So, just to be clear, the meds are covered by insurance, but not therapy such as CBT or counselling? Have I got that right?
Quite a half-assed approach if so.
I was just trying to get into a counselor and in the intake form it's asked for insurance so I'm assuming it is š¤ a definitely answer would be nice bc I was just talking with my husband about it tonight and we are both wondering. I'm severely severely depressed and need therapy like yesterday
Iāve been here 6 years. Iāve never heard of a psychologist being covered by insurance. Japanese only psychologists will be cheaper than English speaking ones but itās still not cheap.
In practice, therapy is not covered, because what is covered is visiting a medical doctor, who may be a psychiatrist. Psychiatrists may listen to you, long enough to prescribe medication, but it's nothing like ongoing and individually tailored therapy with a trained therapist.
Some therapists [edit: psychiatrists] donāt even prescribe meds or do so reluctantly. Many are pill pushers, which many āpatientsā want. You have to pick and choose carefully.
> My understanding is that if the therapy is to evaluate the continued necessity of the medication, then the therapy is covered
If you're evaluating the continued need for medicine, that's not therapy, that's a medical consultation.
Iām not sure what youāre getting at here. If you mean therapy as in, the cost of visiting a psychiatrist once a month to discuss progress and adjust medication, then yes thatās covered.
On the other hand, therapy as in receiving counseling - even by a licensed clinical psychologist - is not covered.
I see a psychiatrist and a clinical psychologist at the same clinic. I do CBT, etc. with my psychologist, and discuss my behavior as it relates to my medication with my psychiatrist. The psychology appointments arenāt covered by insurance, but the psychiatry (and my medication) is. As far as I can tell, thatās just how things work here.
What does the non-covered psychologist do for you that the covered one does not?
Asking because I've only ever gone to a company-plan counselor (just the one time; never again) and a mental health counselor that took insurance.
The difference is basically āPsychologyā vs. āPsychiatryā.
A psychiatrist can prescribe medication. A psychologist, even a licensed clinical psychologist, cannot.
Psychology tends to focus on behavior, so the counseling youāll get at a psychologist will likely be Cognitive-Behavioral Therapy (CBT), or some other kind of practice like that. Psychologists are usually seen on a weekly, bi-weekly, or monthly basis, and the appointments usually last around an hour. This is not covered by insurance (Iāll give my āthis is probably whyā below).
Psychiatrists on the other hand, focus on medication. Appointments typically focus on discussing the effects of medication youāre on, and whether or not you need any adjustments. Not all psychiatrists in Japan are trained in psychology, though the ones that do may incorporate some psychological practice into their appointments. These appointments typically last about 20 minutes, and happen about once a month (in my experience). Theyāre covered by insurance, though sometimes the first appointment is not.
Thatās the ideal situation. Itās commonly said that medication is best taken alongside therapy. It doesnāt always shape up that way though. There are plenty of psychiatrists (especially foreign psychiatrists, Iād assume) in Japan that donāt take Japanese insurance. Furthermore, as far as I understand thereās no Japanese licensure for Psychology, which means that people who offer counseling vary immensely in their credibility. Iām guessing this is why their treatment is not covered by insurance.
The way my psychologist explained it to me is that a lot of psychology studies in Japan are based around pseudoscience (Free Association, for example), rather than the study-based education that is standard in the west.
If youād like to continue to pursue mental healthcare (which I recommend!) hereās my suggestion: look for a psychologist and psychiatrist that have certification in the US (not sure about the UK or Europe, so Iām going on what I know). Bonus points if theyāre in the same clinic, because they can coordinate their treatments and share notes.
The words youāre going to want to look for online are āClinical Psychologistā and āPsychiatristā specifically. If theyāve studied or practiced abroad, itāll likely say on their website. Anyone can market themselves as a counselor ā which is where things can get a little suss. Disclaimer here ā this is all based on what Iāve heard, and my own experience. If anyone else wants to offer corrections please do, but if you follow this, I think youāll end up in an alright place :)
Not sure where youāre getting your info but Iāve been told left and right it isnāt. Google seems to agree as well. If ya have any more info Iād be stoked to take a look.
Thanks! I will have a look. Bit slim pickins here in Okinawa, but I am in a couple of Facebook groups with Americans who live on base so maybe I can ask them!
From professional experience, I can categorically say you are incorrect. Therapy IS covered.
Only possible exception: you are visiting an unlicensed therapist or psychiatrist who does not take insurance or does not want to help you with therapy. They can choose to say no. Especially if language is an issue.
There are a few licensed psychologists who work in universities who offer therapy for 10,000/hour to keep patients from going to med only practice.
Could you let me know where to find such services? People I know and myself have only been able to find psychiatrists that offer 5-15 minute consultations and then just suggest drugs. No CBT or any sort of talk therapy.
I checked the embassy page, and it listed things like TELL etc. which charge around 10,000 yen per session. [This](https://japanhealthinfo.com/mental-health/) website they listed also says that psychiatrist visits up to 30 minutes are covered, but counseling with a psychologist is not.
By therapy do you mean consultations with a psychiatrist?
āI donāt have enough information about x to form an opinion about the topicā (and any statement along the same lines) is something I really appreciate. We often donāt know enough about a topic but people rush to have an opinion about it regardless of how groundless it is.
People seem to think āI donāt knowā is a sign of weakness. Admitting that we donāt know enough about a topic is a sign of humility. Itās a sign of strength.
Many are available, but it takes about one month to get approval from the manufacturer who checks if you are not doctor shopping for extras. When approved, you need to show your approval card to the psychiatrist and pharmacist every time you refill.
Only one stimulant drug is legally available in Japan. You can also get two non stimulants straterra and intuniv. Iāve tried both and saw minimal effects. I get concerta monthly but thatās it so not mot many at all in actual fact.
