Gender Inequality Is Driving a Mental Health Crisis in Japan

Gender Inequality Is Driving a Mental Health Crisis in Japan

Gender Inequality Is Driving a Mental Health Crisis in Japan

For many Japanese women, social isolation stems from deep economic problems and social inequalities that the Ministry of Loneliness will never address.

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Kobe and Tokyo—On a brisk morning in late February, I met Reiko Masai at a community center in the outskirts of Kobe, about three hours from Tokyo by bullet train. A lifelong advocate for gender equality in Japan, Masai, 73, has come here every Saturday since 2011, offering an open consultation for struggling women.

Most attendees are single mothers or divorcees facing financial and emotional hardship, marginalized in a society where these labels carry heavy social stigma. Some women bring their children, who play with puzzles and blocks as their mothers meet with legal advisers and mental health counselors in offices scattered around the building. Meanwhile, volunteers prepare grocery bags of rice, ramen noodles, curry, and cookies for the women to take home.

In 2011, Masai founded Women’s Net Kobe Inc., the country’s first nonprofit to call attention to gender-based violence after the “3.11” earthquake and tsunami that devastated eastern Japan. Following the disaster, domestic violence soared, and women, saddled with caregiving responsibilities, reported more mental health problems than men. Masai told me, “Any time there’s an event or period that worsens inequality, women always bear the brunt.”

Among countries with developed economies, Japan has some of the highest rates of gender inequality. Women are underrepresented in politics, higher education, and the labor force, and face acute gaps in wages. Although more women have begun working in the past several decades, that’s largely come in the form of precarious part-time or contract jobs that shut them out of stable career paths in a rigid labor market.

Then Covid-19 hit, pushing women further into the margins. Pandemic job losses disproportionately affected women in Japan, with a severe financial and psychological toll.

Many of the women Masai works with, some of whom are victims of domestic violence, have had difficulty finding work. Even before 2020, single mothers in Japan struggled enormously. Fifty-six percent live in poverty—the highest of all OECD nations, eclipsing the US rate of 33.5 percent. Women in Kobe said that a deep-seated stigma locked them out of the workforce, making it nearly impossible for them to stay afloat.

One woman, who preferred to provide only her first name, Sachaa, left an abusive relationship a decade ago with her then-3-year-old son. Because she had married and had her son young, she had limited work experience, and wasn’t able to find a job after the divorce. But applying for government benefits was “off the table,” she said. Most struggling single mothers, according to Masai, go to great lengths to avoid government assistance, concerned that it will hurt their job prospects or even their chances of remarrying. Even worse, as per a policy that was on the books until March 2021, benefits officers would contact an applicant’s close relatives to see if they could financially assist before determining whether to disburse benefits. Sachaa’s divorce had soured her relationship with her parents; the prospect of the benefits office contacting them was humiliating.

An employment agency set her up with a series of interviews, where, as a single mother, she was bombarded with questions about childcare: Who will look after her son during her shifts? What will she do if he gets sick at day care? “I retreated,” Sachaa, now 45, told me. “I stayed at home, I had no community, no connections. I was isolating myself.” Friends offered support, but she was wracked by guilt. “I didn’t want to go out and socialize. I felt I was to blame.”

Her experience reflects the devastating interplay between gender discrimination and social isolation. Yet this has been an overlooked element in otherwise robust coverage of Japan’s mental health crises: unhappy, overworked young people; a so-called loneliness epidemic, marked by an explosion of the number of extreme recluses and lonely deaths among the elderly; one of the highest suicide rates in the developed world.

The pandemic disrupted that narrative, prompting new government attention to the problem. Women started killing themselves at an unprecedented rate. And while the overall suicide rate—which spiked as of 2020—has leveled off amid the easing of pandemic-era restrictions, the rate among women has remained elevated. Between 2019 and 2020, the number of women who died by suicide jumped 15 percent. That continued to increase in 2021, when 7,068 women killed themselves, up 42 from the previous year. In comparison, the number of men who died by suicide fell by 116 to 13,939—still an extremely troubling rate, but also the 12th consecutive year of decline.

“Suicide was always a men’s issue,” said Michiko Ueda-Ballmer, an associate professor at Syracuse University who studied suicide in Japan. During the pandemic, “suddenly, women’s suffering became visible.” For the first time, “the government was forced to confront an approach to suicide prevention that had previously focused exclusively on middle-aged men.”

The past two decades of economic reforms in Japan—while promising major gains for women—have pushed women to the sidelines. According to Chizuko Ueno, a 74-year-old sociologist and leading feminist critic, policies to boost women’s economic opportunities—notably, former Prime Minister Shinzo Abe’s “Womenomics,” launched in 2013—have helped solidify their economic disenfranchisement.

Ueno’s calls for women to shun marriage and motherhood have earned her enemies among Japan’s establishment, but she doesn’t discount the gains women have seen over her career. Still, she says those gains mask another reality: Women make up 70 percent of “irregular workers,” with short-term, low-paying contracts that offer little stability.

And even with a push to boost women’s employment, strict gender roles have made change slow. Women still tend to stay home with children—nearly two-thirds leave the workforce after having their first child; Japanese companies often give bonuses to husbands whose wives stay at home, and the tax system benefits single-income families.

Ueno blames Japan’s drift away from a “society with a true middle class” on Abe’s economic policies, a spate of reforms that did little to improve economic livelihoods and worsened inequality. Japan has the second-highest poverty rate among G7 nations and the ninth-highest in the OECD, according to 2020 data; nominal wages rose just over 1 percent from 2012 to 2020, and average household wealth dropped by 3.5 percent from 2014 to 2019, while the top 10 percent grew wealthier.

