During the first half of the 2020 pandemic year, suicide in Japan was running at a five-year low on top of a decline that had seen the annual suicide count decline from 31,600 in 2010 to 20,169 in 2019.
There was a further notable decline in the first half of 2020. The long run secular decline has been barely mentioned in general interest English language news media. I found only one article in a prominent news venue that took note of this.
In contrast, during the latter half of 2020, when the suicide count started to move upward, especially for women and young people, mainstream media suddenly became interested. There was a spate of articles beginning in October, 2020, and continuing to the present.
The articles that appeared can be two broad categories. The more intelligent articles treated Japan (and South Korea) as being indicative of what might be happening as a result of COVID-19 in countries that publish suicide data months or even years after the fact. Another set of articles treated Japan as an exceptional case, relying on vague ethno-racial generalizations and clichés.
As might be expected from her previous writing, Motoko Rich, the New York Times bureau chief in Tokyo, led the pack with not one but two articles.
The Deadly Attraction of Clichés
On October 5, 2020, the New York Times published “The Pressure to Be Perfect Turns Deadly for Celebrities in Japan,” keyed to the suicide in late Sepetmber of Yuko Takeuchi, a popular actress known internationally.
Rich then repeated the same ethno-racial clichés in a second article published on February 22, 2021, under the headline “As Pandemic Took Hold, Suicide Rose Among Japanese Women.”
According to Rich, the Takeuchi suicide and three other celebrity suicides she cited, took place in the context that “many feel pressure to hide their personal struggles. The burden is compounded for celebrities whose professional success depends on projecting a flawless ideal.”
Takeuchi did not, however, leave a suicide note and was reported as being in seemingly good spirits up until hours before her suicide.
Possibly because Takeuchi left behind two minor children, Japanese media, including the “wideshows” (daytime variety shows heavy on celebrity gossip), had carried little speculation about what led Takeuchi to suicide. What had appeared had been very generic, including postpartum depression (she gave birth to her second child January 31, 2020) to conflicts with relatives.
Rich made no mention of celebrity suicides in other countries, including South Korea, Britain, and India. Her only backing for her claim were statements by several Japanese “experts” who provided Rich with vague supportive generalizations of the type common in the much-derided Nihonjinron genre.
The experts she cited were not specialists in the cross-national study of suicide. The one Japanese expert cited in other articles, Michiko Ueda, had not stressed alleged social peculiarities for Japan, instead focusing on factors that drove suicide in all countries.
The United States as the ‘Gold Standard’
In this article as in others she has written, Rich assumed that the United States was the one and only reference point for judging Japan and finding it defective. She wrote, “And unlike in the United States, where celebrities now talk more openly about seeking out psychological help, such behavior is largely taboo in Japan, which has been slower to develop mental health services, despite some improvement.”
Once again, Rich offered no real evidence to support her two points.
Japan being different from the U.S. as imagined by Rich does not mean that it is an inferior or deviant case. It is not hard to find examples of celebrity suicide in the U.S. where the individual did not talk openly and did not seek help — the 2014 suicide of Robin Williams being a case in point. A subsequent study found that there had been a 10% increase in suicide in the US following his death.
That Japanese are reluctant to talk about mental issues may have been true at one time, but that is far from the case today.
Everything in Japan Carries a Stigma
The claim by Rich that Japanese are reluctant to talk about mental health issues is an example of a common ethno-racial cliché about the Japanese that is usually phrased in terms of stigma.
While there may well be stigma in Japan, that is not equivalent to demonstrating that it is only in Japan or is more prevalent in Japan.
A search on “mental health stigma” or “suicide stigma” will instantly turn up scores of articles for the U.S./U.K., stating that stigma is a major issue in those countries. The stigma associated with mental health issues has been debated in the U.K. parliament.
In the absence of data or studies to show that stigma is more common or more pronounced in Japan, the assertions made about Japan are nothing more than ethno-racial stereotyping.
Japanese Who Peddle Stereotypes
That Japanese respondents will make similar assertions does not validate the claims made in foreign-language reporting. As in the case of foreign reporters, the Japanese cited have no data to support their claims, and have not been involved in mental health care or suicide prevention in countries other than Japan.
日本人論 (Nihonjin-ron, “theories/discussions about the Japanese”), a genre long popular in Japan, has conditioned many Japanese to believe without hard evidence that Japanese are exceptional in everything, including the length of their intestines.
