Mental Health in Japan During the COVID-19 Pandemic
John Houlette shares cultural insight on the pandemic's effects in Japan.
Posted Jan 19, 2021
This guest post is written by John Houlette.
Japan is no stranger to crisis. Throughout its thousands of years of history, the nation has been barraged by disaster after disaster, and more recently, is still recovering in the wake of the devastating earthquake, tsunami, and nuclear triple disaster of 2011.
The Japanese cultural value of emphasizing social harmony and not inconveniencing others, and the existing habit of mask-wearing have helped keep the infection rates down. Well before the pandemic, people pragmatically wore masks in public when they have a cold to protect others from their germs or to minimize the effect of pollen-related allergies. In a compliant, harmonious culture where following rules and thinking of others is paramount, it would be shameful and socially anathema to pass on a cold or even worse, COVID, to someone else. In fact, the healthcare workers who assisted the infected members on the infamous Diamond Princess cruise ship experienced discrimination and were stigmatized by the public1. This anxiety about becoming infected, as well as the shaming and bullying of those who have become infected is likely contributing to the mental health struggles with the advent of the coronavirus.
In addition to general anxiety about the pandemic, there are two urgent mental health crises in Japan, specifically the increase in domestic abuse cases as well as an increase in suicide rates, particularly among women, youth and children.
The Japan Times reported that school closures and transitioning to remote work in Japan (steps to stem the spread of COVID) have led to an increase in domestic violence. As more people have been forced to stay at home, victims of domestic abuse are confined to the same space as their abusers. Daily rhythms for parents and children have been greatly altered causing stress and conflict in the home. In fact, according to the Tokyo Shimbun, consultations regarding domestic abuse with national and local governments was up by 60 percent since the state of emergency declaration2.
Suicide, which averages over 20,000 reported cases a year, is outpacing the number of deaths due to COVID, according to CBS News. Michiko Ueda, associate professor at Waseda University and expert on suicide, states, "We didn't even have a lockdown, and the impact of COVID is very minimal compared to other countries ... but still we see this big increase in the number of suicides … That suggests other countries might see a similar or even bigger increase in the number of suicides in the future."3
There have been significant layoffs in the retail and service industries with the pandemic, and in Japan, more women are likely to be in these industries. As such, many women in Japan have found themselves unemployed and also disproportionately bearing the burden of caretaking, leading to an increase in mental health struggles. Although making up a smaller proportion of suicides, the number of women who have committed suicide have increased about 40 percent.
As a clergyperson living in Japan for over 38 years, I have witnessed the importance of the dynamic of ibasho in Japanese culture, and its value in improving mental health. Ibasho, which means “a place where you can feel like yourself,” is a safe place in time and space, to exist or belong. It is where a person can be authentic and can share their feelings, be heard and experience nurturing and acceptance of their identity. Domestic abuse, school bullying and workplace stress crush a victim’s ibasho which can lead to isolation, emotional and physical pain, loss, and in worst-case scenarios, suicide. I have assisted two families on their journey to recover a place to belong after the tragedy of suicide. In one case, a widow has remarried, and in another situation, a widow is working hard to raise her daughters as a single mother.
A Theology of Pain
After Japan’s 2011 triple disaster, disaster zone clergy developed a practical theology of pain to care for themselves and others as they built, nurtured and sustained ibasho. This practice invites people to share their pain with God and others, through presence and listening, experience intimacy, receive power, and then have influence4. It is a relevant COVID-19 care strategy.
Japanese pastors have experienced stress in caring for congregants during COVID. It has been taxing to prepare church buildings for smaller numbers. Creating Zoom and YouTube services required a steep learning curve for some. Resilient churches have thrived by developing new small group communities.
Fukushima Case Study
I partner with a faith community in Fukushima city, which runs two cafes: an Orange Café for family caregivers and elderly facing dementia, and a Kid’s Café, for families in need.
These groups gather monthly (as COVID protocols allow) where volunteer staff provide food, games, exercise, emotional care, education, and a place for social interaction.
Adult children bring their elderly parents to the Orange Café for encouragement, skill training, observation, and connections. At a recent Christmas event, guests ranging from grandkids to grandparents learned how to play "Silent Night" on handbells.
The Kid’s Café is a drive-through event, where people come to the front of the church one family at a time to receive food and participate in an activity. Staff connect with each family to see how they are doing emotionally. In August, one single mother shed tears after receiving a shaved ice (snow cone) exclaiming that she had never been given a gift like this before. Consistent, safe connections help to keep people from isolation and give them a place to belong, physically, emotionally, and spiritually.
About the Author: John received a Doctor of Ministry degree in Congregation and Family Care from Bethel University. He serves with Asian Access. He is the director of Three Stream Ministries which provides clergy care, mentoring, and consulting services to church leaders and congregations in Japan and Greater Asia. He is a credentialed leadership coach, disaster response chaplain, Prepare-Enrich marriage counselor, and ordained minister.
He is the author of Resilience: How Japanese Pastors Can Thrive in Every Season and Stillness Tools: A Survival Kit for Pastors.
(1) Japanese Association for Disaster Medicine. (2020). Shingata coronavirus kansenshou ni juuji suru iryou kankeisha eno futou na hihan ni taisuru seimei [Statement against wrongful criticisms to health care workers responding to novel coronavirus infection]. Retrieved from https://www.jadm.or.jp/sys/_data/info/pdf/pdf000121_1.pdf).
(2) The number of domestic violence consultations increased 1.6 times due to COVID-19 [Japanese]. 2020. https://www.tokyo-np.co.jp/article/60602 (accessed October 26, 2020).
(3) Wang, Selina, et al. “In Japan, More People Died from Suicide Last Month than from Covid in All of 2020.” CNN, Cable News Network, 30 Nov. 2020, edition.cnn.com/2020/11/28/asia/japan-suicide-women-covid-dst-intl-hnk/index.html.
(4) Terry Walling, Stuck!, Navigating the Transitions of life and Leadership, (Wheaton, IL: ChurchSmart Resources, 2008), 17.