Rising Mental Health Challenges in Japan: Why Change Is Needed
Understanding the gaps in Japan’s mental health care system and the need for accessible psychological support
Mental Health Issues on the Rise — Globally and in Japan
Worldwide, rates of people experiencing mental health difficulties have been increasing — and Japan is no exception. In fact, as early as 2017, the number of diagnosed psychiatric cases in Japan exceeded the combined number of patients with heart attacks, diabetes, and cancer. This highlights the scale of mental health needs in the country.
Japan also has one of the highest numbers of patients hospitalized in psychiatric facilities and consistently ranks among the top OECD nations in terms of suicide rates. These statistics point to a serious public health challenge that affects both Japanese residents and expatriates living in the country.
Government Initiatives vs. Public Awareness
While the Japanese government has introduced standardized programs to address the situation, two major issues remain:
Lack of general public awareness about mental health conditions, and
Limited alternatives to pharmacotherapy (i.e., reliance on medication as the primary treatment).
Although some non‑pharmacological treatments exist, they are still insufficiently promoted and supported within the healthcare system.
The Role of Psychologists in Japan: Underutilized and Undervalued
Japan does have trained psychologists, but they often face limited career opportunities. Similar to historical patterns seen earlier in Europe, the mental health field in Japan is still predominantly controlled by the medical profession, rather than by psychological practitioners.
Another critical issue is that the Japanese health insurance system continues to largely exclude psychological and psychotherapeutic treatments from reimbursement. While pharmacotherapy prescribed by psychiatrists is covered by social insurance, “talk therapy” provided by psychologists must generally be paid for entirely out of pocket. This cost barrier prevents many people in need from accessing essential psychological support.
Discussions on Reform: CBT and Integration into the Healthcare System
In recent years, both national and international expert groups have been meeting to discuss potential improvements in Japan’s mental health care system. A major topic of discussion is how approaches such as Cognitive Behavioral Therapy (CBT) could be more formally integrated.
However, progress has been slow and incremental. Many proposals remain in the discussion stage rather than being translated into concrete policy changes.
What Japan Can Learn from Europe
Meaningful transformation in Japan’s mental health care may ultimately depend on adopting reforms similar to those seen in parts of Europe. For example:
Sweden and Austria have established laws that integrate psychologists and psychotherapists directly into the national healthcare systems.
These reforms enable partial reimbursement for psychological and psychotherapeutic services, making them more affordable and accessible to the general population.
If Japan were to pass a similar psychologist‑oriented mental health law, both Japanese citizens and expatriates could more easily afford the psychological care they need.
A Crucial Step Toward Better Mental Health Access
The introduction of such legislation would represent a long‑overdue and critical development in Japan’s approach to mental health. Removing financial barriers and recognizing the value of psychological treatment would not only improve individual well‑being but also strengthen public health across the nation.
At Refugium Tokyo, we believe that accessible, high‑quality mental health care — including culturally sensitive psychological support — is essential for everyone living and working in Japan.
You may also be interested in: https://refugiumtokyo.com/mental-health/counseling-and-psychotherapy-in-japan