Mental Health

Finding Mental Health Resources in Japan:

Download: Mental Health Resources StonewallJapan[PDF]

 

Disclaimer

The content of this guide is meant solely for informational purposes and not meant to substitute any advice provided by medical professionals. If you suspect that you are facing mental-health related problems, you are strongly encouraged to seek professional help.
While Stonewall hopes to keep this information up to date and correct, Stonewall makes no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, or suitability with respect to the content or the information contained on this guide for any purpose. Any reliance you place on this guide and information is therefore strictly at your own risk.

 

Please seek immediate professional help:

• If you have thoughts of killing (or otherwise harming) yourself or others;
• If you are gravely disabled (unable to care for yourself or those in your care);
• If you are abusing substances or have an addiction;
• If you or someone else is in any danger of harm;
• If you have been diagnosed with a mental health disorder or suspect you have one;
• If you or a loved one are in need of an intervention.

Call TELL Lifeline @ 03-5774-0992

(If you get a busy signal keep calling! They can get backlogged sometimes!)
Or call an appropriate emergency number

Emergency numbers

Emergency Services

  • Police: 110
  • Fire: 119
  • Ambulance: 119

Emergency Medical Interpretation Service
(English/Spanish/Chinese/Korean/Thai)
Monday to Friday 5pm – 10pm
Saturday, Sunday and Holidays 9am – 10pm
03-5285-8185

Tokyo English-Speaking Police
Telephone: 03-3501-0110
Days: Monday – Friday
Hours: 8:30am – 5:15pm

Drug Overdose & Poison Control Centers
U.S. Air Force Hospital, Yokota: 0425-52-2511, ext. 57740
Honolulu Poison Control Center: 1-808-941-4411
Osaka Toxicity: 0990-50-2499, 06-871-9999

Stay calm. Always speak clearly and slowly when making an emergency call. If possible, enlist the aid of a Japanese speaker in placing the call. The Japanese phrases below will be helpful if the operator does not understand English.
Remember: Stay on the line! DO NOT hang up until the operator hangs up.

Emergency Japanese
Kyukyusha o yonde kudasai. Please send an ambulance.
Keikan o yonde kudasai. Please send a policeman.
Watashi no namae wa _____ desu. My name is _____
Watashi no jusho wa _____ desu. My address is _____
Watashi no denwa bango wa _____ desu. My telephone number is _____
-TELLjp.com

 

LGBT+ Mental Health Overview

“Mental health problems are common, so common in fact that when you look around you, one every four of those people you see will experience poor mental health at some point in their lifetime.

We also know that LGBT individuals are even more likely to be affected by mental health problems, but why is this?

Just because a person identifies as lesbian, gay, bisexual or trans doesn’t mean that they will necessarily struggle with coming out, accepting their sexual orientation, gender identity or worry about being honest with other people, but many do. One of the greatest myths surrounding LGBT mental health is that being LGBT is the problem – when in fact it’s more likely that their wellbeing is being affected by common issues such as money worries, relationships, work stress, bereavements and so forth.

Often, what’s difficult to deal with is the way people get treated because of their sexual orientation, gender identity (or both). That can really be the most difficult thing to deal with. Having to cope with things such as: verbal abuse, discrimination, rejection by friends and family, bullying, prejudice, harassment, physical abuse, abandonment.”

– http://lgbt.foundation/information-advice/mental-health/issue-faced-by-lgbs/

 

Downloadable guide here (http://lgbt.foundation/downloads/169 [PDF]) discusses important topics like:

  • What can influence my mental health? (Positively and negatively)
  • How does physical and mental health relate to each other?
  • Things I might struggle with: depression, self-harm, anxiety, Bipolar, PTSD, eating disorders, stress, etc.
  • Who can help me?
  • How can I help myself?
  • How can I help someone else with their mental health?

Note: This guide is informational, however, as this guide was created by a UK organization, most of the support contact information is likely not usable for those of us living in Japan.
Also, while they are working on a trans inclusive guide, be aware this current edition is not inclusive​.
If you think you might suffer from a mental illness, do not delay seeing a professional. Self-help tips may only mask more serious issues that need to be addressed.

