Yuko Kawanishi has been a sociologist specializing in cross-cultural mental health issues for years. She has also researched and written about family, gender, and youth problems in Japan. More recently, she also gained clinical training in the US, and obtained a social work license from the state of New York. Currently, Yuko is teaching for international (university) programs in Tokyo as well as working as a psychological counselor/psychotherapist at an American University campus in Japan.
This research project aims to examine how clinical depression affecting the middle-aged population is being treated in the United States and to explore the applicability of such approaches to Japanese society. A rising suicide rate and clinical depression are two of Japan’s most serious public health problems. 2005 was the eighth straight year in which more than 30,000 people killed themselves, giving Japan the highest suicide rate among highly industrialized nations. However, evidence shows that almost 90% of suicide attempts are caused by depression that is treatable if timely discovered. Individuals experiencing midlife transition often face many challenges. Middle-aged or older Japanese men (including the baby boomer generation) are particularly vulnerable to depression or stress because of an overly work-focused life and poor help-seeking behaviors. They rarely seek treatment for mental health issues voluntarily or discuss their mental condition with family or friends. In contrast to a medical or psychological model that sees depression and suicide originating in individual personality or affliction, a public health model approaches the issue through interventionist measures. These include improving inter-agency collaboration, creating effective media policies to increase public awareness, and trying to eliminate stigma and prejudice against mental illness. Compared to Japan, the United States has a much lower suicide rate, greater mental health literacy and a more developed public health model. It is crucial that Japanese health policy makers – and practitioners – examine how their U.S. counterparts determine cases of depression, ensure sufferers receive treatment from mental health professionals, and provide the appropriate follow-up care for these individuals. At a time when Japan has finally started to take a serious look at strategies to treat depression and measures to lower the suicide rate, it needs all the information available on the mechanisms of social interventions that may be applicable and useful to its own situation. The investigation will be made through comprehensive ethnographic fieldwork in New York City, focusing on two levels of social intervention: the societal/organizational level and the individual level. Interviews with professionals at mental health policy agencies (federal-, state- and local government-level) and service delivery agencies, human resource management in the private sector and media agencies will be conducted, with the aim of determining how new and effective intervention policies and systems have been created. In-depth interviews with successfully treated sufferers of depression will also be conducted to find out the social resources that helped in the process of their recovery, in other words, the consequences of the intervention system. Collectively, these individual case studies will help paint a comprehensive picture of how U.S. society copes with depression. Structural factors and cultural factors will be carefully distinguished and analyzed in order to make realistic comparisons with Japan’s current intervention structure and to assess the feasibility of future public health policies. The project is believed to fit perfectly the Abe Fellowship Program’s research agenda.