Post WWII Trends in

Addressing the Issue of

Suicides in Japan

GGR353
Charisma Kumar
996729786
8/14/2014
Dr. Natalie Waldbrook





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Introduction
Branded as a suicide nation, Japan has one of the highest rates of suicides in the world
(Kaga, et al., 2009; Ken, et al., 2007). In 2012, suicide was the leading cause of death in males
15-44, and the leading cause of death in females aged 15 to 34 (Japanese Ministry of Health,
Labour, and Welfare, 2012). While there was an all-time low suicide rate following the Second
World War, suicide has steadily increased. With more than 30,000 people dying as a result of
suicide every year since 1998, and with 71% of suicides victims being male, there are large
socio-economic implications of these deaths (Masahito, et al., 2005; Kaga, et al., 2009). This loss
of a large portion of male plays a significant role in the already precariously low birth rate of the
nation and causes a further strain on the already high dependency rate due to the large aging
population (Ken, et al., 2007).
History of Suicide
In Japan there has been a history of honorable suicide deaths with the tradition of death
before dishonour entrenched deep within Japanese culture (Toyomasa, 1980). The free
choice of death never had any opposition from Japanese society (Ozawa-de Silva, 2008).
Obligation suicide was closely related to other traditional roles such as loyalty and morality.
Suicide was highly institutionalized as a way to express views of life and death and even today
has many impacts within the culture. Seppuku, a type of ritual suicide performed in Japan by
slitting the stomach, also known as hara-kiri within Western media, has been a type of
traditional suicide within Japan for centuries in order for captured Samurais to maintain their
honour. These ritual suicides have been carried out since first recorded in 716 A.D.
(Toyomasa, 1980). While originally reserved for the Samurai class warriors, the eventual
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breakdown of aristocratic rule and cultural admiration has caused the tradition to be spread
from beyond the military division to all Japanese people. While the use of seppuku as judicial
punishment was made against the law in 1873, the tradition of seppuku did not die out
(Toyomasa, 1980).
Shame is an important motivator within Japan and the concepts of pride and honour are
usually ways of social control (Naito, 2007; Ozawa-de Silva, 2008). This shame is what often
causes aggression to be turned inward instead of outward, which is more common in western
cultures, leading to greater possibilities of suicide when there is a large build-up of shame
(Ozawa-de Silva, 2008). It is suggested that external pressures are what cause people to commit
suicide, usually as a way to perform a duty to their community.
This type of an almost altruistic suicide as acceptable and even encouraged behaviour
has been reinforced through centuries of cultural traditions and legends. It was during the
Second World War that Japan earned its nickname of suicide nation through the use of
Kamikaze, suicide airplane attacks and Kaiten, suicidal submarine attacks (Orbell & Morikawa,
2011). While originally employed as desperate tactical method of self-sacrifice to ensure the
survival of future generations, as defeat was looking more likely, the motivations changed
(Toyomasa, 1980). As the war progressed, Kamikaze attack saw less of a hit ratio to number of
Kamikaze attacks launched, leading to the thought of suicide as method of preventing
dishonour, not necessarily as a method of attack against the allied ships (Orbell & Morikawa,
2011). After the Japanese surrender in World War II mass seppuku was carried out by Japanese
soldiers in front of American soldiers following the countrys surrender to preserve honour
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(Toyomasa, 1980). Hundreds of people committed seppuku in the Imperial Palace in Tokyo,
both military and civilian, as an apology to the emperor for losing the war (Toyomasa, 1980).
Jigaki, female ritual suicide, was often taught to females as children (Toyomasa, 1980) .
Evidence of the institutionalization of suicide as a way of preserving honour is evident
even as recent as the death Toshikatsu Matsuoka, the Japanese Minister of Agriculture,
Forestry and Fisheries in 2007, who committed suicide during an expense scandal. He was
commended by other members of the parliament for preserving his honour (BBC News, 2007).
Furthermore, positive and sympathetic media attention of high profile suicides often leads to
imitation suicides (Ozawa-de Silva, 2008).
Homes where suicides have taken place are impossible to resell due to fear of angry
spirits coming to claim them. To prevent this from happening, hundreds of people commit
suicide every year in suicide sites like the Aokigahara forest at the base of Mount Fuji (Picone,
2012).
While suicide is tolerate and even thought of as an honourable response to their current
situations, suicide pacts are strongly forbidden, as the people are often thought of as being too
weak willed to die alone (Ozawa-de Silva, 2008). The strong immergence of internet suicide
pacts in the recent years has become an epidemic that is especially prevalent within the youth
population of Japan (Ozawa-de Silva, 2008).
Modern Trends
In 1998 the suicide rate increased by 35.2% compared to the previous year which has led
to the connection of economic conditions with suicide (Ken, et al., 2007). Increase of suicides in
