Game Changers of Japan: Director of Tell JP Talks About Mental Health in Japan

Written by: Abbey Kruska | Date Published: 17th December, 2019

In the past, Vickie has worked with brain injury patients with the Brain Foundation in Australia, and with disabled children in Hong Kong. She tells us, “every country is at different stages [in mental health care], with different unique qualities.”

Vickie's Story of Coming to Japan

Vickie arrived in Japan in 2001, following her husband’s work transfer. Since the mid-90’s she had lived with her family in Hong Kong, and was initially against the move.

“I had heard from friends about professional women ending up only serving coffee, or becoming secretaries. I was also a little afraid of the latest fashion trend--the girl’s with white make up and crazy hair.”

Vickie was referring to gyaru, a fashion trend that ruled Japan in the 90’s and early 2000’s.

Initially having studied Neuropsychology, Vickie found a lack of positions in that field in Asia and unable to find any way to study or perform in that field, unfortunately lost her license during her time in Hong Kong.

In 2008, she got another masters degree in counseling as opposed to clinical psychology, hoping to be able to make better use of it. After coming to Japan, Vickie was introduced to TELL, along with the shocking fact that, at the time, Japan’s suicide rate capped at 35,000 people a year--nearly 100 deaths a day. Shocked by this outlandishly high number, Vickie began working at TELL first as a therapist, and in 2013 stepped down from her therapist position to step into the position of director.

What is TELL?

TELL, initially the Tokyo English Life Line, was established in accordance with Japan’s main suicide hotline Inochi no Denwa, in 1972, and had a lot of foreigners calling out for help.

In a time without internet or google, foreigners used the hot line to find help and learn about their options for dealing with mental health issues in Japan. No longer just in Tokyo, or just a phone line, TELL now provides services across Japan in a variety of languages, as well as offers in-person therapy, marriage and couple’s counseling, an online chat line, and more.

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“The mission is to save lives; to reduce the impact of mental illnesses.”

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TELL boasts a team of all officially licensed therapists, who can provide state of the art practices with the proper qualifications. Now TELL not only saves lives via their lifeline, but also has an outreach program in which they visit schools, companies, and even embassies to give talks on mental health and get attention to help at-risk populations (LGBTQ, learning disabilities, domestic violence, rape).

“Mental health issues are not uncommon. The sooner you catch it, the better. 50% of mental health problems start before the age of 14, 75% before 24. 1 in 4 will have mental health problems some time in their life. The majority of people are not in treatment, but people getting treatment typically only need it for 3-4 months.”

Challenges in Treating Mental Health Issues in Japan

Vickie tells us Japan has a lot of stigma when it comes to mental health. “There is less history of mental health research here. If you look at European countries, there’s a long history of research, whereas research has only just begun in Japan.”

In Japan, you can only use insurance to see a psychiatrist, not a counselor. Vickie tells us that because of this, “the psychiatrists have too many people coming, and they can’t properly treat all of them. They can only treat them with medication, so people are being over-medicated just to keep them alive and safe.”

Regardless, Japan has taken the suicide down to 20,000 since Vickie has arrived. From 100 a day to 57. Still, Vickie isn't satisfied. She says she won’t rest until the suicide rate is zero.

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“It is possible.”

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Regarding the unique factors that affect mental health living in Japan, Vickie tells us some main issues include “workplace differences, cultural differences, long working hours, isolation, relationship issues, custody issues, visa issues, medical issues--there’s a huge range. Cities can be quite taxing, lights, noise, things at you all the time.”

Finding certified professionals has also proved an issue.

“Japan is in the process of licensing people, and trying to standardize it. Japan is considering including counseling on the national health insurance in the next few years. There is a change in process, but at this point just about anyone can claim to be a therapist and open a clinic.” Still, the biggest issue TELL faces is finding volunteers to work TELL’s many lifelines and chat rooms, and getting funding.

Vickie tells us, “we’re losing volunteers as fast as we’re training them. As an NGO there is always a struggle to keep the lights on. Last year struggled and had to cut half the staff, and just run on the bare minimum. Getting funding is really really difficult. Especially as a foreign community, talking about mental health, and as a non-profit organization. Our Lifeline and other functions run solely on donations and grants. Our biggest events are the Wine auction in March and the Tokyo Tower run. We also do Global Giving Campaigns and Giving Tuesdays. Some people do fundraisers for us."

It takes roughly 5 months for a volunteer to become self-sufficient on the TELL hotline, and the training is mostly done online. However, volunteers who complete the program will receive a certificate which can help them get into graduate schools or universities to study psychology and counseling-based fields. If the volunteer stays for 12 months, they can receive an official recommendation.

Word of Advice

On Living in Japan

“Some people might be overwhelmed by trying to fit in and do everything correctly. Trying to become Japanese is impossible—instead, try to feel okay in your own skin and have confidence in who you are.”

On Dealing with Mental Issues

As for dealing with mental health issues, or trying to help a friend, Vickie explains that encouraging rather than sheltering is the best thing to do, and that we are all more capable than we realize.

“The point is to empower that person to find their own coping skills and learn to talk about their problems. You don’t want to create a dependency. Rather, you want to liberate them and help them recognize that they have the coping skills to get through whatever it is they’re going through.

Vickie adds, "Your mental health is no different from your physical health. Don’t feel ashamed about it. Address it. Talk to someone. 1 in 4 people are struggling with a mental health issue. We don't need to find a cure, there are good treatment options available, people just need to feel it is okay to access help. Sadly too many people in Japan feel a failure and are not seeking help.”

Mental Health Resources in Japan

If you need help, below we have listed some resources for those dealing with mental illness, depression, and suicidal thoughts. Always know there are people on your side, and you can get help.

• Tell Japan - A non-profit organization that offers professional English-speaking counselors, a lifeline, information and resources, and more. (Tell Japan’s Lifeline: 03-5774-0992 | Tell Japan’s Weekend Lifeline Chat website: https://telljp.com/lifeline/tell-chat/)
• Tokyo Counseling Services - Tel: (03) 5431-3096. Email: tokyocounselingservices@gmail.com | Twitter: @tokyocounseling
• Japan Health Care Info - General information about healthcare in Japan including mental health resources.
• Jhelp - An English and Japanese online emergency hotline and chat service.
• Japan Helpline - An English and Japanese speaking emergency hotline. Tel: 06-6313-1010