PsychoDoctor and internet suicide: mental health and psychiatry in Japan

Cover of the DVD for PsychoDoctor.

The latest issue of Transcultural Psychiatry includes two articles which address mental health and psychiatry in Japan.

In “Widening the Psychiatric Gaze: Reflections on PsychoDoctor, Depression, and Recent Transitions in Japanese Mental Health Car,” Ken Vickery examines Japan’s status as something of an outlier among post-industrial states in terms of mental health services (long-term hospitalization continues to be a common mode of care for patients with schizophrenia), and looks at the efforts made to transform representations of psychiatry by PsychoDoctor, a recent television series (right). His abstract:

“Japan has one of the world’s highest rates of psychiatric institutionalization, and popular images of mental health care and public attitudes toward mental illness there have been stigmatized for decades. However, there are transitions underway that are reshaping the mental health care landscape as well as affecting public representations of mental illness. Those transitions include attempts to promote community-based care, move away from long-term hospitalization, reduce stigma, increase utilization of services, and bring clinical psychological services under the national health insurance umbrella. This article discusses one cultural representation in which those transitions are brought into relief: a 2002 television series entitled PsychoDoctor that portrayed the clinical practice of a psychiatrist. The article analyzes the messages inherent in the series about the nature of mental illness, the everyday-ness of sufferers, and the expanded repertoire of treatments now available. In so doing, the article suggests that the efforts of progressive clinicians, pharmaceutical companies, and mental health activists to put forth new images of mental illness and mental health care are now having a degree of success in the arena of popular culture,” (Vickery 2010).

“Existing models for understanding suicide fail to account for the distinctiveness of Internet group suicide, a recent phenomenon in Japan. Drawing from an ethnography of Internet suicide websites, two social commentaries in Japanese popular culture, and the work of developmental psychologist Philippe Rochat, I argue that participation in Internet suicide forums and even the act of Internet group suicide result from both a need for social connectedness and the fear of social rejection and isolation that this need engenders. These needs and fears are especially strong in the case of Japan, where the dominant cultural rhetoric ties selfhood closely to the social self that is the object of perception and experience by others. I show how such an understanding of Internet group suicide helps us to understand some of its basic characteristics, which are otherwise difficult to explain and which have puzzled the Japanese media and popular accounts: the “ordinariness” or casual nature of Internet group suicide, the wish for an easy or comfortable death, the wish to die with others, and the wish to “vanish.” Internet group suicide sheds light on questions of Japanese selfhood in modernity and expands our understanding of suicide in Japan in general,” (Ozawa-De Silva 2010).