Koichi Naka

Attacked by the gods or by mental illness? Hybridizing mental and spiritual health in Okinawa

In 1972, the reversion to Japanese rule brought with it many changes for Okinawans, among them the widespread introduction of psychiatry. Psychiatry was not well received at first due to the extensive presence of shamans, who had traditionally dealt with Okinawans’ spiritual and psychological afflictions. Both psychiatrists and shamans claimed to be able to heal those who were labelled ‘mentally ill’ or ‘mentally disordered’ by psychiatrists. This conflict between systems over the body of the patient/client is relevant to debates today about both the perceived value of generic mental health diagnosis and treatment regimes compared with indigenous healing,1 and the question of isolating how markers or symbols of identity are employed in patients’ help-seeking choices. We examine three cases from the 1970s of patients who were diagnosed as suffering from both schizophrenia and an indigenous condition known as kami daarii.

Assessment of psychosocial stressors and maladjustment among foreign students of the University of the Ryukyus.

An extensive survey of problems encountered by foreign students of the University of the Ryukyus and the resulting levels of stress was carried out in order to determine the main stressors hindering academic progress and personal adjustment. Subjectively perceived stress levels after arrival in Japan were obtained from 134 subjects through a comprehensive questionnaire for reporting specific stressors. The 30‐item General Health Questionnaire (GHQ) was included to assess mental health state. Differences in scores by area of origin were also determined for the total GHQ scores and its sub‐scales. The GHQ results showed that regardless of length of time in Japan, more than 60% of the subjects scored within a range usually indicative of a mental health risk. Mean scores by area of origin showed a 50% reduction over time for non‐Chinese Asians and North American/Europeans, but only a reduction of 1.1% or less for Chinese, Latin American, Middle/Near Eastern and African subjects. Limitations in achievement of academic goals were reported by the greatest number of students as causing moderate to excessive stress (57.5%); most frequently reported causes were language inadequacy (55.2%), reference materials unavailable (34.3%), unfamiliarity with Japanese study methods (32.1%), and inadequate guidance from teachers/advisors (26.9%). Various social, personal and daily life problems in the non‐academic setting were also reported as causing high stress levels. Most of the stressors identified are not considered inevitable and point toward directions to pursue in preventive strategies in mitigating psychological distress and maladjustment of students.

Longitudinal change in youth suicide mortality in Okinawa after World War II: a comparative study with mainland Japan.

Abstract Okinawa prefecture has a unique socio‐cultural status in Japan including the experience of having been occupied by the USA from the end of World War II to 1972. In this study, the longitudinal change in youth suicide mortality for those aged 10–29 years in Okinawa (1960–90) was compared with that for the same sex‐age groups in mainland Japan (1950–90). In contrast with mainland Japan, no dramatic change in the youth suicide mortality was observed in Okinawa in the 1960s. The rise and fall of teenage suicide mortality in Okinawa during the 1970–80s might be associated with ‘reversion anxiety’, rather than with the traumatic experience of World War II itself. This seems to be inconsistent with previous speculation regarding the change in youth suicide mortality in mainland Japan. The suicide mortality for men aged 20–29 in Okinawa was significantly higher than that for the same sex‐age group in mainland Japan through the observed period. The possible effects of the USA occupation, economic anomie or migration on the suicide in Okinawa should be further examined.