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Comment by mrhappyunhappy | Hacker News Reader

It’s funny that the govt wants to conduct studies and analyses, to study what exactly?! Is it a secret that Japan has piss poor mental health services? Nope! There’s your answer. Japan would rather classify people as weirdo recluses than take a deep look at the underlying mental health issues plaguing its society.

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Mental health has become far too medicalised in the west in the interest of multiple large entities (including but not limited to the pharma mafia), so your vision of Japan might be influenced by your standards for mental health.

Worth pointing out is that the mental health issues are only the symptom and not the cause, the cause should be adressed first rather than the symptoms.

Treatment for mental health involves more than just medication, for any program worth its salt. My current treatment includes weekly group therapy, weekly individual therapy, and weekly mindfulness class, in addition to medication. All of this together has completely changed my life over the past six months, to the point I'm actually about to be able to seek employment in programming again (sincere thanks for the fantastic healthcare for people in poverty, Massachusetts!).

Too medicalized compared to what? Is there strong evidence of other approaches delivering superior outcomes on a cost adjusted basis? I know CBT has been shown to work well for some patients with some conditions, but it isn't effective for everyone.

How do you determine the root causes to be addressed?

As an example, maybe instead of giving kids speed so they can concentrate we might admit that being forced to sit in a room all day with less and less recess is actually quite boring.

You could say some mental health issues are symptoms of underlying social/cultural issues. Since the latter are difficult to diagnose and heal, it's up to the individuals to cope and adapt to the "sick" mental environment.

No treatment and just letting it as it is does not sound superior to western approach.

I did not say otherwise.

Or, you know, Japan has the right idea, treating these people are normal but reclusive, and the US sees their own as "sick" to sell them all kinds of drugs and processes.

Not to mention in the US many of these would have ended up on the streets...

https://news.ycombinator.com/item?id=19534845

The first step to solve a problem is to acknowledge there is a problem.

What makes you so sure they're due to mental health issues? If I could chose to play video games all day instead of working, I probably would.

Try it out. It can be somewhat okay the first year. Never heard of anyone making it through three years and still enjoying it.

I mean, you go for variety. There are countless games / type of games to choose from. You can also watch shows/films/educational content. Read interesting stuff on social media / hn. So many different interesting ways to spend your time. And online communities can give you the bit of social validation you need without being productive to society or justifying aspects of yourself.

To me the bigger cause of not enjoying it was/is external life getting back at you, notably worries about the future. I don't want to go to far into personal details, but I enjoyed it long enough to be confident I could indefinitely, if our society would be supporting it. This might be fine for a "robots do all the work" kind of future, but I have my doubts about UBI.

Anyway, after some point you most definitively want help to get out. As for mental health, there are probably reasons that made you retreat, but it likely caused new issues as well. But that's just one part of a well functioning support network.

I think it's more the "not interacting with others" part that's unhealthy, not the "not working outside the home" part. We don't consider, for example, stay at home parents to have a problem, nor do we consider retired people.

playing video games all day long is probably just to fulfill a deeper need for something else.

Which country are you from and what qualifies you to criticize Japan I wonder?

I'm more curious as to why one would need a particular qualification in order to criticize Japan.

I’m from US and live in Japan. I know first hand about the lack of availability of mental health services and even the basic acknowledgment of depression as an issue that requires treatment. I would wager a large majority of these recluses are suffering from treatable depression.

Oh, there is acknowledgement that it needs to be treated alright. Especially by those who suffer it, counterintuitive as it sounds.

It's the basis for the wildly successful and profitable "mental clinic" franchise business. There is one of those ( or two, or three, or four ) in front of every train station in Tokyo. For those who don't know Japan, take a look at a train map of Greater Tokyo and count stations, just for fun. You'll be doing that for a while. Then multiply the number by 2 or 4 to get to the number of "mental clinics".

Those are little more than drug dispensers run by legally authorized pimps with no medical expertise of any kind or a psychiatrist or psychologist anywhere on the premises, but anyone ( and millions do ) can "treat" their anxiety, depression, or insomnia, with half a dozen prescriptions a month. For good measure, they make sure to book appointments weekly in both the clinic near home and also the one near work. And maybe have a third one as backup.

What's needed is proper mental health services, on that you're spot on. And as another comment points out, to erase the stigma of suffering a mentall illness, so people don't use alcohol or these vending machine style clinics with no oversight to treat themselves.

That it is a problem and it needs to be treated everyone's perfectly aware of.

Easy to explain, Japanese deny themselves the right to be weak, they are all supposed to be samurai. Same as in Russia, you are supposed to be a Communist hero whatever happens, mental health issues, especially among men, are as if don't exist there - guys just 'fix' themselves with vodka when they have to, or with suicide if vodka doesn't help anymore. In Russia people can't become hikikomori en masse just because the country is poor so their parents won't be able to feed them - and also because they have same hero mentality so would just beat the crap out of their kids if they tried to lock themselves up in their rooms.

Also, on the good side, in Russia there are much fewer social obligations before people. As in Japan, if you didn't get a college degree to become a salaried employee in a huge company, you are fucked and no one respects you. In Russia, you can do a lot of things and with vast majority population being dirt poor and apathetic, social standards of what constitutes 'successful enough' are very low - some kid who dropped out of college to make $1500 on Upwork writting crappy PHP code at the age of 30 is a success story and his parents are proud of him - in Japan he would be a hikikomori because it would be a total shame to be in that state.

You are getting downvoted for some reason but you are right, in fact this problem and this attitude is present in almost all countries from post-soviet block [0] Men are not allowed to be 'weak' and any display of it is usually ridiculed by society

[0] https://jakubmarian.com/suicide-rates-by-country-in-europe/

With the added problem of the very strong stigma in japan against mental health issues which means that most would be very unlikely to consult.

I don't have any first hand experience but I have several Japanese friends that got diagnosed with mental illness or depression and given paid months off work by doctor's recommendation, something I'm not aware of in the USA

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