There is an undeniable stress and numerous emotional hurdles that come with living in an unfamiliar place. Mental health issues can affect anyone, and luckily the topic is being more normalized thanks to social media and the shifting culture towards it. However, this doesn’t mean that access to mental health resources is easier than before. Finding mental health care in general is hard, but finding help for your mental health in Japan could be more difficult due to language barriers and limited options.
A note: this article is about mental health and mental illnesses so it may mention topics of anxiety, depression and suicidal thoughts. This may be triggering if you are experiencing or have experienced such issues. Please call 119 (in Japan) or you local emergency hotline in an emergency. Always seek advice from a mental health professional before making any decision regarding treatment of yourself or others.
Finding Help for Your Mental Health in Japan Doesn’t Have to Be So Hard
In Japan, broadly speaking, the majority of hospitals and clinics take Japanese health insurance with the exception of a few clinics. Psychiatric and psychosomatic care is covered by insurance while many counseling services are not. We know that finding out which clinic takes your insurance or which counselor speaks your language can be exhausting.
Here are some services you can use:
1) Your Local Hospital
Most towns and cities have a local government-run hospital. If you currently live in a remote area, you can try to find a hospital in the nearest city in your prefecture. These hospitals tend to be referal hospitals that offer many specialized services ranging from Psychiatry to Endocrinology
If you are going to a local hospital, depending on the hospital rules, you might need a referral letter from a general practitioner stating the issues you are concerned about. Having a referral letter can help speed up the process of seeing a doctor. Your initial appointment might take a long time depending on the size of the hospital, so you might need to make an appointment way in advance.
If you are a student at a university, you can reach out to your school counselors who may act as translators for you when speaking to hospital officials. Speaking to your school counselor will also help you understand what options you have available to you depending on the city or town you live in.
If you happen to not be a student, you might want to ask a trusted friend to do the translation for you. Some hospitals might have a translation device that you can use, however, using a device or google translate can be frustrating when trying to explain something complicated. If you don’t have any Japanese speaking friends nor have a hospital near you that uses a translation device, you may need to travel a bit further into a bigger city to find the right hospital.
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2) Private Clinics and Counseling Services
Frustratingly, most of the private clinics are located in big cities like Tokyo. However, depending on your situation, a trip may be necessary to get the help you need. Here are some places that accept non-japanese speakers.
1. Yotsuya- Yui Clinic
Yotsuya-Yui Clinic is one of the few that offers both counseling and outpatient psychiatric care all in English. They do have services in other languages such as Spanish, Portuguese and Korean speakers. They accept Japanese national health insurance and jiritsu shien iryo (自立支援医療). Appointments need to be made weeks or days in advance as they do not accept walk-ins.
2. International Mental Health Professionals Japan (IMPHJ)
The International Mental Health Professionals Japan (IMHPJ) contains a directory for professionals that offer mental health care in Japan. The directory consists of psychiatrists, counselors, therapists, psychotherapists and social workers that are currently practicing in Japan. Although it may be difficult, going through the directory to see the background of each professional and their specialities along with the services they provide can be really helpful to find the right fit for you. You will have to contact each professional directly to set up an appointment and ask about payment options. You could also ask the individual if a reduced payment option is available for those with low income.
3. Tokyo Mental Health
This is another place that offers both counseling and outpatient psychiatric care for non-Japanese. However, Tokyo Mental Health does not take insurance and all costs must be covered out of pocket. When it comes to obtaining prescriptions, the doctors will issue and fill the prescription in-house; meaning there is no need to take your prescription to a pharmacist as they have an in-house pharmacy that will fill your prescription. They do offer psychological testing such as testing for Attention Deficit Hyperactivity Disorder (ADHD), Autism spectrum disorder and learning disabilities. As mentioned earlier, the only downside is that everything here must be paid out of pocket which could be very expensive.
4.TELL (Tokyo English Life Line)
TELL is an organization that not only provides counseling services both for individuals and families. They have several offices in Tokyo, Yokohama, Kyoto and Okinawa. They also offer distance counseling for those who are not able to attend physical counseling. However, this is another one that does not take Japanese health insurance. If you do have health insurance from overseas, you can call to ask if they take your specific insurance provider.
One great aspect of TELL is that they charge patients based on a sliding scale fee system. This means that the amount charged per counseling session depends on the patient’s annual earnings. To see if you qualify for this service, you must submit your annual proof of income to them.
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Cost Saving Tips
You can tell your psychiatrist to try cheaper medication. Please keep in mind that the medication your doctor initially prescribes may be what works best based on his/her professional experience. However, if you are in a dire financial situation, you can try to ask for a cheaper medication. For example, there are a group of medications called SSRIs that treat depression, some can be more effective and/or more expensive than others.
If you and your doctor believe that your condition might take a long time to treat and the treatment cost is financially straining,you might qualify for financial assistance called jiritsu shien iryo (自立支援医療 ). This document allows you to only cover 10% of your medical costs including your regular check up and medication refill.
For example, if you are a student who is working part-time or not at all but your treatment is taking more than 3 months or so, you can ask your doctor to support your application for a jiritsu shien iryo (自立支援医療 ) by providing a letter and the proper supporting documents that you need to take to your local city office. Depending on your city office, the process might take a month or longer. Once you receive your jiritsu shien iryo (自立支援医療 ) certificate, check the validity period of the certificate. Generally, the certificate is valid for one year and may be renewed depending on your condition. In addition, depending on the time of your application and the validity period of your certificate, you can retroactively get a reimbursement from your hospital and pharmacy.
Pro tip: Always keep your hospital and pharmacy payment receipts. If you qualify for reimbursement, you will be asked to produce them.
- TELL Lifeline is a phone and chat service that allows you access to speak to speak to someone free of charge. However, if you or a loved one is at risk, please call emergency services instead.
- Japan Healthcare Info. is a service that provides health services assistance for foreigners. They provide help with translation, hospital related paper-work and making hospital appointments when needed. However, all of their services come with a fee.
All of Us Need a Little Bit of Help Sometimes
Although it might be difficult to find the right doctor or counselor in Japan, seeking help when you need it is worth the effort. The pandemic has shown all of us the importance of mental health and as a response, more and more counselors are offering services online. There is no reason you should bear the weight of your burdens. Always remember, help is out there for when you need it.
If you are experiencing an emergency, please call emergency services by dialing 119.
Related Articles on Mental Health in Japan :
- Useful Japanese Medicine to Buy From Your Local Drugstore
- I Can’t Find a Good English-Speaking Doctor in Japan – Help!
- General Hospitals and Clinics in Japan
- The Breakdown: 5 Over-The-Counter Medicines You Need in Japan
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