Los Angeles Times: Japan's Suicide Epidemic

http://www.latimes.com/news/nationworld/world/la-121401jecon.story
COLUMN ONE
Japan's Suicide Epidemic
In a nation where mental illness is shamed and lifetime jobs are a memory, some
desperate workers see no way out.
By MARK MAGNIER
Times Staff Writer

December 14 2001

TOKYO -- As pressure mounted from his job as an auto parts designer, Kazuhiro
Kuroda encountered bouts of listlessness. Then the odd night of poor sleep
turned into chronic insomnia and irritability. He had trouble breathing.

A perfectionist, he redoubled his efforts and tried to power through the
problems. But as cost-cutting intensified and colleagues quit, leaving him with
more work, the stress proved relentless.

He attempted suicide. Twice.

Kuroda, 45, a resident of central Japan, asked for mental health leave. He took
the maximum allowed by regulation, 18 months, but still wasn't back on his feet,
so the company forced him to resign. A few weeks ago, he joined at least 3.5
million others on the unemployment line as the jobless rate here hit a record
5.4%.

Japan's economic deterioration is damaging a lot more than balance sheets and
bank statements. Extreme stress and mental instability are at record highs.
About 425,000 people were treated for stress-related mental disorders last year.
In 1998, when the economy started tanking, suicides jumped 25% to more than
30,000 and haven't declined. Suicides directly attributed to employment,
personal debt and the economy now number 8,500 annually, up fourfold from a
decade ago. Because of population changes, the mortality rate per 100,000 people
has eased slightly.

Mental health professionals say the actual number of stress-related illnesses
may be much higher because psychological difficulties are often ignored or swept
under the tatami mat in Japan, where depression is still viewed as a character
flaw and treatment is inadequate.

"There's a very dark cloud hanging over Japanese society as more and more people
lose their psychological signposts," said Dr. Yoshitomo Takahashi, a researcher
with the Tokyo Institute of Psychiatry. "Mental illness still carries a lot of
shame, so most people are referred only at the terminal stage. This makes our
job very difficult."

Countries around the world have for decades lived with high unemployment and the
social, economic and political costs it engenders. But in Japan, workers saw a
job as an entitlement, and for years that was the case until Japan's economy
faltered.

Companies began pruning payrolls, and the pain now is jolting the core of
Japanese society: breadwinners in their 40s and 50s. This generation sacrificed
almost everything for the company and now feels betrayed, isolated and worthless
at being let go.

"Japan is suddenly waking up from a 56-year dream," said Hirotake Araya, general
manager of Tokyo Shoko Research, a private data-collection company. "The end of
lifetime employment is very difficult to accept, particularly for middle-aged
people."

At the Aokigahara forest at the base of Mt. Fuji, where suicide by hanging or
overdose is common, a large sign at the trail head entreats visitors to think
twice before killing themselves. "Wait a Minute!" it says. "The world holds
bitterness but also joy. You only have one life to live, so think it over."

The forest has been a magnet for distraught Japanese since a popular 1970s
television drama used it as a backdrop for the heroine's suicide. The reality is
far less romantic, but people keep coming, said Yoshiaki Watanabe, patrol leader
of a volunteer cleanup and rescue crew that periodically combs the dense woods.

"With this economy, we're bracing for a lot more," he said. "Some bodies are
found, but many others probably never will be. Sometimes there's nothing left
but bones, even though it's obvious what happened because there are pills
littered nearby."

Souvenir stand worker Kouki Watanabe said he alerted the fire department in late
October after a car went untouched for days. The owner's body wasn't found in
the ensuing search, but five others were.

Drivers with the nearby Fujikyu Yamanashi taxi company use an informal profiling
system. People who arrive on the last train from Tokyo without much money and
ask to go to "the woods" despite the late hour and no camping equipment are
immediately suspect.

"After a while, you can tell instinctively," said Yukihiko Igari, a driver of 14
years. "We drag them into our office here and do absolutely anything but drive
them up there. Often their problems--bad debt, a lost job--seem rather trivial
to an outsider."

Another spot long popular with suicidal Japanese is the Chuo Line in central
Tokyo. Parent company East Japan Railway reported 196 people jumped from
platforms into the paths of oncoming trains throughout its system last year. The
railroad company charges family members up to $65,000 in cleanup fees as a
disincentive in this responsibility-conscious society.

Last year, the company took a new approach by painting platforms bright colors,
adding lights and installing talking sensors and large mirrors to cheer people
up or prompt them to reconsider.

Japan's medical system, meanwhile, reinforces social stigmas, critics charge, by
funding giant, impersonal mental hospitals over community-based clinics.
High-dose sedatives and physical restraints are preferred treatment methods,
they say, with relatively little attention given to prevention or early
outpatient treatment, the direction taken since the 1960s in the U.S. and
Europe.

"Outside of a few places like Tokyo and Fukuoka, the approach is just to feed
patients drugs, keep them in bed and leave them there," said Dr. Rika Tanaka, a
psychiatrist with Fukuoka's Shiranui Psychiatric Hospital. "Many see Japanese
hospitals as asylums using straitjackets, so nine out of 10 people stay away."

Many patients also are deterred by social prejudice and a long-standing view
that gaman, or perseverance, is the best approach.

"There's great discrimination throughout society regarding depression," said Dr.
Toru Sekiya, president of the Hatsudai Sekiya Neuro-Psychiatric Clinic in Tokyo.
"Some of this goes back to rural Japan when families traditionally kept sick
relatives locked in small rooms. The stigma continues."