A common argumentative strategy on the part of Japanese pushing a reform agenda or seeking more funding for their particular area is to assert that “Japan lags behind” some countries, many countries, the U.S., the West, global standards, either with no evidence whatsoever or with only cherry-picked evidence.
This is what I call “the grass is greener everywhere else” style of argumentation. While this may be an effective device for pushing an agenda in Japan, it supports foreign notions of superiority vis-a-vis Japan and the Japanese.
Selling Pills for Mental Colds
Further, claims that mental health issues are not talked about in Japan are simply untrue. In 2010, Ethan Watters published Crazy Like Us: The Globalization of the American Psyche (Free Press, 2010). The final chapter was entitled “The Mega Marketing of Depression in Japan” and described an extraordinarily successful campaign by SmithGlaxoKline to sell the Japanese public on a pharmaceutical answer to generic depression.
His study became a must read for courses in marketing in U.S. colleges. His case study of Japan is the subject of various cram manuals for college students.
Until I read the Watters study, I did not know what was going on. But in searching for television programs that I might use in teaching, I remember being struck by the number of programs dealing with depression. It seemed that if you were not suffering from it, there was something wrong with you.
The New York Times noted this phenomenon in a 2004 article headlined “Did Antidepressants Depress Japan?” This was one of a number of articles on the same subject.
Programs dealing with mental health issues, especially depression, are a staple of the Heart Net (ハートネット) series on NHK, Japan’s public broadcaster.
Bloomberg Does It Better
Shortly after the Motoko Rich article, Bloomberg distributed an article entitled “Suicide Spike in Japan Shows Mental Health Toll of COVID-19,” authored by Aya Tomisawa and Marika Katanuma.
In striking contrast to Rich and her emphasis on alleged Japanese social peculiarities, Tomisawa and Katanuma began their article by saying that Japan might offer “a first glimpse into the consequences of the mental health strain brought about by COVID-19 around the globe.”
Japan could play this role because it was one of only two major countries that publish timely suicide statistics. Suicide numbers for April will appear in mid-May. Data for other countries appears with a lag ranging from five or six months to several years.
The Bloomberg report also took up South Korea, which like Japan publishes timely suicide numbers, noting that South Korea had “the highest suicide rate in the OECD.”
While the Bloomberg report was not entirely free from ethno-racial clichés, these were incidental, not central as in the case of Rich’s writing, and were stated in tentative terms. Thus, they said, “In Asia, the toll could be compounded by greater stigma around mental health issues compared to western societies.”
No such conjecture in the absence of evidence would have been better, but given the tendency of foreign media to claim stigma for just about everything in Japan, this is probably the most that could be expected of journalists.
The Japan Times — which seems to have a business model based on telling foreign readers that “Japan lags behind some countries” for this, that, and the other thing — carried the article under the headline “Suicide spike in Japan shows mental health toll of COVID-19,” obliterating the key point of the article, which was that Japan and South Korea might be indicative of what was happening among countries that did not publish timely suicide data.
CNN Really is Fake News
Donald Trump frequently labeled CNN as fake news. Whatever the merits of Trump’s claim, the network’s reporting on suicide trends in Japan definitely deserves the fake news label. On November 28, 2020, it released an article under the headline “In Japan, more people died from suicide last month than from Covid in all of 2020. And women have been impacted most.”
While nominally correct, this head is misleading clickbait. That more people in Japan “died from suicide last month than from Covid in all of 2020” is testimony to the low COVID-19 death rate in Japan, not the high suicide rate.
As of April 16 Japan has had 520,745 total infections and 9,538 deaths attributed to COVID-19. The U.S. has had more than 32 million cases and 579,000 deaths. In other words, the U.S. has had more deaths than Japan has had infections.
Even allowing for the fact that the U.S. population is 2.6 times that of Japan, it is clear that the CNN headline is an example of what was a major theme in my course “Japan in the foreign imagination” — an effort not to inform foreign readers about Japan, but something intended to make them feel superior to the Japanese and fortunate not to be in Japan.
This intent is made even more explicit by other statements in the article.
“Japan has long struggled with one of the highest suicide rates in the world, according to the World Health Organization. In 2016, Japan had a suicide mortality rate of 18.5 per 100,000 people, second only to South Korea in the Western Pacific region and almost double the annual global average of 10.6 per 100,000 people.”
“One of the highest” is weasel wording common in articles about Japan. The rates cited are also for the crude suicide rate, not the age-adjusted rates that are considered to better represent the propensity of people in a given country to commit suicide.
