Here’s this week’s Media Mix about the media’s treatment of mental health issues, which have been in the news lately. The main thrust of the article is that, influenced by government policy, which has always advocated for isolating people diagnosed with “mental disorders,” the press mostly takes a sympathetic but nevertheless shikata ga nai (“it can’t be helped”) attitude. They rarely question government statements that defend past policy as being acceptable at the time, even when organizations like the Japan Bar Association show that such policies were clearly unconstitutional at the time. The Eugenics Protection Law, which allowed medical institutions to sterilize people with disabilities for the express purpose of safeguarding the gene pool, was mirrored in other countries like Germany and Sweden, both of which have apologized for their respective policies and compensated victims. Japan has done neither and doesn’t seem to think it’s necessary. In the Asahi article cited in the column, the writer, Junji Kayukawa, says that 24,991 sterilizations were performed under the law—16,475 of them without patients’ consent—and 58,972 abortions. He mentions several cases that imply some subjects of the law were simply incovenient to their families, who asked doctors to sterilize them. In many of these cases, they simply came from impoverished backgrounds and likely did not receive sufficient education, so they were “diagnosed” as being somehow “mentally deficient.” One of these people, a woman who eventually married, is suing the government. The problem goes beyond the lack of official accountability. The increasing acceptance of prenatal checks through blood tests to discover any “abnormalities” in fetuses that could develop as birth defects has prompted expectant parents to abort fetuses that may have problems. Kayukawa is afraid this practice is simply maintaining the Eugenics Law under a new guise. If the media properly explained the Eugenics Law as an historical fact that society should learn from, then people could understand more fully their rights as human beings.
Similarly, the government’s policy of isolating people diagnosed with mental illness, as explained in the NHK documentary, has never really gone away, though doctors have wised up to its tragic consequences and many no longer participate. NHK interviewed one of the nurses who worked with the subject of the doc, a man named Tokio, and when asked if she thought he needed to be institutionalized for 39 years, she said she always thought he was “normal,” but that according to hospital policy a patient who insisted he be discharged, which Tokio did on occasion, was automatically classified as being “unstable.” It was the classic Catch-22. The doctor who was in charge of Tokio at the time—he eventually left that hospital and now supervises elderly people with dementia—admitted that the circumstances were “really bad.” He was in charge of 200 mental patients, presumably because the hospital took in every case they could in order to make money, and that he wanted to discharge most of them but couldn’t. “It was legal at the time,” he said. “I didn’t know what my role [as a doctor] was.” Now, many of these patients have been discharged simply because hospital management has become more enlightened, but it’s still a big problem, and one reason it’s a problem is that patients’ families don’t want them to be discharged because they think they will have to be responsible for them. Until the government or some organ of authority simply states a change in basic policy toward people with presumed developmental disabilities, this attitude will no doubt prevail.