Ultimate Guide to Tokyo Mental Health
By Camilla Vigotti | March 28, 2022
Living in Tokyo can be as beautiful as it is challenging. It takes time as a foreigner to get used to the unique aspects of Japanese culture and to find your place within Japanese society after the honeymoon phase is over. And in the meantime, Tokyo mental health can be easily affected by it, especially during these difficult events currently happening around the world. Due to language barriers, it may seem challenging to find English-speaking mental health providers in Tokyo but there are some options available to foreigners.
In this guide, we will cover all you need to know about Tokyo mental health and more. Please if you are struggling do not hesitate to seek help.
This article is a part of our extensive series on Japanese Culture for people who want to learn Japanese.
Is There Stigma Around Mental Health in Tokyo?
Before moving forward, it is important to address the “elephant in the room”, which is a common concern among foreigners living or planning to move to Japan. Does Japan have a stigma towards mental health illnesses and people that suffer from them? The answer is unfortunately yes (according to our sources).
Although things are slowly changing in Japan, the overall view of mental illness is still for the most part negative. Although mental illnesses are as common in Japan as in any other country, there is not a lot of knowledge or awareness. Japan as a collective society tends to prioritize the well-being of the community rather than the individual which means that people’s mental state isn’t too valuable.
There are two common responses to people with mental illnesses depending on their visibility. If it is rather hideable, like depression or anxiety, the person in question often gets labeled as “lazy” because “they don’t try hard enough”. This is because Japanese people tend to consider certain personal attributes as a cause of mental illness. Basically, there is the implication that it is someone’s fault if they have mental health issues.
If it is a more visible mental illness, it is common to hide them from society and have them live in a house under their family’s care or inside an institution. The process to institutionalize a person for mental health reasons is actually rather fast. Within the umbrella of mental health disorders, there is a stigma hierarchy. For instance, schizophrenia is more stigmatized than depression as it can be harder to conceal in public (depending on the severity) and can be “disruptive” for others.
Understanding cultural values: tatemae and gaman
The term tatemae (建前) refers to the idea and mindset of maintaining a public facade within society. This prevents individuals from showing their true emotions, desires, and thoughts. It is the polar opposite of honne (本音), which represents the true personal and emotional sphere of an individual. Adapting the tatemae mindset allows the individual to prioritize others and their feelings, as well as to conform to societal standards and not stand out.
The term gaman (我慢) is a Zen Buddhist term that translates as “enduring the seemingly unbearable with patience and dignity” or simply put, to suffer in silence. Just like tatemae, this mindset also prioritizes the wellbeing of others above the individual’s wellbeing. Burdening someone else with your problems is a big no-no in Japanese society. You don’t want to be a meiwaku (burden) to others.
Both mindsets are practiced outside of Japanese culture to a certain extent. It is normal to act differently and not show our real emotions in certain settings and situations, like in the workplace. However, in Japan, the concepts of tatemae and gaman are taken to the extreme causing people to suffer from severe depression or other mental health issues. There have been cases in which students or employees refuse to report cases of bullying and harassment to not inconvenience others. Often this has led to cases of suicide, unfortunately.
If you struggle to understand certain aspects of Japanese culture, read the Ultimate Guide to Japanese Culture to learn more.
What Kind of Mental Health Provider Are You Looking for?
When looking for mental health providers, it is important to understand the different kinds of providers and what they can do. Not every doctor or health practitioner can help you and support you with what you need, so make sure to do your research.
Psychiatrists are licensed medical doctors that have the ability to prescribe you medications since they have gone through medical school. Their main job is to assess, identify, and diagnose mental disorders. Although they can practice psychotherapy, they focus on chemical imbalances and physical symptoms associated with and caused by mental illnesses.
Psychologists have a master's and doctorate degrees in psychology. In order to practice, they obtained a license that is valid in their area (country, state, or region) meaning that they can’t practice outside of those borders. During a session, they tend to focus on emotions, thoughts, and behaviors rather than chemical imbalances. Psychologists utilize psychotherapy to help treat mental disorders. Psychotherapy is also known as counseling, talk therapy, or simply therapy.
Other mental health providers that can practice psychotherapy are counselors, therapists, and social workers. Keep in mind that they are not allowed to assess or diagnose mental disorders as well as prescribe medications because they do not have the training and qualifications.
