Cultural Constraints for Mental Health Care in Japan: Patterns and Correlates

An extensive body of literature has documented the under-utilization of mental health services among Asian populations, regardless of where they live. While Japan is one of the Asian countries where the mental health care provision system has improved substantially in the past decade, it is still reported that 80% of those with 12-month DSM-IV disorders do not receive any mental health services (Naganuma et al. 2006). According to the World Health Organization’s (WHO) psychiatric epidemiological surveys, the estimated under-utilization of services in Japan was considerably higher than that found in other developed countries (WHO 2004). The cultural climate, which includes the stock of cultural knowledge surrounding mental illness among the public in Japan, is considered one of the important causes of this under-utilization and of the resulting health disparities. However, previous studies have not fully examined whether and　how constrained the cultural choices are among the Japanese population. This is partly due to the methodological limitations of these studies which have not yet explored the types of mental health care Japanese actually suggest in case of mental health problems and which social factors shape such decisions. As a part of the Stigma in Global Context—Mental Health Study (SGC-MHS), we examined culturally acceptable suggestions for mental health problems in a nationally representative sample of Japanese individuals. The results of the preliminary analyses showed that there are several different cultural patterns in the recommendation of mental health care among the Japanese. Furthermore, the results of regression analyses showed that these patterns are affected by various social and psychological factors, including the beliefs and attitudes toward those with mental health problems.