Seattle University Collaborative Projects - International Academy of ...

Mental Health Services in Japan: A Historical OverviewYoji Nakatani, University of Tsukuba (yojinaka47@yahoo.co.jp)Junko Koike, Jichi Medical University (koike@jichi.ac.jp)This paper will illustrate the development of mental health services in modern Japan, dividing itinto three stages. (1) Despite the enactment of the first law dealing with the mentally ill in 1900,their condition continued to be gloomy through the first half of the twentieth century due to anextreme paucity of psychiatric facilities. The majority of patients were cared for by their familyusing a seclusion room in patients’ own homes ─ shitaku-kanchi (domestic confinement). Somepatients were given folklore medicine in temples or shrines. (2) Beginning in the 1950s, custodialcare developed with drastic growth in psychiatric hospitals and beds, prompted by governmentpolicy to encourage the building of mental hospitals through subsidies as well as by increasedaccessibility to medical treatment through the implementation of national health insurance. (3)Since the 1980s, harsh criticism against human rights violations in mental hospitals led thegovernment to establish new mental health legislation putting an emphasis on community-basedcare. From a comparative view, Japan is unique in having pushed forward with hospital-centeredpsychiatric treatment while deinstitutionalization developed in most Western countries.Particularities of Japanese mental health services with regard to global trends will be discussed.Between Legality and Illegality: Folk Therapy for the Mentally Ill in ModernJapanAkira Hashimoto, Aichi Prefectural University (aha@ews.aichi-pu.ac.jp)Following the Meiji Restoration in 1868, the Japanese government prohibited superstitiousremedies and illegal confinement of the mentally ill in order to “modernize” or “Westernize”psychiatry. However, it was not easy for people to change their beliefs and customs, and most ofthem depended on folk therapy. As it was difficult to draw a hard line between legality andillegality, folk therapist practices were not fully controlled by the law. As a result, some practicescontinued as before and were even praised by medical doctors who recognized the “scientific”effectiveness of traditional remedies, although some practices were sharply criticized for theirmoneymaking activities or for human rights violations. However, during the course of themodernization of psychiatry, folk therapy needed to change to survive. Some religiousinstitutions for folk therapy were successfully converted into modern mental hospitals, but otherssooner or later disappeared. By showing several examples of traditional practices in thispresentation, we will explore how folk therapy was dealt with in the context of mental healthpolicy and law in modern Japan.178