Does Your Health Insurance Cover The Cost of Tokyo Mental Health?
If you come from a country with public health insurance, chances are that you are already familiar with and used to this system. There are different insurance providers available in Japan but only two main ones for non-Japanese residents.
The National Health Insurance (NHI) is the insurance option offered to students, freelancers, and self-employed foreigners. It will help you cover part of your medical expenses when you visit clinics or hospitals and when you buy prescribed medications. At the end of your visit, you will pay only 30% of the total cost. You apply to the NHI at your ward office not long after you move to Tokyo. It is a fairly simple process that only requires your Zairyu Card (resident card), my number, and passport.
The Social Health Insurance (SHI) is the insurance option offered to full-time employers through their company. Although there are some exceptions, so make sure to check with your company what kind of insurance you are entitled to. Workers under this insurance plan will also pay 30% of the total cost of care.
Both health insurance plans are accepted by 90% of hospitals, clinics, and even dental clinics in Japan. This also includes lady’s clinics and OBGYNs. Moreover, they also help cover part of the expenses for hospitalizations, surgeries, and childbirth. But what about the cost of mental health? The answer is yes and no.
Your health insurance (NHI and SHI) will cover the cost of a visit with a psychiatrist but not with a psychologist or counselor in most cases. This is because psychiatrists are medical doctors that can assess and diagnose mental disorders as well as prescribe medications for said disorders. However, they do not offer counseling sessions. One Redditor on the r/japan thread disclosed that with the NHI, they pay 1,500 yen (approximately $15) for each visit with a psychiatrist and the medication is extra.
If you want to know more about Japanese health insurance, check out the Guide to Health Insurance in Japan.
Before you visit a Tokyo Mental Health Clinic…
Most clinics disclose on their website that they cannot accept the Japanese National Health Insurance. In some cases, if you have a private health insurance plan that covers mental health services, the clinic might be able to accept that. There are some exceptions, however, like the Mejiro-sola Clinic so make sure to check their policy online.
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How Do You Pay for Your Appointment?
If it is your first time visiting a clinic or a hospital, you will have to go to the reception desk first. The receptionist will ask you for your insurance card (hokensho) and at times some kind of documentation, like your residence card. This is in case the mental health provider of your choice accepts health insurance.
During your check in, after you have filled in all the necessary modules with personal information and previous medical and family history, you will receive your medical card (shinsatsuken). Each hospital and clinic hands out one. A medical card contains the information and contact number of the facility, your name, and a customer number. The more clinics or hospitals you go to, the more cards you will accumulate so be careful with that. These cards are free of charge.
You will use your medical card to check in for your future appointments as well as pay for your appointment in certain clinics and hospitals. If the facility has an automatic machine for payments, you will have to use your medical card to access your bill. You just have to insert it and the total amount of your visit will show up on the screen. After that, you just have to choose your method of payment, cash or credit card. If you are not familiar with Japanese and kanji, you can change the language in the machine. Just make sure to do that before inserting your medical card.
If the facility does not have a machine, you will have to pay at the reception desk. In some cases, after your appointment is over, you can go to the front desk and pay immediately. In other cases, you might have to wait a few minutes for your name to be called at the reception desk. When you hear your name, walk up to the desk and you will receive your bill. Usually, you can pay with both cash and credit card but not all clinics accept credit cards, so make sure to check beforehand.
Based on our research, it doesn’t seem that an automatic payment through your bank is possible. Each appointment has to be paid manually before you leave the clinic.
Where Can You Get Your Prescription Filled?
Getting your prescription in a different country can be a stressful process that takes some level of planning and research.
Getting Your First Prescription
Once you have found a clinic that you feel comfortable with, bring your national health insurance card with you. As a first-timer, you will have to fill out some forms with personal details and medical background. Because it takes some time to fill out these forms, make sure to arrive at the clinic 15 to 10 minutes before your appointment.
Then you will have a brief mandatory consultation with a psychologist that will cost around 3,000 yen (approximately $30). Afterward, you can talk to your psychiatrist who will prescribe you some medications. It is a quick 5 minutes procedure that will cost 1,050 yen ($10.50). For future appointments and refills, you will only have to talk briefly with your psychiatrist.