 

Understanding Mental Health Resources in Japan

In Japan, there are 3 major groups of mental health care providers:
 
Psychiatry
Psychiatrists work at psychiatrist department in hospitals or specialized clinic. They specialize in the diagnosis and treatment of mental health problems, such as depression or insomnia.
The consulting time they can provide is generally very short, less than 20 min or so. They can prescribe medications to treat mental illnesses. Psychiatrist services are covered by Japanese Health Insurance.
Note: Sleep apnea is treated by a pulmonary/ENT specialist, not a psychiatrist.[…]

Clinical psychologist
Clinical psychologists provide counseling services. They are working in mental health clinics, mental hospitals and counseling centers. Some clinical psychologists work on freelance basis, or provide telephone counseling.
In general, clinical psychologists can deal with patients with wide range of mental health issues. However, depending on the skill and experience of the psychologists, the quality of service a patient receives can differ.
Clinical psychologists can perform psychological tests, but cannot prescribe medication.
Their counseling service is not covered by Japanese Health Insurance. The costs vary, generally 5,000 yen to 10,000 yen or more/50 min.[…]

Psychosomatic medicine
“Psychosomatic medicine doctors are generally working in specialized clinics. They mainly treat physical problems caused by psychological stress, such as IBS (irritable bowel syndrome). Psychosomatic medicine specialists do not treat mental-oriented disorders like depression or schizophrenia.
If you have a physical symptom and general doctors do not know the cause or treatment for it, psychosomatic medicine clinic is a recommended place to visit.[…]” -JapanHealthInfo.com

A Warning about Japanese Psychiatry

“In Japan there’s no licensed therapist. They have Psychiatrist who prescribes anti-depression if you’re depressed. You can also find counselors but they’re not licensed (I mean they take a course to become a counselor it’s not like overseas that you need to go through hours of actual therapy to get your license) so they don’t know what they’re doing. If you’re depressed and unfortunate enough to try one of them you’d find out that they literally shame you for being selfish and dare to feel suicidal cos that’s how they trained!” – telljp.com representative

How Do I Find a Good Mental Health Care Provider?

Mental health care providers with licensing are typically better quality, however, if distance is prohibitive consider using a foreign licensed practitioner for counseling and going to a local practitioner in the case that medication is necessary.

There are several services that can help you find, schedule, navigate your way with as much English support as possible!

International Mental Health Professionals Japan (IMHPJ) is an interdisciplinary network of individuals and organizations providing mental health care, therapy and related services (in English) to the people of the various nationalities living in Japan.
http://www.imhpj.org/find-a-therapist.html
*This resource is recommended as it is Japan based, English focused, and the qualifications/licensure of each practitioner is listed.
(One therapist,Kim Oswalt, is well known for her work with LGB and especially T clients.)

Japan Healthcare Info: Can help find English-speaking medical providers in Japan and help make doctors appointments.
http://japanhealthinfo.com/

AMDA International Medical Information Center: Help find medical providers in Japan who can speak English (or several other languages if needed) and free medical telephone interpretation.
http://eng.amda-imic.com/?ml_lang=en

Tokyo Metropolitan Health and Medical Information Center (Tokyo area only): Help find hospitals with English-speaking doctors in the Tokyo area.
http://www.himawari.metro.tokyo.jp/qq/qq13enmnlt.asp

Online list of Psychiatric Hospitals/Clinics where English/Other languages are spoken:
http://www.groupwith.info/htdocs/index.php?action=pages_view_main&page_id=26

The Japan Society of Certified Clinical Psychologists (JSCCP) provides a resource (Japanese-only) that helps locate JSCCP-approved therapists in any part of Japan, and can be searched for by language, among other specifications. You can use a browser translation tool to help you navigate it, or ask someone you trust who can help you read it and search.
http://www.jsccp.jp/near/rinsho/

 

How Do I Refill My Prescription From Home?

 

“Refilled” by a Japanese Doctor

Japan, in most cases will not honor prescriptions from abroad. This means you will need to go and get a new prescription while in Japan. You can, however, bring your prescription (preferably translated) as a guide for your Japanese psychiatrist to help better prescribe you. (Note that the same drugs may not be common/available in Japan and you may be prescribed something similar but not identical to your current prescription.)
An example experience/ step-by-step guide here: (scroll down) http://japanhealthinfo.com/faq/mental-health/

Medication from Overseas

Before mailing or bringing any medication to Japan, read the following section carefully. If you fail to follow Japanese Law you may be arrested and detained.