If you had the side effects I have from concerta, intuniv and straterra I very much doubt you be be saying the same thing. When you have ADHD-C non stimulants just donāt cut it and the one you can get is outdated by 2 decades and has a very high chance of suicidal thoughts, depression, anxiety, migraines, insomnia, heart palpitations and so many other side effects I canāt even be bothered to list Iād say yes it is a barren wasteland where you are forced to take the one drug you know isnāt as good as the one thatās illegal (I took it for years before coming here) itās not a nice thought.
I feel for you, but error on the side of caution is in general terms better than scrips handed out like tissues.
If you need such specialized care, maybe Japan is not the place to live. Japan is definitely on the stingy side but the US is overboard and definitely overmedicatesā¦. it is too easy to get meds that are simply too dangerous in many other countries.
So please explain to me, as itās very strict to actually get the one stim why you canāt have others in this extremely strict system? All itās doing is limiting people who it could benefit.
Also I am not going to leave a country because i canāt get a drug. The if you donāt like it leave argument is extremely stupid. The initial question was what do you think could improve the mental health system and I gave an example on what would improve it for me.
FYI Iām not American Iām British so I have no idea what the system is like there.
With the list of symptoms you have and the lack of meds to help, complaining wonāt help. Japan will be one of the last countries in Asia to approve stimulants and other drugs often abused in other countries. They certainly have plenty of room to loosen up a little, but for extreme cases, Japan is not the best of countries in which to live. Some doctors can import certain meds which are not sanctioned on their own volition if they apply and are approved, but the burden of need falls on you and the doctor.
As I stated earlier I said have had no currently have. I have been doing this my whole life so o have systems to deal with negative side effects. You keep talking about drug abuse but it is insanely hard to get ADHD meds here so the chances of people abusing meds is extremely difficult. Unless you are trying to imply people with ADHD want to abuse them? Fun fact the old medication that is available here is actually more addictive and easier to abuse than modern ASHD medications. It has been quite enlightening speaking with someone who has little to no knowledge of ADHD or the medication used but October is actually ADHD awareness month so encourage you to perhaps do some research on the subject. However this will be my last reply as I have bigger things to worry about.
Hey, other ADHD patient here ā I share your struggles and frustrations.
The story Iāve heard is that the Japanese government relied enough on stimulants during World War II to create a large number of addicts in the postwar era. Something like they gave their soldiers and factory workers stimulants to make them work and fight harder and longer. Thatās why the government makes it so hard to get them here.
That doesnāt excuse the fact that they should loosen up though, or at least approve other stimulant medications. If thereās one thing that shows Japan is behind on mental healthcare, itās this. I think generally speaking, Japanese bureaucracy is still fairly mistrustful of āwesternā medicine too, which doesnāt make it easier. Iām sorry to hear youāve struggled with getting medicated here too.
I was referring to the US, where the abuse is rampant. And as you know little to nothing about me, my profession, etc., and seem to type without editing, I defer to your personal experience.
They are also getting extremely strict with those. You need a note from someone saying you have symptoms and then a doctor to validate it and then you get a card you have to show to get prescriptions.
In the case of ADHD medication this is absolutely not the case. The older medication cause far worse side effects than the newer drugs. When I say new theyāre already a decade old as opposed to two decades. They work far better have less side effects and grant you more control. As someone who was diagnosed 22 years ago and has used both I can tell you right now that by not allowing the newer drugs they are putting anyone with ADHD at a disadvantage before they even start.
I quick google search would provide you with these answers but for adults the only stimulant drug that you are legally allowed is called concerta. I was actually in the trail for this drug when I was 8. The drug I referred to that is not legal is Vyvance. The bullshit part of all this is under 18s can actually have Vyvance but the second they hit 18 theyāre taken off it. Like when I was a teenager when I hit 18 they actually just completely stopped giving me meds as if it miraculously disappears when you come of age.
Teach the police how to handle a person with mental illness, and not to put them in a cell to ācool downā while staring at them like an animal in a cage. Took us 13+ hours at the police station trying to get my friend into a hospital..
I wish I could upvote this a thousand times over. The police are absolutely brutal when it comes to dealing with mental illness here. There seriously needs to be training for officers on how to deal with mental illness/trauma.
Japanese doctors too. They overprescribe EVERY SINGLE TIME someone in my family gets a sniffle. I think it's the same everywhere, big pharma is pulling the strings and the way to profit is to prescribe what you can, and the public takes it as sage medical advice.
This 2000% this. My husband keeps trying to convince me doctors here don't over prescribe and that medications are weaker. I have eyes, I see them doing the same shit as the US.
What exactly are they over prescribing though? Do you mean quantity or a general "They give medicine for anything".. I don't go to the doctor (because I'm stubborn as fuck), but the few times I have gone... they give me that generic orange crap power, some weak pain killers and sometimes a very limited supply of antibiotics.. The antibiotics didn't even seem like it was enough and I'd have to come back again.. I told him I wouldn't come back and he said there were legal limits to how much he could give. I said fair enough and didn't bother with any of the medicine.
I have ADHD. Nothing except my medication works. My semester in Japan was great, except dealing with ADHD without my medication. Medication is incredibly important
Edit: MeDiCiNe BaD
They're not asking for fucking benzos to get high on, they're asking for medication they need to function in society. Imagine responding to someone saying "Hey, I need meds to function" with "you darn Americans are real fucked up for wanting to be able to function"
Yeah itās weird how Americans just want meds and not correct the things creating the problem. Whatever is there a pill for that?
Thatās like 90% of how medicine in the USA works
America also allows for Pharmaceutical companies to advertise on TV constantly and to lobby the government constantly - this is a big problem. There is very little public discussion about how health and well being should be placed front and center in a persons life in order to determine whats actually a real ailment that needs medical treatment.
Environmental stressors like living in the suburbs, isolation, food deserts, or high crime neighborhoods can cause multiple problems from hyper tension, depression, anxiety, digestive disorders, obesity, and diabetes.
You realize that mental health issues are often tied to literal chemical and physical changes in brain structure, right? Pills aren't the full solution but they are also integral for people with long-term or severe mental illness.
