Mental illness, as Kazuhiro Soda notes in his documentary “Seishin” (“Mental”), is one of the big taboos of Japanese society.
In the United States, doctors prescribe psychotropic drugs as commonly as cold tablets and memorists detail their breakdowns and addictions in best-selling books. In Japan, however, the mentally ill often try to hide their condition from employers, family and friends, while seeking treatment only as a last resort.
They fear, rightly in many cases, the stigma of being labeled “weak,” “strange” or “crazy” in a conformist society with a culture of shame. Suicide starts to look like the only, tacitly approved, way out.
Soda, a New York-based documentary filmmaker who has screened “Seishin” at film festivals in Busan, Berlin and elsewhere, picking up several prizes along the way, opens a rare window into their lives, but less as an impassioned advocate than as a fly-on-the-wall observer.
In condensing hundreds of hours of footage shot at a mental-health clinic in Okayama in 2005 and 2007, Soda added no editorializing titles, narration or music. He also let his subjects, as much as possible, speak for themselves, minus the digital masking considered de rigeur for television interviews.
One problem with this minimalistic approach is that we have to piece together even basic information from on-the-fly comments, rather than answers to specific questions. The mysteries of how, when and why Dr. Masatomo Yamamoto, the elderly psychiatrist who is the film’s hero, came to run his clinic, which many of his patients regard as a second home, are never quite explained.
Also, Soda’s camera can be ruthless in exposing the vulnerabilities, character flaws and even crimes of his subjects. In one chilling scene, a schizophrenic woman confesses to killing her baby in a black fit of frustration — and one wonders at the consequences for her, both social and legal.
But this dedication to showing the bad as well as the good creates more trust between the filmmaker and audience than propagandizing, which can present the mentally ill as saintly victims. True, Soda could have told his story more concisely — his 135-minute film is at least half an hour too long — but by the end I knew his subjects and their world in the raw and in the round, as though I’d spent a few weeks hanging around the clinic.
“Seishin” ‘s central figure is Yamamoto, now 73, who started the Chorale Okayama clinic in 1997 as a sort of postretirement project. He has since added a milk-delivery and restaurant business, staffed by patients, as well as opening a shelter where patients can stay temporarily. His aim, with the support of a dedicated staff, has been to create a community where the mentally ill can develop the self confidence, survival skills and human connections they need to ease their transition into the larger society.
In his dealing with patients, Yamamoto initially comes across more as the crusty neighborhood sensei (teacher) than the crusading reformer: Doctor-patient conversations are short and drugs are doled out by the fistful. But Yamamoto’s methods, such as his habit of tossing his patients’ questions back in their faces (“What do think you should you do?”) and drawing little diagrams to illustrate his points (a straight line for the stages of life in the West and a circle for the East), have a Zen-like wisdom.
He has not, however, created a happy little utopia — many of his patients are suicidal, socially isolated and living on public assistance. One middle-aged woman tells how, the night before, she ended up in the hospital after overdosing on her medications. She shows her wrists, crisscrossed with scars. Her face tear-strained, she speaks of wanting to die. Several other patients confess to similar thoughts, and after filming was completed, two carried fatally through.
Yamamoto is also no miracle worker, restoring patients to health with a pithy word or two. One, a heavy-set, quick-witted raconteur whose monologues are punctuated by punning gags and party tricks, tells how he had his first breakdown as a high-school student prepping 18 hours a day for his college entrance exams. Instead of answering the questions on his semester tests, he assigned ratings to his teachers, grading them on a scale of 1 to 100. After being tagged as “strange” for this incident, he was referred to Dr. Yamamoto, and has been seeing him for 25 years.
“He’s like a god to me,” he says. But God can’t erase that long-ago trauma or restore the lost time.
What Yamamoto and his staff do provide, though, is a vital lifeline that gives patients the support they need to recover — or simply make it through the day.
But, now, as Soda also shows, the patients are faced with government-mandated cutbacks in services and hikes in payments. They hold meetings and voice their objections, but compared with other, better funded and connected constituencies, they are all but powerless.
“Seishin,” which Image Forum theater in Shibuya will screen in an English-subtitled print daily at 6 p.m., and which will later open around the country, ought to be seen by, not only Diet members voting on health-care legislation, but anyone interested in how minds can become sick — and be cured. As Soda so eloquently shows, the mentally ill aren’t marginal “others,” but like people we see around us every day at work and at home. Even in the mirror.