A Disability of the Soul

Japan has a wonderful record when it comes to education. Their reputation is one of absolutely no wrong, and I believe every word of it. But a classmate from graduate school, who taught English in Japan, had seen what they keep hidden; the special needs students are warehoused in the basement. I also read an article by artist Takashi Murakami, where he says that people with deformities, dermatitis, or obesity are not accepted when in Japan. My research tells me that retarded people are welcomed in the Yakuza gangs, but not much else. So what does a seemingly flawless country like Japan do about the mentally ill? Something tells me it can’t be good.

From the outset I was predisposed to some facts. I know that Japan is smaller than the USA, fewer people to care for, homogenous, non-religious. With their ethic of self-discipline, mental illness must be stigmatizing, and according to the book, I was right. The author says that mentally ill people are warehoused, and their families are loath to talk about it. I’m not surprised, because it was the same thing with upper-class English families until recently. Having a child who was retarded could be disguised as “eccentricity,” but mental illness or epilepsy had to be hidden.

The history of Japan’s care for the mentally ill is bad. In the 1970’s a reporter named Kazuo Okuma went undercover as an alcoholic, and found that the mental facilities were horrific-overcrowded, no time for therapy, Alzheimer’s patients were locked up for days at a time, and they were used for voter fraud. As for psychiatry, the laws were lax, any MD could practice it. The Utsunomiya Hospital scandal revealed a patient beaten to death by orderlies.

But there are improvements, though few. Bethel House is an outpatient commune on the island of Hokaido, and it offers a place where mentally ill adults can work together to help each other cope. Most of them were successful in their jobs until they started hearing voices, feeling paranoid, etc. One middle aged mental patient was in the same hospital for 37 years. He’d rather not leave, because he has no job skills, no friends, nowhere to go, and his family has long since given up on him.

Hokaido is also the home of the Ainu, Japan’s indigenous people. Among the Ainu, mentally ill people were appointed Shaman, or holy people. It was thought that they had a connection to the spirit world. But among the Japanese, mental illness is seen as a flaw in moral character. Whatever problem Japan has in dealing with the mentally ill, it’s all the result of the social norms, not economics.