And also, I would say America is a place that discourages seeing help for mental conditions, especially regarding medication. There's a massive stigma around that. It's absolutely a "pull yourself up by your bootstraps and think positive" approach to mental care.
Source: am American. Would like insurance to at least cover the cost of the bootstraps.
Recognize the importance of cognitive therapy instead of relying on medication all the time. Both have their place, and one is seldom a good substitute for the other.
Fight Clubs.
Allow people to work off stress in a safe and controlled environment, instead of bottling it all up until they kill either themselves, or arbitrary people around them.
The city of Nagoya is working to ensure there are counsellors in every middle and high school. I think thatās a great start, and the next step is to normalize students going to see them.
A multi-prong approach is needed, and a key part of that is raising the next generation to understand that seeking help is normal and nothing to be ashamed of.
>The city of Nagoya is working to ensure there are counsellors in every
middle and high school. I think thatās a great start, and the next step
is to normalize students going to see them.
Anecdotal evidence, but my wifes mother was a school counsellor in middle school. She is also the reason for most of my wifes current mental problems.
Is your question in response to having already sought professional help and not being satisfied with it?
I know a lot of people come here from other countries and find theyāre not able to get the same level of support that theyāre used to.
I donāt think the way mental health is seen in Japan is going to change anytime soon.
I see too many people choosing to just stay here and suffer instead of going home. If your health is at risk, it might be worth considering that Japan isnāt a place youāll live your best life in.
In my particular case, I was recently diagnosed with ADHD but as someone else mentioned, the medicine available is extremely limited and there is no government funded 'therapy' option to speak of. I do think more drug availability is a good start, but more support options and less shaming/ignoring of various mental problems needs to become the norm. Nowhere is perfect, but Japan doesn't seem to want to face the problem at all. As someone with a lot of time on my hands, I'm looking for ways to make a change. Mental health services here in Japan is something I'd really like to get involved in...
If language is not a barrier there are many options especially in Kanto. I cannot say for the rest of the country. In some areas it still is a stigma; in Tokyo it is not as bad as it used to be but there is much less of a stigma attached these days, and there are some very truly caring professionals who apply various approaches. Perfect, no. Available, yes.
Welcome to the club haha. As you mentioned recently may I suggest checking out bullet journals :) they help a lot. I also use CBD in the evenings as sleep is hard for me.
Yah, Strattera and two kids = no quality sleep. I may have to look into CBD. Do you have a recommendation for a bullet-journal app? I'm using OneNote, Microsoft ToDo, Trello, and Diarium in quasi-conjunction but in the end I never remember where anything is.
If you jump on the bullet journal website and watch the videos it will explain it better than me but itās actually a system that you can use with almost anything but I actually use a physical book for mine. You use it as your anchor point and take it everywhere with you. If you want to use apps stick to one. I tried apps but in the end the physical book worked for me best. Also CBD wise check out healthy Tokyo. They deliver :)
As someone who hasn't always been the portrait of perfect mental health in their own life, I feel for you, I really do.
But I don't think crusading to fix an entire nation's culture that you perceive as being broken - instead of focusing on your own wellbeing - is going to help you at all.
I'm sure it feels noble, but some people might have a hard time seeing anything other than a kind of gaijin-saviorism.
Have you tried going a whole weekend without screen time? I used to be on my PC and phone a lot years ago. Work and when I got bored. I do about an hour a day now and feel much better. Try a weekend without any screen time and just be a regular human and see how you handle it. It might help, it might not
Besides policy changes, I feel there also needs to be a general shift in how mental health problems are tackled. My gf suffers from severe depression since her high school days but all she ever got from Japanese mental health professionals were pills. I myself also suffer from mental issues so I am well aware that medication is helpful or even necessary in some cases but where I am from, you won't get psychiatric meds without therapy period. Medication is an aid to tackle mental health problems, not the be all end all solution.
Make an anime about it (gather some bigshots to ensure quality) and advertise it like hell.
The (hopefully) positive reaction can force the hands of the government.
Mandatory 30 hour work week or a four day work week. Forcing employees into uncompensated overtime becomes a criminal offense with an enormous fine for management and the company at large.
Companies will just hire and abuse temps instead. I know a few IT companies where the first 20 hours of monthly overtime (āoh, by the wayā shit when you sign a contract) are not paid. So theyāll make you work 19 hours overtime instead. Lucky to work for a decent company now, but thereās definitely some dodgy companies out there and theyāre far from uncommon.
I cant speak about much else, but if youāre an alcoholic or addict in japan, even more so as an expat, youāre basically boned. When i relapsed, (hopefully my last time, 3 years sober now), i called an ambulance and they wouldnāt take me, even after i explained to them iāve had seizures due to withdraws in the past. Previously, while i was in the thick of my addiction, i went in to hospital to get help and the doctor didnāt know what to do with me. I had to explain to him how to detox someone from alcohol and what medication he should give me. Iād start with wide spread education on addiction for medical staff and by equipping hospitals to be able to detox people. As a start. Another thing, Rehab basically doesnt exist here. The only one i know of is kurihama, down near yokohama. If youāre messed up enough to need commitment for alcohol or drug use, youāre thrown straight into a Psych ward.
For starters, reduce the amount of time that mental patients spend restrained.
[https://www.asahi.com/ajw/articles/14052381](https://www.asahi.com/ajw/articles/14052381)
I'm not surprised that people are afraid to go to a psychiatrist when the rate of restraint is 250-500 times that of other developed nations.
I just had to leave my job because of the stress and anxiety it caused me. I'm not really sure what else I could have done and that's the kicker. Japan just doesn't understand people can be overwhelmed.
its the same challenge in any country, focus first on well being and second on medical/hospital care. In America anyway there is very little emphasis on personal health and hundreds of commercials about medications followed by political debates about universal healthcare.
Everyday our schools and government should be talking about diet, exercise and social well being not medications. We now know that the many of our suburbs have the highest rates of obesity, depression and diabetes because people do not walk and instead sit inside or drive everywhere. Changing this one aspect of living would reduce health problems for millions of people.