The last step is to go to a nearby pharmacy and pick up your medications. If you do not know where to find one, nurses at the receptionist desk will indicate to you the nearest pharmacies. They often have a small printout map that you can use. The cost of your medications is not included so that will be an extra charge
If You Already Have a Prescription
If you are in your home country and planning to move or return to Japan, you will want to have your prescription translated into Japanese to show to your doctor in Tokyo. This will help you make your refilling much easier. However, it is important to know that some medications might not be available in Japan due to different pharmaceutical regulations. In this case, your doctor will prescribe you a similar medication to the one that you have been using.
Tokyo Mental Health in-person Providers
Finding a reliable clinic for mental health in Tokyo can be a stressful experience full of ups and downs. Are the online reviews to be believed? Are these prices accurate? Do they really speak English well enough to understand what I’m going through? It is completely normal to experience sadness, disappointment, and even anxiety after a while. There are multiple factors that can affect our Tokyo mental health. For some people, cultural shock and the end of the honeymoon period (initial period of enjoyment after moving into a new place) can be huge stressors.
If you want to learn more about cultural shock, read our Guide to Japanese Culture Shock.
How to find a mental health provider
Finding a good mental health provider that fits your schedule, needs, budget, and general preferences is not an easy task. The process gets more complicated if you add a language requirement. Even if you speak Japanese fluently, it is not easy to express personal emotions and conditions in another language. Moreover, not every hospital or clinic in Japan offers an English-speaking staff, and the same applies to mental health services. However, there are ways to look for it.
The International Mental Health Professionals Japan (IMHPJ) is a voluntary professional organization that helps you find therapists and mental health providers in Japan, not just in Tokyo. This platform allows you to look for professionals using specific keywords, such as “depression” or “anxiety”, and other settings such as location, gender, fee, language, and culture. This allows you to have full control over the choosing process and find the best fit. If IMHPJ does not work for you, there is always the option of Googling “Tokyo mental health” or “English Tokyo mental health” or a similar combination to find what exactly you are looking for. However, it is always better to do extensive research instead of settling for the first result on your Google page. In this article, we will provide you with some in-person and online popular recommendations that offer mental health services in English.
If you need to find other English-speaking doctors, check our Ultimate Guide to English Speaking Doctors in Tokyo.
Popular Recommendations
Tokyo Mental Health Shintomi Therapy Office
Tokyo Mental Health Shintomi Therapy Office offers face-to-face counseling, psychotherapy, and other psychological services with English-speaking mental health providers. The cost for an individual therapy consultation is 22,000yen ( approximately $220) with tax included for 60 minutes. Meanwhile, they charge 25,000 yen (approximately $250) with tax included for 60 minutes for psychological services with a psychologist.
They do not accept Japanese health insurance, however, in special cases in which clients pay out of their pockets, the Shintomi Office offers discounted sessions. For a standard 50 minutes consultation, they charge between 13,500 yen to 19,000 yen ($135 to $190) with tax included. The exact price is based on your income level.
The office has a very flexible schedule. They are open seven days a week, including national holidays, from 9 AM to 8 PM with the last appointment scheduled at 7 PM. You can book your first appointment through their online form or via email.
The Tokyo Mental Health Shintomi Therapy Office is located on the 6th floor of the Urbane Mitsui Building in Shintomi 2-4-6, Chuo-ku. It has easy access from the Yurakucho line, Hibiya line, Asakusa line, and JR Yamanote line.
Tokyo International Psychotherapy
Tokyo International Psychotherapy (TIP) is a fully bilingual counseling service that offers individual therapy with three licensed therapists. The cost for a 50 minutes counseling session is between 11,000 yen to 13,200 yen ($110 to $132) with taxes included, while a 75 minutes session ranges between 16,500 yen and 19,800 yen ($165 and $198). The change in fees depends on your income level.
TIP does not offer walk-ins appointments, to start your therapy you must fill in their contact form available on their website. The staff at TIP will reply back to you within 3 business days and book you for your first appointment. Also, TIP does not offer psychological evaluation and assessments.