What can I ship?
“When bringing prescription medications to Japan you may have items inspected and cleared upon arrival by the Customs Agency, and avoid further processing if the following conditions apply:
Items are brought for personal use only, and may not be sold or given to anyone while in Japan
Items are oral or external medications, and are not taken with a syringe (i.e. insulin, EpiPen, etc.)
Items are not prohibited drugs in Japan such as stimulants (i.e. Adderall)
Items are not narcotics, or other highly controlled medications in Japan (i.e. morphine, oxycodone, etc.)
Quantities do not exceed a one-month supply per unique medication as prescribed

For syringes and an extended supply of medications, it is necessary to submit an application along with supporting documents to a Regional Bureau of Health and Welfare of Japan’s Ministry of Health, Labor and Welfare for a special import certification called “Yakkan Shoumei” in Japanese. Please refer to the following document for details on applying for a Yakkan Shoumei: (Yakkan Shomei Instructions and Application Forms (March 5, 2015)” –http://www.seattle.us.emb-japan.go.jp/about/import_restrictions.html

*SOME MEDICATION THAT IS LEGAL ABROAD IS NOT LEGAL IN JAPAN! CHECK!
*Note that customs duties may be charged

How do I bring medication with me?
Traveling with medication is slightly different. The rules 1-5 from above still apply so unless you fill out the Yakkan Shoumei, you can only bring a one month supply. Travelers should bring a copy of their doctor’s prescription as well as a letter stating the purpose of the drug. For those that must bring more than a one month supply, you must present your Yakkan Shoumei with the medication at customs.

Visit the US Embassy page for more information in English here [LINK].

Questions about importing your medication? Contact Japan Health Info here [LINK].

 

Online Counselling Options

Online options are for counseling services only. They do not prescribe medication. It is also important to remember that they are alternative tools that people may use if quality traditional therapy (going in person to a licensed therapist) is too difficult to access. Those with serious mental health issues should seek out the help of a health care provider in person.

TELL Japan offers in person and distance psychotherapy counseling services known for being openly LGBT friendly as well as train their staff for LGBT sensitivity. TELL Japan services are not covered by the Japanese National Health Insurance, however, if you do not have a private insurance to cover all or part of the cost they have a sliding pay scale.
http://telljp.com/counseling/

Talkspace is a 24/7 chat based service that matches you with a licensed counselor (although they do some video-chat services as well) based in America known for being LGBT friendly as well as have many counselors who specialize in LGBT+ issues. Talkspace is not covered by the Japanese National Health Insurance.
https://www.talkspace.com/online-therapy/lgbt/

 

Online Counseling Concerns:

➤ Text based services hamper the therapist’s ability help clients as non-verbal cues are absent and are currently seen as inappropriate for diagnosis of clinical issues such as chronic depression and psychotic.

➤ Lack of peer reviewed research that deals with the individual business style of care provision on their effectiveness, issues, etc.

➤ People with serious issues may delay effective treatment (read: going to an appropriate mental health care provider in person) by using online methods that are not appropriate for their more serious issues.

➤ Online providers that promise full anonymity may be putting clients at risk if the care providers are not able to intercede in issues where the client may be a danger to themselves or others.

➤ Text based services lack the ability to create a safe feeling atmosphere/personal relationship and therefore could cause more harm than good when dealing with individuals with PTSD and other forms of trauma.
http://www.forbes.com/sites/toddessig/2015/06/29/should-buyers-beware-hidden-risks-in-talkspaces-text-only-therapy/#471c6f652089
http://au.professionals.reachout.com/online-counselling-pros-and-cons

 

Questions to Ask Your Counselor

What qualifications do you have?

Online, and in real life as well depending on location etc., often almost anyone can call themselves a therapist or counselor. There are a number of different awarding bodies and ways to qualify. Does your therapist have a qualification from a reputable source? Can you google the awarding body? Do they have a complaints procedure?