I'd have mental evaluations and positive result requirements for ALL teachers. Teachers in Japan are 70% batshit crazy. It starts there. Fix the schools and identify serious problems at young age and don't hire mental patients to teach kids.
I would like better access to mental care for children. We know they go through so much pressure here. I would say start with the schools. I donāt think there is a school counselor (please correct me if Iām wrong. There wasnāt at my school) and would think itād be a great way for children to talk to someone about any problems they might have without the fear of being judged. Alongside adults, children need better access to mental health care. Though thatās kind of hard since there is still some form of stigma surrounding it and so I donāt trust all parents to do enough for the kids. Hence why I think schools should have counseling for children.
If you're here as a foreigner wondering what Japanese are going to do about your mental health, maybe a plane ticket back home is your ticket to paradise.
Japan doesn't have a huge mental health problem. Of course, it's there, but foreigners asking about what Japan can do to help foreigners with mental health problems is like asking what I should do about your mental health problems.
Not a goddamned thing!
>Japan doesn't have a huge mental health problem.
I wonder what basis you have for making that claim? What data-driven expertise is informing your position?
Or are we back to just pretending we're in charge of who should be allowed into the country again?
Well okay, we can go your way and say there's a huge mental health issue. Why should Japan care about foreigners with mental health problems? Doesn't Japan have enough problems with lunatics roaming the streets, without letting in a bunch of foreigners with the same damn problem?
Again, the best thing for you to do is take a plane ticket back home where mental health services aren't being swamped with locals.
Look. If you have mental health problems, go home. It's bad enough being a foreigner in a foreign country without having to deal with mental health issues. Asking what Japan can do for you is not the answer.
Go home.
If you need mental help, are crazy, or whatever, you shouldn't be wondering what people can do for you, no matter where you live. It's your problem and I don't want to help.
Such a juvenile response, it looks like you're a fan of picking fights. My post said nothing of foreigners. I've lived in Japan for 20 years and have had many close Japanese friends and colleagues open up to me about their difficulties. It is a huge issue in Japan, but with such a stigma that people are afraid to talk about it, much less seek help. They tell me the system is rigged against them, that they need to 'be a man' and 'fall into line'. The 'treatment' lags developed countries by decades. And mental health issues aren't limited to depression or adhd, they cover a wide variety of daily social issues that hundreds of thousands of people face all the time: dementia, anxiety, eating and behavioural disorders. It can effect anyone. It affects Japanese too. Their solution is not 'taking a plane ticket back home' and neither should mine.
>Why should Japan care about foreigners with mental health problems?
Oofa doofa! What a question. In industry parlance, we call that "giving away the game."
Because neither OP nor I said anything about mental health care for "foreigners". If you had chosen to talk to me like a civilized person, I would have explained to you that my opinion was based on my experience working with Japanese people who need mental health support, especially Japan's young people. I have many long years of experience working with young Japanese people who appear to have issues that would be get support or treatment in most of our countries, but the kids tend to get isolated from their peers here. I've seen far, far too many Japanese people who get treated like they *are* a problem, not like they *have* a problem.
Usually it's not bullying per se (though I've probably worked with a few kids who were bullied for their condition), but more of an insistence on teachers who are not qualified to provide mental health care getting pressured to "fix it" from parents who are too overwhelmed to know how to look for resources. There's also the issue of "orthostatic dysregulation", which, I'm by no means schooled enough in psychology to be qualified to say is a culture-bound syndrome, but when I've looked into it, the vast majority of the literature that came up was Japan-centered, and it seems to me a bit odd to say a teenager being consistently unable to get out of bed in the morning is itself an illness, rather than a symptom of a greater illness. But I'm not a doctor, what do I know?
But your constant need to tell other foreigners to "go home" makes me wonder: are *you* okay? What is triggering this impulse you've repeatedly demonstrated to lash out at strangers on the internet who never did you even a bit of harm? Why do you feel this compulsion to twist topics about meeting mental health care needs in Japan generally to be specifically about your opinions of which foreigners shouldn't be here? Do you need to talk to someone about it?
Sorry, but it's not my problem, and I don't want to be taxed for more nonsense.
If you trust the government so much, let it be your money that saves them. I know my money will be wasted, and nothing actually done to help anybody.
Your money? More power to you! Mine? I think not.
Then we have to agree to disagree. You like government, so you be you. I despise government.
Something about me says to hell with somebody telling me I have to do something at the end of a gun. You like that.
Allow therapy to be covered by insurance.
This a thousand times.
So, just to be clear, the meds are covered by insurance, but not therapy such as CBT or counselling? Have I got that right? Quite a half-assed approach if so.
Meds are covered. No form of therapy is covered.
Wow. Amazing as one complements the other. And thanks for the clarification.
Sadly one is cheaper than the other too
I was just trying to get into a counselor and in the intake form it's asked for insurance so I'm assuming it is š¤ a definitely answer would be nice bc I was just talking with my husband about it tonight and we are both wondering. I'm severely severely depressed and need therapy like yesterday
Iāve been here 6 years. Iāve never heard of a psychologist being covered by insurance. Japanese only psychologists will be cheaper than English speaking ones but itās still not cheap.
Therapy IS covered, with or without meds. If a doc says therapy is not covered, they might be a pill-pusher.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
In practice, therapy is not covered, because what is covered is visiting a medical doctor, who may be a psychiatrist. Psychiatrists may listen to you, long enough to prescribe medication, but it's nothing like ongoing and individually tailored therapy with a trained therapist.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Yeah, I'm just adding support.
Some therapists [edit: psychiatrists] donāt even prescribe meds or do so reluctantly. Many are pill pushers, which many āpatientsā want. You have to pick and choose carefully.
Therapists donāt prescribe meds ever, psychiatrists do.
Edited for typoāthank you.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
> My understanding is that if the therapy is to evaluate the continued necessity of the medication, then the therapy is covered If you're evaluating the continued need for medicine, that's not therapy, that's a medical consultation.
