concerns and the things you have noticed.
- Listen without being judgmental or offering solutions.
- If you think the problem is serious encourage them to get professional support.
- Don’t promise to keep the conversation secret, but instead, share TELL’s number with them and encourage them to reach out.
- Perhaps encourage them to see a doctor, you could offer to go with them.
- If they are seeing someone, encourage them to keep up their appointments.
- If they are unsafe, you may need to call emergency services.
On the importance of understanding your friend’s condition, Grimes said: “Do not tell them just to get over it! Such comments can often do more harm than good. Often the best friends to confide in are those who have been through it. They know depression from the inside and can empathize. The biggest challenge for many sufferers is actually coming to terms with the fact that they need professional help. Overcoming the stigma requires a lot of courage.”
So you’ve talked with your friend, you’ve encouraged them to seek help and they are willing to do so. What happens next?
“In Japan, only certified doctors including psychiatrists can formally diagnose depression or other mental illnesses,” said Grimes. “Japan has 14,000 (psychiatrists in a total of over 270,000 licensed doctors). Your first port of call should be to see one of them. From there, they can recommend a variety of treatment options.” There are over 30,000 board certified clinical psychologists in Japan. It is illegal for anyone other than a Ministry of Health, Welfare and Labour licensed doctor to offer treatment, diagnosis or prescribe medications to the public.
In fact, Tokyo Counseling Services keeps a database of English speaking psychotherapists in the Tokyo area. You can contact the professionals there via the TCS website, by phone (03 5431-3096) or by email for more information. TCS is a purpose-designed counseling center with three counseling rooms available. They have a total of 20 counselors on staff with counseling available seven days a week, all year round.
Of course, being strong for others is one thing, but what if it’s you who’s feeling the pressure?
I asked Annesley what I should do if I ever find myself having suicidal thoughts. “If you are feeling unsafe, then calling the TELL on 03-5774-0992 is a great starting point. We can talk you through the options in Japan and listen to your concerns. You might find it helpful to know many people have thoughts of suicide and never act on it. There is support and you can get through this.”
Having thoughts about ending your life does not make you a bad or weak person. Help is available and you deserve to access it. TELL’s Lifeline is open daily from 9 a.m. to 11 p.m. “From 10:30 p.m. on Saturday night through to 9 a.m. on Sunday morning we also have a chat service that you can access via www.telljp.com,” says Annesley. “There are also other resources on the TELL website that can help.”
If things have already moved beyond this and your life is in immediate danger, then you need to call emergency services: dial 110 for the police or 119 for an ambulance. For example, if you are considering an overdose and possess or have taken pills. Do not worry if you can’t speak or understand Japanese — just stay on the line and the call center will be able to trace your location and get help to you as quickly as possible. If you are in Tokyo, you can reach English speaking police officers at 03-3501-0110.
[Tokyo Counseling Services] can talk you through the options in Japan and listen to your concerns.
Finally, I asked both Grimes and Annesley what their respective organizations were doing to promote Suicide Awareness Month in Japan. TELL is running a grassroots campaign throughout March to raise awareness about suicide prevention. “We are distributing flyers that help people identify the signs that someone might be feeling suicidal, what they can do to help and guidance on where to get help for those who are struggling. Any group, organization or individual can get involved by contacting TELL and asking for some flyers to distribute in their local communities. We’re partnering with some companies here in Tokyo and also working with a large network of ALTs who will be helping distribute the flyers all across the country,” said Annesley.
For Tokyo Counseling Services, the occasion offers them a chance to amplify their message and continue reaching out to those in need via social media channels. Be sure to follow @tokyocounseling on Twitter for regular updates about mental health. You may also want to check out their Facebook page.
Of course, March has an added significance for Japan. It isn’t just suicide prevention month. This March 11 also marked seven years since the 2011 Tohoku earthquake and tsunami.
What many people don’t realize is that suicide doesn’t always come about because of a person’s current situation. Past trauma can also play a big part. Childhood trauma can be especially damaging. This is why Grimes, in addition to his work with Tokyo Counseling Services, also supports the Allied Psychotherapy Relief Initiative for the Children of Tohoku (APRICOT). This non-profit organization aims to provide ongoing counseling, therapy and emotional support for children still dealing with the mental scars from that horrific day and its ongoing fallout.
I would like to thank both of my interviewees for the time they gave me to contribute to this article. More importantly, I would also like to thank them for their ongoing, tireless efforts to bring Japan’s horrifically high suicide numbers down and raise awareness about mental illness in general. These people are real life superheroes who have contributed to saving countless lives.
In closing, I will say this: It is never weak to admit you need help. In fact, it takes a strong character to face up to life and its many challenges. No matter how bad things seem — there is always a better way. Suicide deprives you of the chance to discover that way.
Don’t seek a permanent solution to a temporary problem.