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1998 was likely due to the bankruptcy of three large financial businesses in the fall of 1997,
causing the number of unemployed people to jump to over 3 million people (Naito, 2007).
However, Japan remained an affluent country despite the economic recession, with high levels
of education and standards of living (Motohashi, 2011). Unemployment, which is an important
factor in suicide generally, seemed to be particularly relevant to the increase in suicide rates
among males (Kuroki, 2010). The rate of suicide fluctuates with economics of the country (Kaga,
et al., 2009; Ken, et al., 2007; Kuroki, 2010). After the Second World War, Japan became one of
the most prosperous countries in the world. This didnt mean that the global recession didnt
impact it. Employment, while directly impacting middle aged men, has an indirect effect on
families who become more vulnerable to stress (Naito, 2007; Kuroki, 2010).
The economy was often the focus of many studies and thus was the blame of the
increasing numbers of suicides. Mental illnesses, including depression, have been largely
stigmatized within Japanese culture (Ozawa-de Silva, 2008). Suicide in Japan isnt considered to
be linked with depression, but instead is thought of as an act to preserve honour, strongly
contrasted with western cultures (Shiho, et al., 2005). Suicide notes from teenagers often cited
failed exams and failure to get into certain universities as causes (Kitanaka, 2008).
Studies have been conducted on the attitude towards suicide in current medical students
within Japan and research has shown that while older medical students show a more
sympathetic view towards suicide, younger students have a more judgemental opinion (Sato, et
al., 2006). This critical view is likely due to the lack of education focusing upon mental illnesses
and suicide, let alone suicide deterrence. With a multifaceted problem such as suicide, it is
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important for medical students to better comprehend the different aspects involved in order to
prevent future suicide attempters. However, the lack of educational programs up until 2006
had been implemented in Japanese schools, medical or otherwise, and thus medical
implications of suicide were not well recognized. Statistics such as depressed patients are more
likely to visit physicians than psychiatrists have been ignored for many years (Sato, et al., 2006).
There has to be more education, not just medical, regarding suicide in order to prevent it.
Knowledge is the best combatant to social issues such as suicide.
Male employees are usually subject to more work pressures, while females usually
worked as part time employees and left the employment sector after marriage or childbirth
(Liu, et al., 2013). Since the post-world war II era, there has been a large reduction of female
suicides when compared to the number of male suicides (Shiho, et al., 2005; Liu, et al., 2013).
In 1968, Beall speculated that the causes of this sharp decline are due to the changes in the
social roles of women (Beall, 1968). Increase of male suicides from 1983 to 1990 and the
lowering of female suicides has been identified through the use of gendered studies were
conducted in more recent times (Yamasaki, et al., 2004).
In 1969, an attempt to study suicide of Japanese people was made by Dr. Masaaki Kato,
however conclusions of how many suicides were even attempted and were made successful
was difficult to calculate (Kato, 1969). Kato attempted to collect data in Tokyo over the course
of 8 years by doing a survey by visiting private practitioners and hospitals and with the support
of city police but found only that there were 92 attempted vs 231 completed suicides from
1949 to 1956. His results conflict greatly with other statistics reported within the time period
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(Kato, 1969). He found that many of the surviving relatives and families hid suicides committed.
This led to difficulties collecting accurate and unbiased data. However, the link between the
economy and suicide rates was recognized even in 1969. Kato matched the trends in suicide to
the political and economic trends of the country until 1956 and found that there was a positive
correlation between them.
There is very little research that uses more qualitative measures of exploration into this
area. A few studies show the differences between the Japanese views and western views of
death and suicide. However, not enough studies have been conducted on the degree of social
pressures being placed upon those that are largely impacted. Compared to the United States
which had a suicide rate of 10.8 per 100,000, Japan had a rate of 27 per 100,000 in 2003
(Ozawa-de Silva, 2008).
Due to the value of privacy, personal artifacts that would offer insight into the pressures
of the individuals through letters, wills and diaries have been largely ignored as information
resources in the past (Iga, 1966). Historically, the impact of mental disorders was never
addressed by any researchers. The National Police Agency in 2004 discovered that within
suicide notes, health related problems were the leading cause of suicides with being the cause
of 37.5% of suicides, followed by economic (35.2%) and then domestic related problems (9.3%)
(Masahito, et al., 2005; Naito, 2007). Health issues include mental health issues such as
depression and schizophrenia (Naito, 2007).
While there is a link between all of these causes, it is only the economic cause that gets