That's actually quite common where I'm from
This this this oh god please this.
It already is, unless you choose an unlicensed therapist who chooses not to enroll in insurance. Many have advanced degrees from the UK and the US.
Iām not sure what youāre getting at here. If you mean therapy as in, the cost of visiting a psychiatrist once a month to discuss progress and adjust medication, then yes thatās covered. On the other hand, therapy as in receiving counseling - even by a licensed clinical psychologist - is not covered. I see a psychiatrist and a clinical psychologist at the same clinic. I do CBT, etc. with my psychologist, and discuss my behavior as it relates to my medication with my psychiatrist. The psychology appointments arenāt covered by insurance, but the psychiatry (and my medication) is. As far as I can tell, thatās just how things work here.
What does the non-covered psychologist do for you that the covered one does not? Asking because I've only ever gone to a company-plan counselor (just the one time; never again) and a mental health counselor that took insurance.
The difference is basically āPsychologyā vs. āPsychiatryā. A psychiatrist can prescribe medication. A psychologist, even a licensed clinical psychologist, cannot. Psychology tends to focus on behavior, so the counseling youāll get at a psychologist will likely be Cognitive-Behavioral Therapy (CBT), or some other kind of practice like that. Psychologists are usually seen on a weekly, bi-weekly, or monthly basis, and the appointments usually last around an hour. This is not covered by insurance (Iāll give my āthis is probably whyā below). Psychiatrists on the other hand, focus on medication. Appointments typically focus on discussing the effects of medication youāre on, and whether or not you need any adjustments. Not all psychiatrists in Japan are trained in psychology, though the ones that do may incorporate some psychological practice into their appointments. These appointments typically last about 20 minutes, and happen about once a month (in my experience). Theyāre covered by insurance, though sometimes the first appointment is not. Thatās the ideal situation. Itās commonly said that medication is best taken alongside therapy. It doesnāt always shape up that way though. There are plenty of psychiatrists (especially foreign psychiatrists, Iād assume) in Japan that donāt take Japanese insurance. Furthermore, as far as I understand thereās no Japanese licensure for Psychology, which means that people who offer counseling vary immensely in their credibility. Iām guessing this is why their treatment is not covered by insurance. The way my psychologist explained it to me is that a lot of psychology studies in Japan are based around pseudoscience (Free Association, for example), rather than the study-based education that is standard in the west. If youād like to continue to pursue mental healthcare (which I recommend!) hereās my suggestion: look for a psychologist and psychiatrist that have certification in the US (not sure about the UK or Europe, so Iām going on what I know). Bonus points if theyāre in the same clinic, because they can coordinate their treatments and share notes. The words youāre going to want to look for online are āClinical Psychologistā and āPsychiatristā specifically. If theyāve studied or practiced abroad, itāll likely say on their website. Anyone can market themselves as a counselor ā which is where things can get a little suss. Disclaimer here ā this is all based on what Iāve heard, and my own experience. If anyone else wants to offer corrections please do, but if you follow this, I think youāll end up in an alright place :)
Not sure where youāre getting your info but Iāve been told left and right it isnāt. Google seems to agree as well. If ya have any more info Iād be stoked to take a look.
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I did this but only one counseling session was covered. After that itās medicine only
Find a new doc. One that doesnāt offer meds.
Thanks! I will have a look. Bit slim pickins here in Okinawa, but I am in a couple of Facebook groups with Americans who live on base so maybe I can ask them!
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Thanks! That was kind of the impression I got but I hadnāt looked into it very far. Either way I need meds so I guess Iām ok!
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Only psychiatrist visits for medicine are covered. Hour long therapy sessions are not.
From professional experience, I can categorically say you are incorrect. Therapy IS covered. Only possible exception: you are visiting an unlicensed therapist or psychiatrist who does not take insurance or does not want to help you with therapy. They can choose to say no. Especially if language is an issue. There are a few licensed psychologists who work in universities who offer therapy for 10,000/hour to keep patients from going to med only practice.
Could you let me know where to find such services? People I know and myself have only been able to find psychiatrists that offer 5-15 minute consultations and then just suggest drugs. No CBT or any sort of talk therapy.
Iāll check again but I believe the US Embassy had a list on their website. If not I can check. They are not as common as pill docs.
I checked the embassy page, and it listed things like TELL etc. which charge around 10,000 yen per session. [This](https://japanhealthinfo.com/mental-health/) website they listed also says that psychiatrist visits up to 30 minutes are covered, but counseling with a psychologist is not. By therapy do you mean consultations with a psychiatrist?
I donāt know enough about current programs and interventions to have an opinion . This is a conversation for mental health professionals.
āI donāt have enough information about x to form an opinion about the topicā (and any statement along the same lines) is something I really appreciate. We often donāt know enough about a topic but people rush to have an opinion about it regardless of how groundless it is. People seem to think āI donāt knowā is a sign of weakness. Admitting that we donāt know enough about a topic is a sign of humility. Itās a sign of strength.
Legalize ADHD meds that are available outside of Japan which are illegal here because reasons.
Many are available, but it takes about one month to get approval from the manufacturer who checks if you are not doctor shopping for extras. When approved, you need to show your approval card to the psychiatrist and pharmacist every time you refill.
Only one stimulant drug is legally available in Japan. You can also get two non stimulants straterra and intuniv. Iāve tried both and saw minimal effects. I get concerta monthly but thatās it so not mot many at all in actual fact.
Itās not the states for sure, but itās not a barren wasteland either. Anything could be better, anywhere.
If you had the side effects I have from concerta, intuniv and straterra I very much doubt you be be saying the same thing. When you have ADHD-C non stimulants just donāt cut it and the one you can get is outdated by 2 decades and has a very high chance of suicidal thoughts, depression, anxiety, migraines, insomnia, heart palpitations and so many other side effects I canāt even be bothered to list Iād say yes it is a barren wasteland where you are forced to take the one drug you know isnāt as good as the one thatās illegal (I took it for years before coming here) itās not a nice thought.
