Why Don't Japanese People Use Counseling? Comparison with the United States: Why is Counseling More Common?educational issues.1. Cultural BarriersThere is a deeply rooted cultural value that considers itvirtuous to endure mental hardship without expressing itand to overcome it on one's own. As a result, many peoplefeel a psychological resistance to seeking help from aprofessional. Japanese society tends to prioritize groupharmony over individual opinions. When "being oneself" isseen as being "different from everyone else," people tendto suppress their feelings and worries. While this culturecan enhance social cohesion, it can also place a significantburden on individual mental health. In contrast, counseling is much more widely accepted in the United States. According to a survey on counseling experience in Western countries, 40.3% of Americans have used counseling services. This is because it is used not only for treating mental illness but also casually for routine maintenance, such as "tuning up one's mental state." Three main differences account for this.1. Insurance System and CostsIn the U.S., most counseling services are covered by healthinsurance. This is one of the biggest reasons for the lowerbarrier to access. In Japan, counseling is primarily paid forout-of-pocket, with a typical session costing between 6,000and 8,000 yen. If insurance were applied, the co-pay couldbe reduced to around 2,000 yen, making a significantdifference in the financial burden. In the U.S., counselor qualifications are established as state-level licenses. In contrast, in Japan, all psychology-related qualifications were private until the national qualification "Certified Public Psychologist" was established in 2017. Because their professional status is well-established, the path to qualification is longer. While Japan's "Certified Public Psychologist" can be obtained in a minimum of six years, becoming a "Psychologist" in the U.S. requires a minimum of 10 years, including obtaining a doctorate.This solid institutional foundation contributes to public tust and the widespread use of counseling.The factors hindering the widespread adoption of counseling in Japan are primarily rooted in cultural background and 2. Educational DelaysFor a long time, there was almost no opportunity to learnabout mental health in the Japanese school curriculum.However, changes are underway, based on the scientificfinding that the peak age of onset for mental illnessis in the mid-teens. Starting in the 2022 school year,"prevention and recovery from mental illness" became arequired topic in high school health and physical educationclasses for the first time in about 40 years. This is a majorstep toward helping young people recognize mental healthissues early and develop the skills to seek help. However,experts also point to the need for earlier educationstarting in elementary and middle school—critical periodsfor personality development—and for training to deepenteachers' own understanding.2. Social Status and Qualification System of Counselors The professionalism of counselors is socially establishedin the United States.5
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