Each of the three therapists at TIP has different office hours and it is not a seven days a week service. Kaori Ogiwara-san is available Tuesdays and Thursdays from 9 AM to 4 PM, as well as Saturdays from 9 AM to 6 PM. Keiko Taguchi-san is available on Mondays, Tuesdays, and Fridays from 10 AM to 8 PM. Chie Sawa-san is available Mondays, Fridays, and Saturdays from 9 AM to 5 PM, as well as on Wednesdays from 9 AM to 6 PM.
The office is located in room 403 of the Elegance Tamagawa building, 2-15-10 Tamagawa, Setagaya-Ku. It is a 4 minutes walk from Futako-Tamagawa station, accessible with the Tokyu Denen-toshi Line and the Oimachi Line.
Mejiro-sola Clinic
Mejiro-sola Clinic offers medical and counseling services for not only English speakers, but also for French and German speakers. The clinic is one of the few clinics that accept the Japanese National Insurance, therefore, you will only pay 30% of the total cost.
Mejiro-sola Clinic does not offer walk-ins, if you want to schedule an appointment you should call during office hours. The office is open Tuesday, Wednesday, and every other Saturday from 9:30 AM to 6 PM, Thursday from 9:30 AM to 1 PM, and Friday from 9:30 AM to 7 PM.
On your first appointment make sure to bring your health insurance card and enough cash to pay since the clinic does not accept any other methods of payment.
The clinic is located on the 3rd floor of the Daido Building, 3-16-10 Shimo-ochiai, Shinjuku-ku. It is a 5 minutes walk from Mejiro Station.
Tokyo Mental Health Online Providers
Thanks to technological advances nowadays it is possible to receive the help we need online from the comfort of our home. Although it might feel impersonal, the spread of the coronavirus and the many months of quarantine made these options more common. Online therapy is a convenient resource that saves money as it is cheaper than traditional therapy, time from commuting, and makes scheduling easier.
It is the perfect option for foreigners living in Tokyo that need a mental health provider that can offer flexible hours and English as the main language. Full-time workers can now schedule an appointment at a convenient time without interfering with their working schedule.
Betterhelp
If you watch a lot of Youtube videos, you probably have already heard of this service. Betterhelp is the largest therapy platform online that offers individual, couple, and teen therapy remotely for an affordable price. After you sign up and complete a questionnaire, Betterhelp will match you with a professional licensed therapist that matches your needs and goals. You will be able to communicate with your therapist not only through standard phone calls and video calls but also through live chats, making the experience more personal. You can leave a message or ask a question to your therapist at any time of the day.
If you and your first matched therapist don’t work out, don’t worry because Betterhelp has a wide selection of licensed therapists that you can choose from. You can change anytime without trouble or penalty. However, by changing therapist, you will no longer have access to the page and personal info of your previous one.
The cost of therapy is between $60 and $90 per week depending on your location and therapist availability. The billing is every 4 weeks and Betterhelp allows you to cancel at any time for whatever reason.
Talkspace
Talkspace is another therapy online platform that offers different kinds of therapy (individual, couple, and teenagers) as well as psychiatry consultations. It is a fast three-step process. First, you answer a few questions about your preferences. Then you choose a licensed therapist from a list of recommendations and lastly, you can start your therapy. You can keep in contact with your mental health provider through video calls, phone calls, and chats.
Talkspace offers three therapy subscriptions that can be billed monthly, quarterly, and biannually. The listed price is subject to change depending on your therapist and location.
- Messaging Therapy: starts from $69 per week and includes texts, video, and audio calls.
- Live Therapy: starts at $99 per week and includes four 45-minutes Live sessions a month. However, this plan does not include texts, video, and audio calls.
- Live + Messaging Therapy: starts at $129 per week and includes four 45-minutes live sessions a month as well as texts, video, and audio calls.
Who to call in an emergency? Hotlines!
If you or someone close to you are in need of immediate help, calling hotlines or emergency lines might be the best solution for you.
119 is the number designed for the fire, ambulance, and emergency rescue services. There is multilingual support available in English, Korean, Chinese, Portuguese, and Spanish but it might take a while to transfer so please stay on the line and don’t hang up. If you need to contact the Police Call Center then you need to dial 110.
TELL offers a free, confidential, and anonymous cellphone service for English speakers. The service is available from 9 AM to 11 PM from Monday to Thursday, and from 9 AM to 2 AM on Friday, Saturday, and Sunday.
