Mental health issues are difficult to deal with anywhere, but it is especially hard to go through depression in Japan as a foreigner. You already lack the support network of family and friends, making you more vulnerable to mental health issues. When there’s nowhere to turn to, many are left searching the internet for therapists in Tokyo and therapists in Japan in general, hoping for advice from others who’ve been through mental hardships such as depression in Japan.

There is always hope and help, even in a foreign country. Here’s how to access mental health therapy in Japan.

Therapy in Japan: Hurdles and How To Overcome Them

Recognizing the need for mental health therapy is the first step toward getting better. It’s not an easy one, as many of us will often try to push through. There are many hurdles stopping people from even trying to find therapists in Japan. For foreigners, there is the obvious language barrier for talk therapy. Especially strong in this culture, there is the psychological barrier to admitting you have mental struggles too. And universally, there is always a lack of money and time.

Language Barrier to Finding Therapists in Japan

Living abroad in any country comes with a whole host of language struggles on a daily basis. This means foreigners need much more energy, effort and help to do basic paperwork and chores. This is the case even when one is quite fluent, as it still requires much more effort to speak a foreign language than one’s mother tongue. The language barrier is often part of the cause of burnout and mental struggles. And when one starts suffering from depression in Japan this barrier is then making it difficult to ask for help, book an appointment and talk to a therapist.

Furthermore, if you manage to find a therapist in Japan that speaks another language other than Japanese, chances are it will only be in one of the world’s major languages. People from smaller countries often end up having psychotherapy in their second language. While this might not be an unbreakable barrier, there will be a psychological gap to expressing one’s feelings for many. Documented research and studies show that “interventions conducted in clients’ native language (if other than English) were twice as effective as interventions conducted in English.” Recently, however, there are more options for online counseling in one’s country of origin. 

Financial Barrier to Finding Therapists in Japan

Mental health therapy in Japan is often not covered by the Japanese National Health Insurance and is prohibitively expensive. People who suffer from mental health issues are already likely to be suffering stress from financial hardship, losing their job in connection to mental health or having poor work performance due to it. If you are searching for financial help, check out this detailed guide from Japan’s Ministry of Health, Labour and Welfare. 

Talk therapy in Japan can cost around ¥20,000 an hour or more. Meeting a therapist once a week can cost one as much (or more) per month as a person’s monthly rent. Organizations like TELL Japan are trying to lower this fee by providing cheaper options and a flexible fee based on household income. 

Time Barriers to Finding Therapists in Japan

A common symptom of mental struggles is a lack of energy. In a country where overwork is the norm, it’s hard to find time for healing even if one isn’t depressed. Someone who has depression in Japan is very unlikely to have the time and energy to research the best possible help. A similar issue arises when trying to book an appointment for mental health therapy in Japan — work hours are longer and inflexible and most clinics close at 6pm. People under stress and with mental health issues might already be overworked and not allowed to take time off to go and see a therapist in the first place.

Social Barriers to Finding Therapists in Japan

In Japan, there’s the often-repeated word “gaman” which means “to endure or withstand,” which people usually do in silence while putting on a brave face. This notion is present in other cultures to a degree, however, one does soak up a lot of it by being immersed in Japanese culture. Thus, admitting you need help is usually the last thing and comes only after pushing yourself to a breaking point. Furthermore, foreigners in Japan might have an additional psychological barrier in asking for help — many don’t want to fail and leave the country without accomplishing what they came here to do.

How To Find Therapists in Japan

The fastest, easiest and cheapest way to get mental health help is to search for a psychiatric clinic near you. Consultations here will be covered by the National Health Insurance, which everyone residing in Japan has. They can help immediately, prescribe medicine, refer you to talk therapy and even prescribe mental health time off that your employer must then grant to you.

One simple way to find a psychiatric clinic near you is through Google Maps. If you are in no state of mind to talk and call, many have websites and online reservation systems. These can be auto translated in your browser if you don’t read Japanese. It will be easier if you call them or ask someone to call them on your behalf. You don’t have to explain too much for an initial consultation.

If you cannot find a non-Japanese-speaking psychiatric clinic, you can go to your local City Hall and ask for help. They can assign a free interpreter or point you to free mental health consultations. Even if these are not the perfect fit for you, it’s an important start to getting help.

Psychiatric clinics can be lifesaving, especially in emergencies and times of acute stress, anxiety and panic attacks, insomnia and similar ailments. However, long-term talk therapy is often needed for making bigger, long-lasting changes in one’s mental health. Here are a few ways to find mental health talk therapists in Tokyo and therapists in Japan.

Ask Online for Recommendations for Therapists in Japan

The internet has expanded the scope of community and it can often serve as a place for sharing important information and experiences. You can search the therapy in Japan Reddit threads, Quora, Facebook groups and any other social media sites. Many of these supportive groups have people willing to help personally, walk you through the process, share names and contact information of therapists and so on. You can join an online community for help and do so without many barriers. It’s free and anonymous, possible to do from your own home and at any time of the day.

TELL Japan

TELL Japan is one of the best-known Tokyo-based not-for-profit organizations dedicated to providing mental health therapy in Japan. It has been providing therapy to the international community for almost 50 years. As well as an online and phone counseling service, it also has a mental health clinic. TELL’s diverse therapist team provides counseling services in multiple languages including English, Portuguese, Japanese, Spanish, Cantonese, Mandarin and Bahasa. It also offers various types of therapy: couple and family therapy, counseling for children, for workplace issues, postpartum depression and more.

TELL Japan is not covered by National Health Insurance, but it can accept certain private insurances.

IMHPJ: International List of Therapists in Japan

Founded in 1997, International Mental Health Professionals Japan (IMHPJ) is an interdisciplinary network of individuals and organizations providing mental health care and therapy in Japan to residents of various nationalities. They have compiled a searchable database of therapists in Japan for finding the best fit. You can search by education, specialty, gender, culture and so on. All IMHPJ therapists are licensed professionals.

Tokyo Mental Health

Tokyo Mental Health specializes in online therapy in Japan for the international community. The multidisciplinary nature of the team covers a wide range of mental health care for individuals, children, couples and families. Therapy is often complemented with various tools such as CBT (Cognitive Behavioral Therapy) worksheets. Consultations are by appointment only and can be booked via Tokyo Mental Health’s official website

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Online International Therapy in Japan

Online therapy became an even more common and viable option during the pandemic. Many therapists in Japan and other countries have started providing online talk therapy in recent years. This type of therapy can help with the language barrier and even more with time management problems as it can be done at home at a time convenient for you. Depending on where you’re from, chances are it will be more affordable too.

You can connect with a therapist in your country or try one of the many worldwide services for online therapy on a monthly subscription basis. Note: make sure these are recommended by someone and that you are indeed talking to a licensed therapist.

Therapy in Japan: In Times of Urgent Help

It’s understandable that in times of struggle going through all the steps of trying to find a therapist in Japan can be overwhelming. If you find yourself suffering and feeling suicidal, or know of someone in that state, there is emergency help out there. For foreigners in Japan, the best place to call is Tell Japan Lifeline at 03-5774-0992 or chat online.

This service is sustained by donations so donate if you can. Visit TELL Japan’s website for more details.