Age-adjusted WHO suicide rates for 2016 show Japan in 30th place with a rate of 14.3, well below the highest reported rate of 30.2 per 100,000 for Guyana, as well as European countries such as Russia (3rd, with 26.5), Lithuania (4th, with 25.7), Latvia (16th, with 17.2), Belgium (22nd, with 15.7), and Estonia (29th, with 14.4).
The CNN article is also careful to avoid mentioning that the Japan rate of 14.3 was not notably higher than the U.S. rate of 13.7. It also avoided mentioning that the U.S. rate had been increasing for two decades. As stated by the National Institute for Mental Health, “During [the] 20-year period (1999-2018), the total suicide rate in the United States increased 35% from 10.5 per 100,000 in 1999 to 14.2 per 100,000 in 2018.”
The Japan rate went in the opposite direction, such that some sources put the Japan rate for 2019 as almost identical to the U.S. rate.
Suicide Among Women
The jumping off point for all articles was that the increase in suicide numbers was on a month-by-month basis primarily among women, and for the year entirely among women.
CNN and all other articles emphasized what was seen as a dramatic increase in the number of women committing suicide, typically coupling this to assertions that women were singularly burdened in Japan.
This emphasis was warranted in that the increase in some months was quite striking, and ultimately there was a 15% increase in the number of female suicides in 2020 relative to 2019, while the male suicide count was essentially unchanged.
The emphasis was also warranted in that previous events, such as the financial crisis following the collapse of Lehman Brothers (September 15, 2008), resulted in an increase in male suicide but little change in female suicide — a point stressed by Michiko Ueda in a presentation at the FCCJ (Foreign Correspondents Club Japan) in February 2021.
What was not warranted was the use of single cases, such as the Takeuchi suicide cited by Rich or the suicide of a Tokyo woman who “was worried that she might have transmitted the virus to her daughter.” A sample of one does not warrant generalization.
This applies even more to an aggravating pattern I call template journalism in which it appears that stories are being written by filling in a template: clickbait headline, exaggerated, personal story from someone who allegedly personifies the issue, some cherry-picked data, some quotes from “experts” who all just happen to agree with what the journalist believes, and finally a conclusion that Japan has a problem not seen in other countries, or of far greater magnitude than elsewhere.
A BBC article featuring an interview conducted “in a walk-in center in Yokohama’s red-light district, run by a suicide prevention charity called the Bond Project” with “a young woman who has repeatedly tried to kill herself” struck me as tabloid-style journalism about a very serious subject. This detracted from an otherwise decent article that also relied on an interview with Michiko Ueda.
This can be seen by comparing such articles with the presentation that Michiko Ueda made at the FCCJ. She did not use individual anecdotes or indulge in generalizations about how alleged Japanese cultural or social peculiarities might drive suicide in Japan. And, above all, she stressed that not only was the Japanese data too limited for sweeping generalizations, there was as yet no comparative data for other countries — and there would not be for months or even years.
If nothing else, the fact that there are countries — including some in Europe — that even in the best of times have suicide rates higher than Japan should make journalists cautious about asserting alleged Japanese social and cultural peculiarities as explanatory factors.
Similarly, the fact that news media in other countries has stressed the pandemic impact on women in their home countries should lead to caution about making Japan an outlier. But that has not been the case and does not happen in practice. On January 16, 2021, The Guardian ran an article by Justin McCurry headlined “Japan’s suicide rate rises 16% in second wave of Covid, study finds.”
Despite the author having a Japan-Korea remit, no mention is made of the South Korean case taken up in other articles. The emphasis is taken from a journal article in which it was said, “Unlike normal economic circumstances, this pandemic disproportionately affects the psychological health of children, adolescents and females (especially housewives),” but there is nothing at all that is Japanese about this.
This is what I have taken to calling a sunrise, sunset statement. The sun rises in the east and sets in the west in Japan, but it does that everywhere. What precisely makes the content of this newsworthy just because the source is Japan?
Closing the Gender Gap
There is one glaring problem with the emphasis on female suicide common to all articles. If suicide is taken as an indicator of the oppressive nature of Japanese society, even with the increase in female suicide in 2020, the fact remains that, in Japan, as in other highly advanced countries, men commit suicide at roughly twice the rate of women.
This emphasis on female suicide was noted in comments by readers of the second Motoko Rich article who sensed an anti-male bias.
The same tendency to normalize suicide by men while treating it as exceptional in the case of women is also found in reporting on karoshi (death by overwork). When a young woman working for the advertising giant Dentsu was certified as a case of karoshi, it was very widely reported in both domestic and foreign news, although male karoshi is far more common than female karoshi.
