Child Welfare in Japan: Children’s Care Homes and Mental Health

Background: While the prevalence of child abuse in Japan is low in comparison to other countries, such as the US, the number of reported child abuse incidents in Japan has exploded since 2000. This is in part due to legislation pertaining to reporting, but is also likely due to changes in Japanese society. Methods: This paper describes the Japanese system for the prevention of child abuse. We focus on children’s care homes that accommodate abused children. Generally, these facilities are relatively large residential units. Children’s care homes face significant staff shortages. We examined the needs of the children and requirements for the provision of psychiatric care in children’s care homes. A child psychiatrist conducted clinical and structured interviews with a sample of children and staff members. Results: Many children who reside in these facilities display psychiatric symptoms. However, very few children attend psychiatric clinics. Many children were diagnosed with disruptive behavior disorders such as attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Children received diagnoses of depressive and anxiety disorders during both types of interviews. However, the diagnoses differed between the child and the staff interviews, and no children received the same diagnoses from both interviews. These results reveal the difficulties staff members face when they attempt to determine children’s levels of emotional functioning. Conclusions: Currently, the living environments and mental health of these children remain poor. We suggest concrete ways to address these issues and describe some improvements. To achieve greater success, further research should be conducted to gain a better understanding of the psychiatric problems of children who reside in Japanese children’s care homes.