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Mental Illness Care: Currently Reliant on Families

Asahi Shimbun Morning Edition, July 10, 1999


"I was born from the depths of the Earth. To save this doomed planet, I became a god."A man in his fifties, long hospitalized for paranoid psychosis, speaks these words.


Before his hospitalization, he helped out at his family's ironworks. However, after his father passed away and the factory was closed, he showed no intention of returning to work.


"That's not the issue—I'm deeply concerned about the future of humanity," he insists with utmost seriousness.His younger sister has visited him without fail every week since their father's passing, hoping for his swift recovery. She brings sushi, seasonal Japanese sweets, and dozens of cans of his favorite coffee. More than anything, she wishes for him to return to being her ordinary older brother—not a savior of the Earth or humankind.


Sakura, the sister of Tora-san, the wanderer from the film Otoko wa Tsuraiyo (It's Tough Being a Man), is a kind and supportive presence for her older brother. The free-spirited Tora-san occasionally returns to his uncle's dumpling shop in Katsushika Shibamata. At first, he is warmly welcomed, but he soon causes trouble—teasing the owner of the neighboring factory or getting caught up in a hopeless romance. Treated like a delicate burden, he eventually feels unwelcome and sets off on his travels again. Yet Sakura always sees him off with a gentle, "Come back again, big brother."


Once someone is married and has their own family, simply managing household responsibilities can be overwhelming. Few people could manage to visit a hospitalized sibling regularly, especially one in a distant hospital, as this devoted sister does.


Fifteen years have passed, yet her brother shows no signs of recovery. She does not complain about the doctor’s inability to cure him. Instead, she simply prepares for the next visit.


For many years, Japan’s Mental Health and Welfare Act has placed the burden of care and supervision on the families of psychiatric patients. Even elderly mothers over eighty, struggling to walk, have been expected to care for their mentally ill children. Married sisters, despite their changed legal status, have also been held responsible.


For patients, the kindness of family members is an irreplaceable source of support. While legal reforms have slowly progressed in recent years, Japan's mental health care system remains underdeveloped, relying heavily on families for support.

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