Call 03-5774-0992 for the Lifeline or visit the TELL webpage for the live chat.
How Can Your University Help You?
If you are a student enrolled in a university in Tokyo with not enough funds to pay for in-person or online therapy, don’t worry there is an option for you too. You don’t have to neglect your mental health in Tokyo.
Read Stepping Out of Your Comfort Zone to find ways to enjoy your daily life in Tokyo.
As a student, you can rely on your university for some support. Japanese universities have a student counseling help center inside their campus to help struggling students with their daily life. Whether you have school-related concerns or personal matters, the student counseling office can help you. You can easily schedule appointments that work around your class schedule and it is free for enrolled students. It doesn’t matter if you are an undergraduate, master, Ph.D., or research student.
To find more, look on your university website for information or ask your student help center.
Sophia University
My experience with the student counseling office at Sophia University has been so far pretty great. I started during my last fall semester after a classmate of mine highly recommended it since they offer free sessions in English.
At first, I was surprised that they do not offer walk-ins appointments since that was the norm in my undergraduate university in the US. Therefore, the first time I went to the counseling office I was able to only make an appointment for my first session. If you are not sure how your university counseling office works, I highly recommend calling them. This will save you lots of time and effort.
Before my first session, I arrived 10 minutes before as the staff requested, so I could fill in some forms. Besides my basic information such as name, department, and student ID, I also had to disclose the reason for my appointment and what I was struggling with. The form had a long checklist of factors to help you describe your current situation. The checklist covered lots of areas such as school life, family, relationships, personal lifestyle, and LGBTQ-related. Moreover, you can write down in your own words why you decided to seek counseling, how you have been feeling lately, and what your goals are for your future sessions.
Once you have completed all of your forms, your assigned counselor will come and start the session with you. Each session is about 30 minutes long and once every week or every two weeks depending on the school calendar and how busy the counseling office is. If you don’t like your assigned counselor, don't worry, you can ask to change the person.
I personally found that the sessions with my counselor were very productive and helpful. I feel very comfortable opening up with them as they are very sweet and considerate. They remember personal details from the stories I sometimes tell them and they often think about my situation while attending educational seminars.
To anybody currently enrolled at Sophia University, I would highly recommend making use of this service. It is free, available to all students, and works around your schedule. The counseling office is located on the 3rd floor of building ten. It is open Monday to Friday from 9:30 AM to 11 AM and from 1 PM to 4:30 PM. Due to the current situation with the virus, they also offer remote counseling sessions through ZOOM.
Taking some time off
Your university and professors want to see you succeed. If you are struggling with your mental health while at university in Tokyo during the semester, you don’t have to suffer in silence. Taking classes and studying in this political climate and/ or remotely with a different time zone is not an easy task. Another option that you can consider to help your mental health is to take some time off. In this regard, you have two options.
Read the Guide to Japanese University to find more universities in Japan.
Ask for extensions on your assignments
First, you can talk to your professors and ask for an extension if you are struggling to meet the deadline. Make sure to clearly explain why you need it and when you think you can turn in your assignment. As long as the extension does not interfere with the final week and grading schedule, your professors should be willing to grant it.
Asking for a leave of absence
Second, if you need to take some time off from university to focus on your mental health, then you might want to look into asking for a leave of absence. This means that you will take the whole semester off. In order to do that, you must notify your university and submit a formal request for a leave of absence. The process might be different from university to university so make sure to check with your department and center of academic affairs.
Keep in mind that there is a deadline to turn in your formal request so if you are thinking of taking a leave of absence, look into it as soon as you can.
Asking for a Mental Health Day at Work
Working can be incredibly stressful, even when you really love your job so it is important to take care of your mental health. Taking a day off to relax and focus on yourself can really help you to improve your mood, mindset, and even make you more productive at work. There are different options that you can consider depending on your situation and company policy.
Asking for a paid leave
Japanese working culture is a bit different from Western working culture. If you work for a more traditional company you will have to get used to a different environment and ways of doing things. So make sure to be comfortable with your company’s guidelines and processes.
If you really just need one day for yourself, you might want to ask to use one of your paid leave days. Japan does not have the concept of paid sick leave so if you have days left from your paid leave, you might have to use one or more of those. Usually, Japanese companies increase your paid leave days with your years of service. The longer you work in your company, the more days you will get. During your paid leave you will receive the exact same salary stipulated on your contract.