It is against this backdrop that the government tried to integrate women into the economy, only to relegate them to “the underclass,” Ueno said. “Japan has become a class society, and in a class society, you cannot have social solidarity,” she told me over tea at her office in a Tokyo suburb. Women have either been pushed into low-paying jobs or “locked out of the workforce entirely,” confined to caretaking roles for children or the elderly. “It’s a man-made disaster, created by policy.”

During Abe’s time in office, he slashed Japan’s once-generous social welfare program, cutting protections for poor households, including the elderly, single-parent families, and individuals with disabilities. And although his successor, Fumio Kishida—also from the conservative and nationalist Liberal Democratic Party—vowed to reverse pandemic-driven inequities and adopt an approach dubbed “new capitalism,” he’s made few changes to Abe’s economic model, reneging, for example, on a promised capital gains tax shortly after his term began.

Ueno draws a straight line from women’s economic marginalization to their mental health challenges. “Poverty and stigma have squeezed women into isolation,” she said. Years of neoliberal reforms have “focused on notions of self-determination and individual responsibility that make it difficult for people on the sidelines of society to access support networks or sources of social solidarity.”

According to Chieko Akaishi, director of the Single Mothers Forum, the dual stigma around mental health and motherhood has hindered efforts to raise awareness about social isolation among women. During the pandemic, her nonprofit surveyed its membership; the majority of women reported experiencing severe depression and anxiety. But she hesitated to publicize those findings, concerned that doing so would exacerbate the discrimination her members face by associating their status as single mothers with mental illness. “If we were to use these results to get the government’s attention, we worried we would just worsen the social stigma against single mothers. So we couldn’t emphasize it. It’s absurd that we had to hide this troubling information, but this is the reality.”

Kunihisa Koyama, CEO of Little Ones, a nonprofit supporting single mothers and their children, said the taboo has diminished on some mental health issues women face, such as postpartum depression, but not on others. He attributes that to the government’s concerns about Japan’s declining fertility rate—not about women’s well-being. “Isolation and loneliness are constant for many women, but the government only focuses on what happens during pregnancy,” he said, describing a “compartmentalized” approach to women’s issues. The government can focus on employment, or on motherhood, but “they’ll never take the big picture view of how women are faring in society as a whole.”

It’s no surprise, then, that attention to depression and loneliness has focused primarily on men. The case of hikikomori, extreme recluses who hole themselves up for years at a time, is an example. While surveys indicate that some 70 to 80 percent of hikikomori are men, experts say these numbers exclude many women by overlooking their experiences with social isolation.

In her research, Sachiko Horiguchi, a professor of anthropology at Temple University in Tokyo who studies hikikomori, has increasingly encountered housewives who became isolated after being pushed out of the labor force. In essence, she explained, they become hikikomori, but are never described as such. Women are expected to be at home, handling domestic tasks. Their solitariness is, in a sense, a given. “For men, marriage is a way to break patterns of isolation, whereas for women, it’s a driver of loneliness,” she told me.

Ueda-Ballmer, the Syracuse professor, put it succinctly: “Women don’t call themselves hikikomori. They call themselves housewives.”

Men don’t face the same stigma around depression or social isolation, Horiguchi said. That’s in large part because the view of men’s mental health has been framed by professional life. “For men, the loneliness crisis is seen as stemming from overwork culture; depression has become a marker of overwork, especially for middle-aged men,” she said. Accordingly, mental health crises among men become a “higher-stakes problem, a threat not just to the economy but to masculinity and manhood.” If men are isolated, she explained, “if they’re suffering from depression due to overwork, that’s valued in a different way. It’s a sacrifice. It’s like they’re working for Japan.”

A government survey released in March, however, undermines the idea that loneliness is primarily a male problem: It showed 40 percent of those identifying as hikikomori were women. According to Kyoko Hayashi, a former recluse who founded a support group for women hikikomori, government surveys did not previously consider homemakers and domestic workers in their samples.

Hayashi’s support group has organized meetings with over 5,000 women. While she said there’s no majority profile, a through line among women she works with is societal pressure. “There’s this feeling that you need to act as a good mother and a good wife, and on top of that, the government is saying, women should shine, they should work more, they should have careers, too,” she said. “And for many women, especially younger women, they think they’re no good if they can’t accomplish everything, they feel guilty.”

During the pandemic, Japan’s government created a Ministry of Loneliness, modeled after the agency the United Kingdom created in 2018, to respond to growing isolation. Although many people told me the agency helped raise awareness about the issue, its efforts have been plagued by bureaucratic snags.

“The government isn’t very well-equipped to tackle loneliness and isolation,” Ren Onishi, an adviser to the ministry, told me. “The pandemic was the first time the government was forced to confront the relationship between economic hardship and loneliness,” but struggled to reach its target population. Although the ministry set up a website with a chatbot connecting people to services, it didn’t record how many went on to receive help. Questionnaires aiming to assist people, Onishi added, were written in overly formal, inaccessible language that almost certainly turned some away. And when it comes to addressing women’s social isolation, the ministry’s efforts have fallen short.

That’s because, for many women, loneliness stems from deeper economic problems that a new website or government agency won’t address.

To confront the problem, Onishi said, Japan must, above all, reduce gender violence and inequality. “Gender inequality is a major barrier to any policy that would effectively tackle loneliness, but efforts to address structural issues, like rates of domestic violence or women’s employment, have not been prioritized. But this government isn’t very good at recognizing the need for structural change.”

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