Home Custody of Mental Patients

in Modern Japan
Various Perspectives of Japanese
and German Psychiatrists

Akira Hashimoto
Aichi Prefectural University
Japan
Did the restraint and confinement at
home no longer exist in Europe in the
19th century?

Inspection of 164 mental patients at

home in the Canton Fribourg,
Switzerland, in 1875
(Klaus Ernst, 1983)
 Home custody in Japan was not a
relic of the pre-institutionalization
phase. But it was reality which was
authorized by the government in
the modern period.
 Mental Patients’ Custody Act
(1900-1950)

• The confinement of patients at home

under the control of the police
 A home custody patient
(Oita Prefecture, 1940)

• A 31-year-old schizophrenic man

• Since 7 years, mentally ill
• trespass at strangers’ houses and
violence on the people and property
there
• His father decided to confine him at
home.
 The plan of custody room
(Oita Prefecture, 1940)
Front view Side view

ceiling

258cm
doorway
latticed
floor windows
ground
45cm
295cm 197cm

Main building
(dwelling house)
custody room

Overall view of Source: The documents of

farmer’s house Oita Prefecture Archives
Patient’s meal menu for a whole week
(Oita Prefecture, 1940)
breakfast lunch supper
Sun rice, miso soup, rice and raw rice,
egg and pickles fish vegetables
and grilled
fish
Mon rice, miso soup rice and
rice and boiled
and pickles vinegared fish
vegetables
(without egg) or vegetables
Tue rice, miso soup rice and rice,
grilled fish boiled

Sat (without egg) vegetables Fish

Source: The documents of Oita Prefecture Archives
 The number of patients in home
custody and in mental hospitals
25000

20000
home custody
mental hospital
15000
The statistics of patients
10000 in mental hospitals
before 1928 are the
estimated numbers.
5000

0
1924 1928 1932 1936 1940 year

Source: Ministry of Health and Welfare

 “Patients are unfortunate
enough to be born in Japan”
Criticism of home custody

Shuzo Kure
(1865-1932)
Psychiatrist,
Professor of the
University of Tokyo
 Kure & Kashida: “The present state and
the statistical observation of mental
patients under home custody” (1918)

Home custody in Gumma Prefecture

Source: Kure & Kashida (1918)

Family, culture, and
nationalism
Approval of home custody
“Cultured nation (Kulturland)”
and psychiatry:
Germany and Japan

“parallelism”
Wilhelm Weygandt
(1870-1939)
Psychiatrist,
“Where a developed care for Professor of University

mental patients exists, the of Hamburg

whole culture there is also

high developed.”
 “beauty of family”
From the 1930s onwards, Japanese
medical doctors belonging to the
government defended home custody.

Nobuharu Aoki:
“Most patients are treated
well because of a good
quality in the traditional
family system in Japan.” Custody room in the house
(Aoki, 1937)
 Conclusion
• Home custody under government oversight:
a peculiar form of institutionalization.
• Duality of its institutional and familial
characters
• Criticism: unacceptable institutionalization
• Approval: family and tradition in the
nationalistic framework from without and
from within