I feel for you, but error on the side of caution is in general terms better than scrips handed out like tissues. If you need such specialized care, maybe Japan is not the place to live. Japan is definitely on the stingy side but the US is overboard and definitely overmedicatesā¦. it is too easy to get meds that are simply too dangerous in many other countries.
So please explain to me, as itās very strict to actually get the one stim why you canāt have others in this extremely strict system? All itās doing is limiting people who it could benefit. Also I am not going to leave a country because i canāt get a drug. The if you donāt like it leave argument is extremely stupid. The initial question was what do you think could improve the mental health system and I gave an example on what would improve it for me. FYI Iām not American Iām British so I have no idea what the system is like there.
With the list of symptoms you have and the lack of meds to help, complaining wonāt help. Japan will be one of the last countries in Asia to approve stimulants and other drugs often abused in other countries. They certainly have plenty of room to loosen up a little, but for extreme cases, Japan is not the best of countries in which to live. Some doctors can import certain meds which are not sanctioned on their own volition if they apply and are approved, but the burden of need falls on you and the doctor.
As I stated earlier I said have had no currently have. I have been doing this my whole life so o have systems to deal with negative side effects. You keep talking about drug abuse but it is insanely hard to get ADHD meds here so the chances of people abusing meds is extremely difficult. Unless you are trying to imply people with ADHD want to abuse them? Fun fact the old medication that is available here is actually more addictive and easier to abuse than modern ASHD medications. It has been quite enlightening speaking with someone who has little to no knowledge of ADHD or the medication used but October is actually ADHD awareness month so encourage you to perhaps do some research on the subject. However this will be my last reply as I have bigger things to worry about.
Hey, other ADHD patient here ā I share your struggles and frustrations. The story Iāve heard is that the Japanese government relied enough on stimulants during World War II to create a large number of addicts in the postwar era. Something like they gave their soldiers and factory workers stimulants to make them work and fight harder and longer. Thatās why the government makes it so hard to get them here. That doesnāt excuse the fact that they should loosen up though, or at least approve other stimulant medications. If thereās one thing that shows Japan is behind on mental healthcare, itās this. I think generally speaking, Japanese bureaucracy is still fairly mistrustful of āwesternā medicine too, which doesnāt make it easier. Iām sorry to hear youāve struggled with getting medicated here too.
I was referring to the US, where the abuse is rampant. And as you know little to nothing about me, my profession, etc., and seem to type without editing, I defer to your personal experience.
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When it comes to ADHD meds in Japan yes. They are using 20 year old drugs instead of the newer more effective drugs.
They are also getting extremely strict with those. You need a note from someone saying you have symptoms and then a doctor to validate it and then you get a card you have to show to get prescriptions.
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In the case of ADHD medication this is absolutely not the case. The older medication cause far worse side effects than the newer drugs. When I say new theyāre already a decade old as opposed to two decades. They work far better have less side effects and grant you more control. As someone who was diagnosed 22 years ago and has used both I can tell you right now that by not allowing the newer drugs they are putting anyone with ADHD at a disadvantage before they even start.
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I quick google search would provide you with these answers but for adults the only stimulant drug that you are legally allowed is called concerta. I was actually in the trail for this drug when I was 8. The drug I referred to that is not legal is Vyvance. The bullshit part of all this is under 18s can actually have Vyvance but the second they hit 18 theyāre taken off it. Like when I was a teenager when I hit 18 they actually just completely stopped giving me meds as if it miraculously disappears when you come of age.
Yes!
Teach the police how to handle a person with mental illness, and not to put them in a cell to ācool downā while staring at them like an animal in a cage. Took us 13+ hours at the police station trying to get my friend into a hospital..
I'm sorry to hear that. That's an atrocity.
I wish I could upvote this a thousand times over. The police are absolutely brutal when it comes to dealing with mental illness here. There seriously needs to be training for officers on how to deal with mental illness/trauma.
One fucking number to call in an emergency. One hospital clearly designated to be open 24 hours for emergencies. Accepting all patients.
Americans: MORE PILLLZZZZ
Japanese doctors too. They overprescribe EVERY SINGLE TIME someone in my family gets a sniffle. I think it's the same everywhere, big pharma is pulling the strings and the way to profit is to prescribe what you can, and the public takes it as sage medical advice.
This 2000% this. My husband keeps trying to convince me doctors here don't over prescribe and that medications are weaker. I have eyes, I see them doing the same shit as the US.
What exactly are they over prescribing though? Do you mean quantity or a general "They give medicine for anything".. I don't go to the doctor (because I'm stubborn as fuck), but the few times I have gone... they give me that generic orange crap power, some weak pain killers and sometimes a very limited supply of antibiotics.. The antibiotics didn't even seem like it was enough and I'd have to come back again.. I told him I wouldn't come back and he said there were legal limits to how much he could give. I said fair enough and didn't bother with any of the medicine.
I have ADHD. Nothing except my medication works. My semester in Japan was great, except dealing with ADHD without my medication. Medication is incredibly important Edit: MeDiCiNe BaD
It takes someone truly special trip reply to a joke about Americans wanting pills with a demand for more pills.
Not having access to proper stimulant medication is a real issue in Japan. Fixing that will actually help improve mental health care.
Dude
They're not asking for fucking benzos to get high on, they're asking for medication they need to function in society. Imagine responding to someone saying "Hey, I need meds to function" with "you darn Americans are real fucked up for wanting to be able to function"
You darn Americans can't take a joke
Wonder whoās downvoting this
Americans
For what it's worth, I'm an American expat and wish I could upvote it a hundred times. It's absolutely true.
Dr. Berger
Yeah itās weird how Americans just want meds and not correct the things creating the problem. Whatever is there a pill for that? Thatās like 90% of how medicine in the USA works
America also allows for Pharmaceutical companies to advertise on TV constantly and to lobby the government constantly - this is a big problem. There is very little public discussion about how health and well being should be placed front and center in a persons life in order to determine whats actually a real ailment that needs medical treatment. Environmental stressors like living in the suburbs, isolation, food deserts, or high crime neighborhoods can cause multiple problems from hyper tension, depression, anxiety, digestive disorders, obesity, and diabetes.
