Stigma of Mental Illness in Japan

This paper examines how people who self-identify as having mental illnesses or neurodivergent conditions that are labeled as mental illnesses in the Japanese health care system, manage stigma and potential stigma in Japanese society. Specifically, the paper explores how individuals in Japan weigh stigma and the potential for stigma against the potential benefits of obtaining medical diagnoses that bring opportunities to receive state health and employment benefits. It discusses how individuals consider whether or not to obtain a diagnosis of mental illness, to “come out” to workplace colleagues, and to apply for state benefits based on a mental illness diagnosis. It considers how these decisions may be related to factors such as gender, age, and educational and income level. The findings are based on research conducted between 2017 and 2023 in Osaka and Tokyo involving interviews of individuals with neurodivergent conditions labeled as mental illness in Japan, and participant observation in self-help groups organized by and for individuals with these conditions. The paper argues that new labels for mental illness in Japan provide opportunities for individuals to better understand their condition even as these labels create new categories and stereotypes, and new forms of stigma. The paper argues that economic necessity – the need to find employment – often overrides concerns about stigmatization, as individuals choose to accept a stigmatizing label if they are able to find work under government disability programmes. At the same time, individuals report that negative feelings related to stigmatizing categories of mental illness are often alleviated by finding others who share a similar diagnosis. The paper also discusses the policy suggestion that to reduce stigmatization and fears of stigmatization, the Japanese health ministry may avoid using “mental illness” as a broad category of disability and instead only recognize specific medical conditions.