To take a day off you will have to talk to your boss and submit a formal request. Depending on your company’s guidelines you might have to submit your request one week or so in advance. This way your coworkers and department can adjust their schedule and workload in preparation for your absence. Japan is famous for having a working culture that vilifies taking days off from work. This is because it is often associated with feelings of guilt and inconvenience towards your other coworkers who will have to work more while you are on paid leave.
Asking for a medical leave
In case you need more time off and your mental health condition is rather severe you might want to get medical leave. First, it is important for you to obtain a letter from your mental health provider, like a psychiatrist or counselor, addressed to your workplace stating that you need to take some time off. You will have to handle the letter to your boss and go through HR. During a sick leave, you will receive 60% of your salary.
Depending on your company’s environment, you might have to negotiate your medical leave due to the traditional Japanese working culture. The stigma around mental health illness is extremely present in the workplace.
Mental health stigma in the workplace
Some Redditors on r/japanlife expressed pressure and guilt-tripping from their supervisors for thinking about taking some days off even when they had a doctor’s note. Others pointed out the inevitable consequences, such as being laid off later with some excuse and being resented by boss and coworkers, for taking some days off in these kinds of companies.
On the bright side, some Redditors that work for international companies in Japan had a very pleasant experience in requesting a paid leave or a medical leave. In any case, taking care of your mental health is fundamental for your well-being, and don’t forget that asking for a paid leave or medical leave is within your right.
Useful Words for Tokyo Mental Health
Even though you might seek and use mental health services and providers in English, you might still need to know a few basic Japanese words when it comes to visiting hospitals and clinics.
If you wish to learn more basic Japanese words, check out our Top 1000 Japanese Words You Need to Know.
|
Japanese |
Romaji |
English |
|
病院 |
Byouin |
Hospital |
|
クリニック |
Kurinikku |
Clinic |
|
受付 |
Uketsuke |
Reception |
|
医者 / お医者さん |
Isha/ oishasan |
Doctor |
|
看護師 |
Kangoshi |
Nurse |
|
心理学者 |
Shinrigakusha |
Psychologist |
|
心理学 |
Shinrigaku |
Psychology |
|
精神医学者 |
Seishinigakusha |
Psychiatrist |
|
精神医学 |
Seishinigaku |
Psychiatry |
|
健康保険 |
Kenkouhoken |
Health Insurance |
|
国民健康保険 |
Kokuminkenkouhoken |
National Health Insurance (NHI) |
|
保険証 |
Hokensho |
Insurance Card |
|
診察券 |
Shinsatsuken |
Medical Card |
|
問診票 |
Monshinhyou |
Medical Questionnaire Form |
|
診察 |
Shinsatsu |
Medical Examination |
|
メンタルヘルス |
Mentaruheresu |
Mental Health |
|
セラピー |
Serapi- |
Therapy |
|
カウンセリング |
Kaunseringu |
Counseling |
|
薬 |
Kusuri |
Medicine |
|
飲み薬 |
Nomigusuri |
Medicine that you Drink |
|
粉薬 |
Konagusuri |
Powdered Medicine |
|
処方箋 |
Shohousen |
Medical Prescription |
|
薬局 / 薬屋 |
Yakkyoku/ Kusuriya |
Pharmacy |
|
予定 |
Yotei |
Appointment |
|
初診 |
shoshin |
First Visit |
|
お支払い |
Oshiharai |
Payment |
|
レシート |
Reshi-to |
Receipt |
|
クレジットカード |
Kuredittoka-do |
Credit Card |
|
現金 |
Genkin |
Cash |
Ex: “保険証お待ちでしょうか”
“Hokensho omachi deshiouka”
“Do you have your insurance card?”
Final Thoughts
It is important to take care of our mental health in Tokyo so we can live better in our daily lives in this beautiful country. Living in a big city like Tokyo can be lonely and alienating at times, especially if you are not used to busy global cities. Despite the stigma, language, and cultural differences, there are accessible mental health providers that you can rely on during a hard time. You do not have to go through it alone.
If you are struggling to navigate and live in Tokyo, read our Guide to Moving to Japan for some helpful tips.
