Here are some things to expect when you use mental health services in Japan
-Appointments need to be arranged well-advanced. Many clinics can take limited number of new patients. They take longer time to listen to new patients and the slots are not many.
-Doctors take time to listen to a new patient. For this reason weekday after 17:00 and weekend (Saturday, Sundays are generally closed) appointments are very difficult to take for a first time patient.
-Often a nurse or a psychologist take a pre-examination interview with a patient or they ask a patient to fill out a detailed questionnaire about the condition and run some paper psychological tests. Many of these services are Japanese only even if the doctor speaks some English – JHI can help translation of this stage with your request.
-Hospitals generally request a referral from a local clinic (psychiatric specialist hospitals may not necessary request a referral though, more like a major general hospital that has many different departments). Some of these hospitals limit accepting new patients and unable to see a patient even with a referral.
-Subsidy to help mental health consultation and medication costs is available for patients with financial difficulties. The subsidy covers 90% of your consultation and medication therefore your pay is 10%. JHI can help with the subsidy application. Please contact us by email.
-It is very difficult to find a hospital that accepts psychiatric emergencies. Here is the example in Tokyo: Emergency hospitals rotate on the shift therefore are different depending on the day. The government psychiatric coordinators will take a call from the patient or family of the patient and coordinate the hospital visit. Patients cannot arrange the visit themselves.
Emergency hospital admission is applied when a patient is in the risk of self-harm or harm other people, not just because the people around the patient want he/she be hospitalized. In case of self or other harm the family or the people near the patient have to call the police first then the police will contact the psychiatric coordinator. English service is very difficult for such cases.
Feedback of visiting a Japanese Mental Health Clinic
The following article is contributed by one of JHI users. The author talks about the personal experience and tips about visiting a mental health clinic in Japan – the information provided here is real and extremely useful. We believe this will help many people who have a plan to use Japanese mental health services. The “Things to keep in mind” list is strongly recommended for preparing for your first visit.
Comments from JHI are added below for your references.
Japanese Mental Health Clinics and Refilling Foreign Prescriptions in Japan
After coming to Japan, you will likely many things are more convenient or easier to take care of than in your home country. However, finding a good mental health professional requires research and often the advice of someone you can trust. JHI helped me immensely with this process, and I felt I could clearly communicate my situation to them without feeling judged while gaining much-needed help and support. Taking care of your health is very important, and especially while living overseas, it is imperative that you have people with whom you feel comfortable explaining your situation to and asking for help.
If you are still living in your home country and are planning a move to Japan, I recommend having your prescriptions translated into Japanese. You will eventually need a new prescription while living in Japan, and this can make it easier to get a suitable prescription from your Japanese doctor.
These are the general procedures for going to a mental health clinic:
Bring your Japanese National Health Insurance card (if you have one) to the clinic, and fill out a form or survey about your medical and family background.
Have a 20 minute consultation with a clinical psychologist (required only for your first appointment, this will cost around 3000* yen).*1
Have a brief conversation with your psychiatrist. (This will be a standard, 5 minute procedure every time you have your prescription refilled. The costs are approximately 1050* yen.)
Take your psychiatrist’s prescription to a pharmacy and obtain you medication. (This will generally take about 10 minutes. The costs of each refill will be approximately 870* yen.)
Coming from a small European country, I was surprised by how similar my experience in Japan was to my experience back home. The procedures were almost identical, except we don’t do Step 2 in my home country.
Please keep in mind that, while Japan is well-known for its punctuality, seeing your mental health professional will require some patience. Upon your arrival, you are going to spend about 25 minutes or more in the waiting room, so your waiting time (before seeing your psychiatrist) may vary depending on the number of people who came before you. You may want to bring some reading material or an mp3 player to pass the time.
While Step 2 was not something usually done in my home country, I was pleasantly surprised with my experience. The psychologist I spoke with was friendly, open for questions, authentic, and there was genuine effort to understand my point of view. I was a person who could simply talk to another person, and that was such an important component in my decision to use that particular clinic.
While in Japan, you may encounter Japanese doctors who speak English or foreign professionals who offer counseling services. However, it is imperative your psychiatrist be open and have a genuine interested in helping you.
Please note that you will only meet with a clinical psychologist on your first visit. It is important that your psychologist speaks English (help him or her by avoiding jargon, idioms, slang and pay attention to non-native pronunciation of English) or that you are able to speak Japanese well enough to clearly explaining particular things related to your well-being. In case you decide to continue seeing a clinical psychologist, note that while this is possible, the fee of 5,000 yen for 50 minutes may seem somewhat steep, and that your National Health Insurance will not cover counseling.
Step 3 — seeing a psychiatrist in Japan might be different from where you’re from, expect a brief check-up with your psychiatrist (often to discuss to changing or switching your medication and dosage) rather than a counseling session.
Step 4 — going to a pharmacy to pick up your medicine will require some waiting, and you might be asked some questions about your medicine dosage or whatever drug you’re picking up (as they might offer smaller doses of your medicine or a giving you generic medicine that has the same effect as the one originally prescribed), having a smart-phone with Japanese-to-English translation might come in useful.
Things to keep in mind:
- Adjust your expectations of the mental health profession to match the reality in Japan.
- Be open to longer commutes if that means finding a clinic where you’ll feel comfortable.
- Make sure you feel comfortable with your doctor, opt out if you feel any judgment or discomfort.
- Even if your people at your school or place of work seem open and friendly, keep in mind that it’s better to abstain from talking about your personal life in a working environment.
- If you have any prescriptions from your home country, have them translated and bring them with you or have them sent to you if finances permit.
Remember — no matter what your problem might be, whether this is insomnia, work-related stress, or a bi-polar disorder; there is no shame in having a problem. Having a problem does not automatically make you or your life a problem. Wanting to help yourself is a sign of courage, not an admission of weakness.
Make sure that you include your commuting fare, the fee for a brief psychiatrist check-up and the pharmacy fee into your monthly budget.
Before coming to Japan, my biggest worry was seeing a psychiatrist in Japan and refilling my medication. However, as often happens in life, thanks to JHI and a friend/blogger on life in Japan who recommended them – this turned out to be the least of my worries, my biggest surprise about my Japan stay, and one of the things I was happiest with. My days going to a mental health clinic in Japan were days of calm and serenity, and I am truly grateful to both JHI and my friend who recommended them for helping me when I needed help the most.
* All the fees in this article are only applied to this author’s case. Each patient is charged according to his/her condition and will differ.
*1 Not every mental health clinic has an in-house clinical psychologist. In that case a patient is likely to have a consultation with a psychiatrist for 20 to 30 minutes at the first time consultation
The information that may identify the contributor and details of the clinic are omitted to protect privacy of the author