Are you registered with a governing body?
Reputable counselors will be governed by their ethical frameworks, and complaints procedures. This provides some protection to clients should they wish to make a formal complaint.

Why are you a counsellor?

Why? Important things to know are, does the counsellor find themselves superior to those they help? Do they put themselves at the center of the work and emphasize leaning on their advices? These could be indications that the counsellor has bad boundaries. Also keep an eye out for toxic views on mental illnesses in general as well as their views on minority statuses such as LGBT+ or nationality.

Have you ever worked with X?

Whether or not they have is not the main point. Rather to see how they talk about their experience or lack thereof with a group may be very telling in of itself.
Example: “Have you ever worked with non-binary people?
Answer 1: “No I haven’t. Can you explain what it means to you? I’ll have to go and educate myself more on this matter. For today, what pronouns should I use?” = Open to learning, doesn’t sound judgmental.

Answer 2: “Oh yes, I have worked with clients of all sorts of sexual preferences! We can explore the issues around your sexual orientation as this is a safe, confidential space.” = Misunderstanding, and focusing on it as “issue” versus a fact about their client.

 

Here are some basic questions you can ask getting started:

  • My problem is _______. How would you go about treating that?
  • What are your strengths as a therapist? / What are your areas of expertise?
  • What are my treatment options?
  • How will my confidentiality be assured?
  • Can you please explanation as to what I can expect to happen in my sessions?

 

Just Need Someone to Talk to?

TELL Japan:

“You don’t have to be suicidal to call. Whatever is troubling you, we are here to listen.
No one needs to struggle alone. Reach out and call us, our phone counselors are here for you.”

LGBT+ friendly! (regular phone charges apply)
9am-11pm JST
03-5774-0992

7 Cups:

An online counseling community with free online chats with trained listeners.

“Talk to someone in a 1-1 chat, or join our LGBT chat room to chat with others who understand what you’re going through.”

LGBT+ friendly!
https://www.7cups.com/lgbtq-chat-room/

 

JET Info

JET Online Counselling Service

JET participants are also able to receive professional counselling for free through Web Mail and Skype, as part of the JET Online Counselling Service established by CLAIR. Please ask your contracting organisation for more information.
http://jetprogramme.org/en/support/

AJET Peer Support Group (PGS)
Number: (050) 5534-5566
Skype:AJETPSG
Call Times Available every day from 8:00pm-7:00 am
Webpage: http://www.ajetpsg.com/

JET Mental Health Counselling Assistance Programme

With the aim of enhancing mental health support for JET participants, CLAIR offers the JET Mental Health Counselling Assistance Programme. This programme provides a partial subsidy (50%, up to ¥20,000 per year) for counselling costs incurred through consultation with mental health professionals in Japan not covered by health insurance. The coverage period is from 1 April 2016 to 31 March 2017. For further information, please ask your contacting organisation.

 

Additional Resources

➤ TELL Japan:
Not only does Tell run a hotline and offer counseling but their website is a wealth of information!
http://telljp.com/more/resources/
TELL Japan also runs an information site on shelters, support groups, etc. here at Wiki-Tell:
http://www.bluejava.com/tell/index.html

➤ QWRC-Queer and Women’s Resource Center
Has an amazing PDF in English and Japanese that can be used for educational purposes to interested persons on LGBT medical/social issues, as well as includes a thorough list of resources for LGBT people struggling with various kinds of addiction.
http://qwrc.jimdo.com/

➤ Downloadable documents in multiple language to help facilitate your interactions with Japanese health care providers:
http://eng.amda-imic.com/modules/useful/index.php?content_id=1

➤ General Health Care in Japan Information:
http://www.survivingnjapan.com/2012/05/what-you-should-know-about-mental.html

➤ General Health Care Information + Refilling Overseas Prescriptions Guide:
http://japanhealthinfo.com/faq/mental-health/

➤ General LGBT+ Resource Link List:
http://www.pflagnyc.org/links

➤ Alcohol Anonymous Meetings in English across Japan:
http://aatokyo.org/

➤ Stonewall’s Trans Support Resource:
http://stonewalljapan.org/resources/transgender-life/