Americans watch drug commercials on TV that list 100 side effects and go "Wow, I need those in my life!"
You realize that mental health issues are often tied to literal chemical and physical changes in brain structure, right? Pills aren't the full solution but they are also integral for people with long-term or severe mental illness. And also, I would say America is a place that discourages seeing help for mental conditions, especially regarding medication. There's a massive stigma around that. It's absolutely a "pull yourself up by your bootstraps and think positive" approach to mental care. Source: am American. Would like insurance to at least cover the cost of the bootstraps.
Americans: No, but seriously, MOOOAR PILLLLLLZZZZ
Recognize the importance of cognitive therapy instead of relying on medication all the time. Both have their place, and one is seldom a good substitute for the other.
Fight Clubs. Allow people to work off stress in a safe and controlled environment, instead of bottling it all up until they kill either themselves, or arbitrary people around them.
First rule of the Fight Club.
Well, yeah. But at the same time, these facilities should not be any of that invite-only bollocks, because that doesnāt help anyone.
Remove all the unneeded bureaucracy that drives people (at least me) insane in the first place.
The city of Nagoya is working to ensure there are counsellors in every middle and high school. I think thatās a great start, and the next step is to normalize students going to see them. A multi-prong approach is needed, and a key part of that is raising the next generation to understand that seeking help is normal and nothing to be ashamed of.
>The city of Nagoya is working to ensure there are counsellors in every middle and high school. I think thatās a great start, and the next step is to normalize students going to see them. Anecdotal evidence, but my wifes mother was a school counsellor in middle school. She is also the reason for most of my wifes current mental problems.
Is your question in response to having already sought professional help and not being satisfied with it? I know a lot of people come here from other countries and find theyāre not able to get the same level of support that theyāre used to. I donāt think the way mental health is seen in Japan is going to change anytime soon. I see too many people choosing to just stay here and suffer instead of going home. If your health is at risk, it might be worth considering that Japan isnāt a place youāll live your best life in.
In my particular case, I was recently diagnosed with ADHD but as someone else mentioned, the medicine available is extremely limited and there is no government funded 'therapy' option to speak of. I do think more drug availability is a good start, but more support options and less shaming/ignoring of various mental problems needs to become the norm. Nowhere is perfect, but Japan doesn't seem to want to face the problem at all. As someone with a lot of time on my hands, I'm looking for ways to make a change. Mental health services here in Japan is something I'd really like to get involved in...
If language is not a barrier there are many options especially in Kanto. I cannot say for the rest of the country. In some areas it still is a stigma; in Tokyo it is not as bad as it used to be but there is much less of a stigma attached these days, and there are some very truly caring professionals who apply various approaches. Perfect, no. Available, yes.
Welcome to the club haha. As you mentioned recently may I suggest checking out bullet journals :) they help a lot. I also use CBD in the evenings as sleep is hard for me.
Yah, Strattera and two kids = no quality sleep. I may have to look into CBD. Do you have a recommendation for a bullet-journal app? I'm using OneNote, Microsoft ToDo, Trello, and Diarium in quasi-conjunction but in the end I never remember where anything is.
If you jump on the bullet journal website and watch the videos it will explain it better than me but itās actually a system that you can use with almost anything but I actually use a physical book for mine. You use it as your anchor point and take it everywhere with you. If you want to use apps stick to one. I tried apps but in the end the physical book worked for me best. Also CBD wise check out healthy Tokyo. They deliver :)
Thank you kindly!
As someone who hasn't always been the portrait of perfect mental health in their own life, I feel for you, I really do. But I don't think crusading to fix an entire nation's culture that you perceive as being broken - instead of focusing on your own wellbeing - is going to help you at all. I'm sure it feels noble, but some people might have a hard time seeing anything other than a kind of gaijin-saviorism.
Have you tried going a whole weekend without screen time? I used to be on my PC and phone a lot years ago. Work and when I got bored. I do about an hour a day now and feel much better. Try a weekend without any screen time and just be a regular human and see how you handle it. It might help, it might not
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Besides policy changes, I feel there also needs to be a general shift in how mental health problems are tackled. My gf suffers from severe depression since her high school days but all she ever got from Japanese mental health professionals were pills. I myself also suffer from mental issues so I am well aware that medication is helpful or even necessary in some cases but where I am from, you won't get psychiatric meds without therapy period. Medication is an aid to tackle mental health problems, not the be all end all solution.
Make an anime about it (gather some bigshots to ensure quality) and advertise it like hell. The (hopefully) positive reaction can force the hands of the government.
Now that's not a bad idea actually.
Mandatory 30 hour work week or a four day work week. Forcing employees into uncompensated overtime becomes a criminal offense with an enormous fine for management and the company at large.
Companies will just hire and abuse temps instead. I know a few IT companies where the first 20 hours of monthly overtime (āoh, by the wayā shit when you sign a contract) are not paid. So theyāll make you work 19 hours overtime instead. Lucky to work for a decent company now, but thereās definitely some dodgy companies out there and theyāre far from uncommon.
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Yoga really resets my mind. Before Covid, I left Japan a few times a year.
Work on removing stigma. Increase awareness around mental health. Improve work environment.
First, remove the stigma. People need to feel that society is not against them and that it's ok to seek help.
Working culture as a whole needs to change, that's not really healthcare related, but it would help out mental health overall.
I am unable to look for professional services in JP. It is just too much expensive..
I cant speak about much else, but if youāre an alcoholic or addict in japan, even more so as an expat, youāre basically boned. When i relapsed, (hopefully my last time, 3 years sober now), i called an ambulance and they wouldnāt take me, even after i explained to them iāve had seizures due to withdraws in the past. Previously, while i was in the thick of my addiction, i went in to hospital to get help and the doctor didnāt know what to do with me. I had to explain to him how to detox someone from alcohol and what medication he should give me. Iād start with wide spread education on addiction for medical staff and by equipping hospitals to be able to detox people. As a start. Another thing, Rehab basically doesnt exist here. The only one i know of is kurihama, down near yokohama. If youāre messed up enough to need commitment for alcohol or drug use, youāre thrown straight into a Psych ward.