After years of essentially ignoring most mental health issues, the Ministry of
Health, Labor and Welfare this year initiated a $3-million suicide prevention
program, with the distribution of brochures at companies and local communities a
cornerstone. The goal is to reduce suicides 30% by 2010.

Although it's a start, critics say it leaves a lot to be desired. The program's
first recommendation: Workers should treat themselves by relaxing and working
less. But professionals say this is unrealistic when companies are looking for
any excuse to hand out pink slips.

"Even if people read the government's brochures and seek professional help,
there's no place they can go," said Masaaki Noda, professor of psychopathology
at Kyoto Women's University. "There are so few psychiatrists in Japan that it's
meaningless. The government approach borders on criminal negligence."

Japan has just one psychiatrist for every 10,000 people, about half the one per
5,300 people in the United States.

In a tiny warren of rooms on the fourth floor of the Japan Lutheran Church in
Tokyo, Yukio Saito oversees the Tokyo Lifeline, part of a national network of
5,000 crisis hotlines for depressed and suicidal callers. Saito helped found the
voluntary effort in 1971.

Three decades later, society is still wary of tackling suicide and depression
issues head-on, he said. Architects of the nationwide anti-suicide campaign, for
instance, refuse to use the word "suicide" on their posters, falling back
instead on the slogan, "Support Life."

The private sector has started introducing more mental health programs. All too
often, however, they're run by personnel departments, leaving workers fearful
that participation will derail future promotions or that details of counseling
sessions will be leaked.

Interest rose sharply after Japanese courts started ruling against companies in
karoshi, or death-by-overwork, lawsuits.

Still, some of the greatest stress by all accounts is found at small and
mid-size companies, many of which are barely hanging on, let alone willing to
fund mental health programs.

"Even my company, which isn't the smallest, didn't have a very good program,"
auto parts designer Kuroda said.

Now that he's out of work, the father of three adolescent children is
increasingly worried about finding a job, something he hasn't had to do in three
decades. Things are pretty bleak, he said. Few employers want middle-aged
workers in a nation where age discrimination is widespread. And, even if they
did, there are few jobs available that pay enough to support a family of five.
Their savings will last a year at most if they live very frugally, he said.

Another big problem, even if he can somehow land a spot, is how to finesse his
illness. If he tells prospective employers about it, he won't be hired. If he
doesn't say anything, they'll find out eventually and fire him for not being
forthcoming about it.

"I wish society were more generous," he said. "It's all seems so hopeless."
_ _ _

Hisako Ueno in The Times' Tokyo Bureau contributed to this report.
For information about reprinting this article, go to http://www.lats.com/rights

Isn't it obvious that the suicides are caused by the ready availability of handguns in Japan?
[>:/]

To bad they can't go to the range to relieve some stress. It always works for me.

He should have come down to Fight Club. I go Wednesdays and Saturdays.

Don't you mean trees and ropes?

TheRedGoat

Well, obviously the answer is banning handguns - they're the cause of most suicides you know.  What?  Japan already bans handguns???  Then no one can be committing suicide.  Handgun Control, Inc. says so, don't they?  They wouldn't lie, would they?  [Sarcasm mode ]

Actually it's obvious:  The primary cause of suicide is lack of government funding.  $3 million?  That won't fund a decent study on hangnails.  (OK, I actually left Sarcasm mode ON)

That's one thing I love about Asian culture, pay as you play...

30,000 a year?  Wow!

Wonder if we could instill this ethic in some other ethnicities that are in the news lately?

Obviously, the proper response is to buy stock in Japanese rope manufacturers and Japanese pharmaceutical companies.

perfectionist, MY ASS!

He can't even do something simple like kill himself properly and I see people driving cars everyday that he probably put his design perfectionism into.

Sad.  Very sad.

I work for a Japanese company here in the US.  I have built many friendships with Japanese people (almost all of whom want to move to America... the Land of Freedom and opportunity).  Japanese culture is at once fascinating and perplexing.

In addition to the reasons for high suicide rates in Japan that were mentioned in the article, I have a few others.  

I think the large urban population centers are a source of stress.  Japanese continually pursue concentrating their populations in cities (consiously or unconsiously).  The crowds are unbearable.  The cost of living is astronomical.  If I were living in Tokyo, I'd want to kill myself too (or somebody else).  But the idea of murder in Japan is very alien.  They are too "polite" for that!

Yes, I have to question his "perfection" if he tried to commit suicide twice and failed.  

Japan is what you get when 99.9999% of the population are sheeple and unable to think for themselves or even act in a self-preserving manner on any level.  It's the borg collective--asian life is cheap and plentiful so it has no value whatsoever.  Japan itself may not be a communist country, but the mentality is exactly the same.  

After having worked with many engineers from that part of the world, I can't say I have any idea where they are coming from.  The word "cubicle troll" comes to mind.  Honestly, many of these guys are completely humor-less.  They are drones.  I have had some good times with a few, but they are the exception to the rule--the ones who leave the far east to come live in the permanently US are less drone-like.

I have observed the samething from news reports after the Kobe earthquake a few years back.  The people were waiting for the govt to do something and they just stood there. No self-motivation at all. So much for the vaulted by west earthquake program. It came crashing down like their buildings.

domo arigato mr. roboto, eitsu mushi atai

Dr TRW volunteers to "counsel" all distraught Japanese females between the ages of 18 and 45.

Tyler says: "Jarhead_22 will [b]NOT[/b] be joining the rest of us in Project Mayhem!"


Tyler

It's really hard to hang yourself from a Bonsai tree.