GKB47 and suicide
Let’s talk about suicide for a moment… not that it’s the most pleasant of topics. I try now and then with my more advanced Japanese students. Most clearly feel uncomfortable discussing it.
Even on trains, the word is somewhat taboo. “Human accident,” the screens say. In the distant past, it was more bluntly referred to by the word “rekishi” – “reki” referring to the roaring noise of a train, and “shi,” for death. The term was coined over a hundred years ago. Soseki wrote stories about it.
Today, Japan has a suicide rate of about 33,000 a year. The suicides aren’t just personal… they’re economic. One study has suggested that the problem of suicide costs Japan about 2.7 trillion yen a year.
Just to put things in perspective – 2.7 trillion yen is about equal to the current Japanese trade deficit. It also represents the Japanese government’s current post 3/11 reconstruction approved disaster relief budget. According to one U.N. study, it is even enough money to eradicate all the hunger in the world.
As a result, you’d think Japanese politicians would take the problem seriously. But actually, it wasn’t until 1998—when Japan suddenly experienced a spike of 32% in its national suicide rate—that the central government began to even address the problem.
Now it is unclear whether the heat over a controversial suicide prevention poster was one of those trivial Monday afternoon Diet debate points that get tossed out by politicians in hopes of being picked up by media, or sincere gripes, but it was serious enough for Prime Minister Yoshihiko Noda to quickly distance himself from it, and almost immediately Deputy Prime Minister Katsuya Okada agreed to trash 3 million yen worth of taxpayer-funded posters.
The furor began with a poster directing people to websites and social media resources promoting Japan’s Gateway 47 basic program – referenced by the catchy easy-to-remember slogan “You too are the GKB47!” The catchphrase evokes images of popular all-girl group AKB48.
The program originated about a decade ago and started as “Health Japan 21”, an initiative to expand localized suicide prevention initiatives to cover all 47 prefectures.
“Gatekeeper” refers to an approach, which aims to develop individuals’ knowledge, attitudes and skills to identify people most at risk – and make sure they are aware of the resources available to help them.
At the time, the Ministry of Health, Labor and Welfare’s goal was to lower the suicide rate to below 22,000 by 2010. The program focused strongly upon workplace intervention, while concurrently, the Ministry of Education also implemented school reforms as well, some triggered by a number of suicides and high profile lawsuits related to them amplifying the school bullying problem.
Unfortunately, while many localized programs yielded significant results, the program failed to catch on nationally and the suicide rate continued to rise.
Frustrated, a group of concerned citizens, mainly families impacted by the suicides of loved ones, began a campaign and collected 10,000 signatures asking for the government to take the problem seriously. The result was the passage of the Basic Act for Suicide Prevention. Its goal is to reduce the national suicide rate by 20% by 2016.
The Japanese government’s approach is straightforward. Study the problem, identify high-risk segments of the population, implement programs.
This is where Gateway 47 comes in. The Gateway approach requires getting everyone in the community involved… from physicians to caretakers, employers, municipal employees and the general public as well; hence the slogan, “You’re also a member…”
The fact is, Japan’s suicide epidemic is widespread. While there is no single ministry or organization that can make it go away, via coordinated efforts, lives can still, nonetheless, be saved.
Take, for example, Japan’s largest risk factor group—men in their 50s. In recent years, workplace intervention programs have been implemented and as result, it is actually one of the few segments of Japanese society that has seen a decline in its numbers. Still, men in this age group make up about 27% of all suicides.
Another hard-hit segment of the population is the elderly. Over one in three people who commit suicide in Japan are aged 60 and over. In response, programs have been developed that educate physicians to screen for depression. Visitation programs and programs to keep senior citizens active and involved in their community have also been implemented. Numerous municipal initiatives have reduced suicides in some populations up to 27% or more, but as the senior citizen population increases, so too do problems related to health, pension and rural isolation, so the numbers continue to grow.
On top of all of this, there’s the emergence of new “at-risk” demographics.
In recent years, suicides of college students and men and women in their 20s and 30s have been rising. Related to this, the term “shokuba utsu” has arisen, which literally translates as “depression in the workplace.” In one survey, more than 26% of businesses surveyed said they had cases of workers resigning or taking leave for mental health reasons.
In the end, Japan’s problem of suicide represents the dynamics of a society that is large, complex and rapidly changing. The only hope to reduce the problem is to identify those at risk and try to get them help before its too late. A key challenge is that this is also a society where open discussion of suicide is somewhat taboo. A suicide, for example, can evoke so much shame that the apartment of a person where one was committed may go unoccupied for years. Landlords have actually sued surviving family members. People simply don’t want to live in such a place.
Now, there’s a situation where public health officials have tried to raise awareness of a program via a poster that aims to get people to stop and pay attention for a few seconds in a milieu where dozens of other public awareness posters are competing for their attention. Yet some lawmakers were offended.
It begs the question: just how aware is this administration of the problem anyway?