attention within Japanese society and during research conducted. In the past, mental health
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and thus health issues were largely neglected and thus lack statistical evidence within Japan;
however there have been positive correlations between mental health and depression with the
desire to commit suicide (Naito, 2007). While economic stresses certainly add to emotional
suffering, wealth, without social relationships is no assurance of mental well-being and
happiness. The belief that more money will lead to less suicides is unsupported (Ozawa-de
Silva, 2008). Of course, in these cases depression and other mental illnesses can be a largely
hidden, leading to the conclusion that economic grounds were the only causes (Masahito, et al.,
2005). While suicide has been deeply established with economic difficulties, sudden economic
crises such as business failures are more likely to be linked to suicide than slowly growing
methods of stress such as unemployment (Kitanaka, 2008). Another cause of suicide that is
related to finance is the life insurance payout following the death of a suicide victim. As
sanctioned by the supreme court of japan, life insurance companies cannot refuse to
compensate the insurance payout (Naito, 2007).
The Future of the Issue
Western values must not be placed upon the people of Japan and extreme caution must
be taken when trying to carry out appropriate methods of suicide prevention methods in a
response so ingrained within the Japanese culture. Suicide is a complex problem with not only
socio-economic ties but also religious and cultural dimensions and the best way to manage it
through the use of a combination of different aspects of each of these areas.
Relatives left behind by those that committed suicide often face stigma for wanting to
grieve for their lost family members. Often, suicides were hidden and masked as natural causes
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or other types of death and thus arent able to grieve at all (Picone, 2012). The government
released programs such as the Basic Law on Suicide Countermeasures in 2006 in order to
provide support for families left behind by suicide victims (Kaga, et al., 2009; Motohashi, 2011).
The issue of suicide was not properly addressed until very recently and there were no
suicide prevention measures in place, largely due to the lack of acknowledgement of suicide as
an issue. However, the sharp incline in the suicide rate and the lack of any strong decline in
numbers has caused the government to take action.
In 2007, in hopes of preventing suicides, the Comprehensive Suicide Prevention Principles
were released (Motohashi, 2011). Changes implemented by these laws include educating
children in school of the reasons why they are valuable to society and promoting more research
on suicide among others. In 2012, for the first time in 15 years, the suicide rate fell below
30,000 people, however it is debated whether this is linked to government protocols or due to
growing public awareness (Kambayashi, 2013). Recently, there has been a more holistic
research approach within Japan as there is a growing consciousness of mental health issues.
In order to lead people to suitable psychiatric treatment, there has to be a rise in the
number of people who consult a psychiatrist in the first place when they have depression. To
achieve this, there has to be an increase of public understanding of mental health and growth
towards abolishment of prejudice that is a part of Japanese culture. Holistic and comprehensive
suicide prevention tactics require the use of multidisciplinary approaches in order to reduce the
suicide rate (Motohashi, 2011). With social problems such as suicide linked to economic
problems, such as recessions and unemployment, medical methods alone may be inadequate
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for suicide prevention. The role that society plays is not addressed in Motohashis (2011)
recommendations. Currently, very few municipalities have suicide prevention programs in place
(Shiho, et al., 2005). With the recent prevention laws passed at the government level,
awareness will hopefully reach the local levels and the tolerant views of suicide will change into
views of concern instead.
Although many studies have shown that employment is often a source of mental and
health stress, research has shown that in 2005, more than 76% of workplaces lacked mental
health care measures (Kaga, et al., 2009). A general lack of professionals who knew how to
work within these areas is missing within Japan. Acknowledgement of the significance of
mental health care is still lacking within the general population.
Health problems that are affecting the population as a by-product of stress needs to be
acknowledged. Mental health issues, such as feelings of alienation and depression, of the
populace need to be addressed and fixed on a nationwide scale. Suicide prevention centers
need to be more readily available to the public and without the social stigma attached to them.
Instead of committing suicide to prevent dishonour, change needs to occur within the
community of stigmatizing suicide. Lifestyle related diseases such as suicide often require
collaboration between all levels of society, not just individuals in order to avert further
misfortunes. The slowly declining numbers of suicides suggest a cultural change, not necessarily
a negative in this case.

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