A History of Mental Health Care in Japan:International Perspectives

Abstract

Background: Japan has continuously received influences from foreign countries to improve care for patients suffering from mental diseases throughout its history. But an article documenting on the foreign influences on Japanese mental health (MH) care is not readily available. Methods: The author reviewed the published books, papers, and government documents on the MH care in Japan. For comparisons, the publications on MH and psychiatric care, especially those in the United States of America, the United Kingdom, as well as countries of the Organization for Economic Co-operation and Development, were also reviewed. The author also recounted his personal observations on the MH care over his own life. Results: Before the Meiji Restoration, Buddhism and temples played a major rôle in taking care of persons with mental illness. Kampo (Chinese medicine and medicinal herbs) was prescribed during the Edo era (1603–1867). After the Meiji Restoration in 1867, the Meiji government adopted Western medicine. German medicine was introduced as an exemplified model. Before World War II (WWII), Japanese psychiatry was under the heavy German influence. After WWII, American psychiatry was introduced. At the same time, the Japan Private Hospital Association (Nisseikyo) was formed, and it contributed to build MH care system. From 1955 to 1993, Japan continuously increased the number of private hospital beds, financed through public funds. The scandals at several private hospitals helped enact the Mental Health Law in 1987, making clear to change hospital-centered services to community-based MH services and improve the human rights of inpatients in Japan. Since then, efforts have been carried out to promote community-based MH care. But Japan nowadays is still characterized by hospital-centered MH care. Conclusion: At present, Japan has more than 1,000 psychiatric hospitals with 300,000 psychiatric beds. Japan has the largest number of psychiatric bedsthat is on the top among all countries in the world. In this review, the author expresses his own personal viewpoints on MH care for the mentally ill in Japan with focus on its international influences.

Keywords

• hospital-based psychiatry
• japan
• mental health system
• private psychiatric hospitals