It’s time to take children’s mental health seriously

In a May ranking of children’s well-being in 36 developed countries, Japan came in about halfway, in 14th place.

Though it secured the top spot in physical health and made gains in the skills category — and rose from 20th place since the 2020 ranking — the survey conducted by UNICEF revealed Japan’s low performance (32nd) in mental well-being, which hasn’t seen much improvement over recent years.

These findings are corroborated by a grim statistic: Last year, Japan saw a record high of 529 child and teenage suicides. And both the number of child abuse and school refusal cases have steadily increased over the past decade, despite plummeting birth rates.

Young people’s mental health is in a critical state and there is a fundamental lack of awareness of human rights — and the government needs to do something about it.

At a symposium held in Tokyo in May, Shigehito Nakahara, director for Policy Planning of the Children and Families Agency, attributed such upticks to significantly improved access to counseling services.

Nakahara’s explanation seems partially true. Over the last decade, the government has made the child abuse hotline 189 toll-free and deployed school counselors to more than 95% of public elementary, junior high and high schools.

However, it is undeniable that these policies are mostly reactive and lack nationwide consistency. For instance, the availability of school counselors and the frequency of their visits varies widely depending on the region. Most commonly, they are available at schools only once a week for four hours and there is a high turnover rate because their contracts last only one year.

Under the current national-level regulations, counselors can renew their contracts up to four times, for a maximum of five years. If they wish to extend their employment, they need to pass an interview. Last year, however, Tokyo’s 250 school counselors — around one-quarter of the total 1,096 who applied — failed the interview and the large-scale dismissal resulted in a lawsuit alleging unfair termination.

There are also reports that children are not always benefiting from school counselors. For example, the city of Nagoya began assigning full-time counselors to its public junior high schools in 2014, but this hasn’t contributed to a decrease in school refusal rates.

Counselors are usually qualified clinical psychologists, but guiding children and handling school refusals require a special skill set in an environment that is especially challenging for counselors as they are prevented by their contract length from building long-term trust.

Regional gaps are also evident when it comes to class support systems. While Tokyo schools largely opt for inclusive classroom management, Osaka offers over 2,600 specially designed classes to support children with autism and emotional disorders. The equivalent number in Tokyo is 167 classes, as of 2023.

A report suggests that 43% of children with potential developmental challenges do not receive adequate classroom support. While many schools are equipped with specially designed spaces, these tend to focus on visual, hearing and intellectual aids. Mental and emotional issues are often handled just by having students rest in the infirmary.

Given these disparities, it is clear the government needs to build a consistent school system with appropriate emotional support mechanisms. As long as the focus is on corrective and not preventive actions, children’s mental well-being will not improve.

Japan adopted the Basic Act on Children’s Policy in 2023 to protect children’s rights, but the majority of elementary and junior high school students report that they have never heard of it. Many are still unaware that they have every right to raise their voices when family members or other adults hurt them.

This lack of awareness extends to mental well-being. In 2022, learning materials centered on mental illness were reintroduced in high school textbooks — after 40 years of silence.

However, elementary and junior high school children are still left out: Moral education and physical education classes cover a wide range of topics, from friendship to cultural appreciation and physical changes in puberty, but curricula mostly focus on interpersonal manners and physical health. Pupils learn about stress management in health and physical education classes only for roughly a one-hour class per school level in elementary and junior high, adding up to just a couple of hours over nine years.

Masafumi Mizuno, author of “Children Struggling with Mental Illness,” strongly advocates for teaching children about mental health. In his book, Mizuno points out that half of all mental illnesses begin by the mid-teens and approximately three-quarters develop by the mid-20s.

Therefore, introducing matters of mental illness in high school textbooks is too late; the subject needs to enter the curriculum sooner — even if some parents and teachers believe that starting in elementary school is too early.

But the clock is ticking. In a 2023 survey of around 30,000 children, 14% of those aged 10 and 11 and 23% of those aged 13 and 14 reported depressive symptoms. Given the realities, Japan can’t continue ignoring the importance of mental health education at a young age.

To pursue this, it can look to examples such as the United Kingdom and Ontario, Canada, both of which have compulsory mental health classes in primary and secondary schools. According to recent research conducted by University College London and the Anna Freud Centre, whole-class mental health sessions are effective in reducing depression and anxiety in children.

Teaching mental illness would help children understand themselves and their peers better, including equipping them to notice irregular mental states if they or their friends become depressed.

One such example is a workshop designed by Chiba University’s Research Center for Child Mental Development. In the program, named “Journey of the brave,” children learn the basics of cognitive behavioral therapy through role-play, writing down their anxieties and exploring ways to cope with them while virtually traveling to a castle. Preadolescents have reported that the program helped them learn how to control and mitigate their anxiety.

Japan revises its national curriculum guidelines only once a decade, even though the environment surrounding children is changing much more rapidly and dynamically, especially as technology evolves.

Without more consistent education on mental health and individual rights and better access to school counselors, yet another student could be struggling with depression or bullying — or, in the worst case, lost to suicide.