AGNES CHONG WRITES — Can the rising popularity of online therapy transform the current landscape of mental health practice in Japan?

Before the onset of the COVID-19 pandemic, online healthcare services were considered a risky niche practice, but now telehealth has emerged as a prominent force in the healthcare industry—especially in regard to mental health services.

According to Japan’s Health Policy, the country has the greatest number of psychiatric hospitalizations per capita in the world. In 2017, it was estimated that 4.193 million people in Japan were living with mental health issues, with that number expected to climb in the years following. Despite these rising numbers, accurate information on mental illness in Japan is still relatively limited for the general public, as many still consider psychological problems to represent weakness of character.

A recent 2022 study by Sage Journals found that many of the current attitudes and values in Asian culture are derived from traditional Buddhist or Confucius ideals of interdependence and interconnection. In Japanese communities, this contributes to a static social order, which limits the expression of individual needs in exchange for social harmony. While this emphasis on group identity has worked to maintain traditional cultural scripts and norms across generations, it also carries harmful repercussions as those suffering from mental illness may not seek professional help in order to avoid community shame.

Yet the emergence of online therapy has created a new avenue that addresses mental health concerns – without social repercussions. One of the most prominent forces in the industry now is Tokyo Mental Health, which works to provide “therapy delivered via the internet on an electronic device. The content of online therapy is just like in-person therapy, but the sessions are held over a live video call.” Research has shown that this method of therapy is just as effective as in-person therapy for treating mental disorders such as depression. Furthermore, a recent study following the effects of internet-based cognitive therapy on young men in Japan determined that online therapy is a suitable technique for Japanese students struggling to cope with stress, depression, and anxiety. In addition, it affords greater accessibility and flexibility to people in remote areas who can now access treatment from the comfort of their own homes.

This is important. According to APCO worldwide, over 50% of Japanese people across generations are interested in telemedicine, and 86% of those who have used it say they’d like to continue.  Telehealth, then, plays a crucial role in tackling mental health disparities in Japan as it improves access and, ultimately, the quality of lives.

Why do things need to change in Japan? While the prevalence of mental disorders is high, the rates of people seeking treatment are significantly lower in Japan than in Western countries. One MEDLINE study, in fact, actually found that almost two-thirds of individuals with mental illness never seek help due to stigma. In the future, these online communities have the potential to challenge stigma through a sense of personal empowerment and hope. For now, they offer a new and vital resource to address mental health problems not just in Japan but throughout the world.

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