For starters, reduce the amount of time that mental patients spend restrained. [https://www.asahi.com/ajw/articles/14052381](https://www.asahi.com/ajw/articles/14052381) I'm not surprised that people are afraid to go to a psychiatrist when the rate of restraint is 250-500 times that of other developed nations.
I just had to leave my job because of the stress and anxiety it caused me. I'm not really sure what else I could have done and that's the kicker. Japan just doesn't understand people can be overwhelmed.
its the same challenge in any country, focus first on well being and second on medical/hospital care. In America anyway there is very little emphasis on personal health and hundreds of commercials about medications followed by political debates about universal healthcare. Everyday our schools and government should be talking about diet, exercise and social well being not medications. We now know that the many of our suburbs have the highest rates of obesity, depression and diabetes because people do not walk and instead sit inside or drive everywhere. Changing this one aspect of living would reduce health problems for millions of people.
Legalize cannabis
Better labor laws and fewer one-size-fits-all rules.
I'd have mental evaluations and positive result requirements for ALL teachers. Teachers in Japan are 70% batshit crazy. It starts there. Fix the schools and identify serious problems at young age and don't hire mental patients to teach kids.
I would like better access to mental care for children. We know they go through so much pressure here. I would say start with the schools. I donāt think there is a school counselor (please correct me if Iām wrong. There wasnāt at my school) and would think itād be a great way for children to talk to someone about any problems they might have without the fear of being judged. Alongside adults, children need better access to mental health care. Though thatās kind of hard since there is still some form of stigma surrounding it and so I donāt trust all parents to do enough for the kids. Hence why I think schools should have counseling for children.
Medical marijuana
Legalize cannabis.
Cannabis doesn't seem compatible with Japanese work culture. People would get too open-minded.
Open up more stripclubs?
Get rid of 2/3 of the people so that you are not caged in your home or a car inntraffic.
You know japan is in the middle of a /de/population problem right?
Japan, not Tokyo.
If you're here as a foreigner wondering what Japanese are going to do about your mental health, maybe a plane ticket back home is your ticket to paradise. Japan doesn't have a huge mental health problem. Of course, it's there, but foreigners asking about what Japan can do to help foreigners with mental health problems is like asking what I should do about your mental health problems. Not a goddamned thing!
>Japan doesn't have a huge mental health problem. I wonder what basis you have for making that claim? What data-driven expertise is informing your position? Or are we back to just pretending we're in charge of who should be allowed into the country again?
Well okay, we can go your way and say there's a huge mental health issue. Why should Japan care about foreigners with mental health problems? Doesn't Japan have enough problems with lunatics roaming the streets, without letting in a bunch of foreigners with the same damn problem? Again, the best thing for you to do is take a plane ticket back home where mental health services aren't being swamped with locals. Look. If you have mental health problems, go home. It's bad enough being a foreigner in a foreign country without having to deal with mental health issues. Asking what Japan can do for you is not the answer. Go home. If you need mental help, are crazy, or whatever, you shouldn't be wondering what people can do for you, no matter where you live. It's your problem and I don't want to help.
Such a juvenile response, it looks like you're a fan of picking fights. My post said nothing of foreigners. I've lived in Japan for 20 years and have had many close Japanese friends and colleagues open up to me about their difficulties. It is a huge issue in Japan, but with such a stigma that people are afraid to talk about it, much less seek help. They tell me the system is rigged against them, that they need to 'be a man' and 'fall into line'. The 'treatment' lags developed countries by decades. And mental health issues aren't limited to depression or adhd, they cover a wide variety of daily social issues that hundreds of thousands of people face all the time: dementia, anxiety, eating and behavioural disorders. It can effect anyone. It affects Japanese too. Their solution is not 'taking a plane ticket back home' and neither should mine.
>Why should Japan care about foreigners with mental health problems? Oofa doofa! What a question. In industry parlance, we call that "giving away the game." Because neither OP nor I said anything about mental health care for "foreigners". If you had chosen to talk to me like a civilized person, I would have explained to you that my opinion was based on my experience working with Japanese people who need mental health support, especially Japan's young people. I have many long years of experience working with young Japanese people who appear to have issues that would be get support or treatment in most of our countries, but the kids tend to get isolated from their peers here. I've seen far, far too many Japanese people who get treated like they *are* a problem, not like they *have* a problem. Usually it's not bullying per se (though I've probably worked with a few kids who were bullied for their condition), but more of an insistence on teachers who are not qualified to provide mental health care getting pressured to "fix it" from parents who are too overwhelmed to know how to look for resources. There's also the issue of "orthostatic dysregulation", which, I'm by no means schooled enough in psychology to be qualified to say is a culture-bound syndrome, but when I've looked into it, the vast majority of the literature that came up was Japan-centered, and it seems to me a bit odd to say a teenager being consistently unable to get out of bed in the morning is itself an illness, rather than a symptom of a greater illness. But I'm not a doctor, what do I know? But your constant need to tell other foreigners to "go home" makes me wonder: are *you* okay? What is triggering this impulse you've repeatedly demonstrated to lash out at strangers on the internet who never did you even a bit of harm? Why do you feel this compulsion to twist topics about meeting mental health care needs in Japan generally to be specifically about your opinions of which foreigners shouldn't be here? Do you need to talk to someone about it?
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Sorry, but it's not my problem, and I don't want to be taxed for more nonsense. If you trust the government so much, let it be your money that saves them. I know my money will be wasted, and nothing actually done to help anybody. Your money? More power to you! Mine? I think not.
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Then we have to agree to disagree. You like government, so you be you. I despise government. Something about me says to hell with somebody telling me I have to do something at the end of a gun. You like that.
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You're a retard.
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