In 2016, the suicide rate for Japanese males was 20.5 per 100,000 population versus 8.1 for females, or 2.5 times the female rate. Even with the 2020 increase, twice as many males committed suicide as did females.
The ratio is lower here because my 2020 vs 2019 comparison is based on total numbers, not the suicide rate, which is adjusted for population structure.
With the recent publication of the 2021 gender gap report from the World Economic Forum in which Japan was ranked 120th, there has been a plethora of articles about why the gender gap in Japan is so large and how it might be closed.
These articles all seemed predicated on the assumption that “closing the gender gap” would be good for women in Japan. It did not figure in any of these articles that the gender gap in terms of suicide may be decreasing as a result of more women being in the labor market, and thus subject to the stresses that have been shown to drive male suicide in the past. It should. Closing the gender gap is not necessarily a win-win situation for women.
Suicide Among the Young
To be sure, the increase in suicide by young people and juveniles is cause for concern, but it needs to be put in perspective. The overall number is quite small. And while the rate in Japan has not been declining, it has not been increasing as is the case for the U.S.
Further, while it is true that suicide is the number one cause of death for young people in Japan, and Japan is the only G7 country for which that is true, this is because Japan has a notably low number of deaths due to accidents, the leading cause of death in other G7 countries.
An alternative approach would be to follow the “American model” and increase the number of young people whose death is the result of homicide. The U.S. is the only G7 country where homicide is among the top three causes.
That journalists repeatedly cite the number of suicides in Japan demonstrates either malice toward Japan, a lack of numeracy, or both. Suicide could be knocked out of its first place position by increasing the death count from accidents. This would, of course, increase the overall death count for young people, but it would allow bragging that suicide was no longer the leading cause of death for young people in Japan.
Journalists (and academics) who cite an indicator that can be “improved” by making things worse overall deserve absolutely no respect and in my view are guilty of unprofessional conduct.
The Problem of ‘Self-Harm’
Suicide is one component of the broader category of statistics that deal with self-harm. It is one of the two major categories that has fatal consequences. The other is death by unintentional drug overdose.
American data for the 2020 calendar year is not yet available, but government reports indicate that the one-year period ending August 2020, which covers much of the 2020 COVID period, saw 88,000 drug overdose deaths — a substantial increase over the same period one year earlier. Scattered reports also indicate an increase in drug overdose deaths in Canada.
Supply chains for illicit drugs have been disrupted. Tainted/mixed drugs are being sold. Self-help groups have not been able to meet, and mental health care, generally seen as inadequate to begin with, has been curtailed.
If the Japanese committed suicide at the rate Americans killed themselves with drug overdoses, Japan should have more than 33,000 deaths each year. The number has never been that large. And, in 2020, even after the increase discussed here, Japan had just over 21,000 suicides. Drug overdose deaths, while not unknown in Japan, are exceedingly rare.
As of April 16, final 2020 crime figures for the U.S. were not available, but preliminary FBI data available in March suggested a 25% increase in the number of murders. The year 2020 also saw record gun sales.
Neither the increase in overdose deaths nor the increase in murders has been mentioned in any of the many articles I have found about COVID-19 and suicide in Japan, although, if the subject is COVID-19 and its social impact, both are relevant.
This omission suggests strongly that even the better articles about suicide in Japan are still consciously avoiding saying anything that would even indirectly imply that overall Japan is weathering the COVID-19 pandemic better than the predominantly white English-speaking countries.
Suicide is a complex subject with many uncertainities. The data associated with it generally does not allow making definitive cause-and-effect statements. This was repeatedly stated by Michiko Ueda in her February presentation at the FCCJ.
As with most serious subjects about Japan or any country, suicide requires knowledge that the typical generalist journalist does not have. When this is combined with stereotypical beliefs about Japan and the Japanese, plus what I suspect is a stated or implicit mandate not to say anything about Japan that makes it look superior to any predominantly white country, the result is articles such as those taken up here.
If you are having trouble with mental health due to COVID-19 or for any other reason, check the website set up by the Ministry of Health:
- Japanese language: Check here for more information.
- For all other languages, make sure to contact your local health center, that are usually provided with a translator that can help you with your queries. Phone numbers can be found here.
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Author: Earl H. Kinmonth
Find other analyses and observations about Japan by Earl Kinmonth on JAPAN Forward at this link.