Mental health care and the cultural toolboxes of the present-day Japanese population: Examining suggested patterns of care and their correlates.

An extensive body of literature has documented the under-utilization of mental health services among Asian populations, regardless of where they live. Japan is one Asian country where the mental health care system has improved substantially in the recent decades. Yet, Japan continues to report greater under-utilization of mental health services than other developed countries. One primary reason for this is hypothesized to be the cultural climate, which includes the stock of social, cultural and medical knowledge surrounding mental illness. Previous studies have not examined the cultural toolkit (Swidler, 2001) of the Japanese public, nor have they linked these to public attributions or assessments surrounding mental health. The Stigma in Global Context - Mental Health Study (SGC-MHS), a multi-stage probability sample of Japanese residents aged 18-64 years (N = 994) in 2006 provides data to describe the unprompted care suggestions from the general population regarding case scenarios meeting psychiatric criteria for schizophrenia and depression. Guided theoretically by the Network Episode Model, we analyze if and how respondents socially organize solutions into patterns of culturally acceptable care for mental health problems in Japan. Six cultural utilization patterns appear to be shaped by beliefs about underlying attributions, perceived severity of conditions, and type of mental health problem. Further, women, older individuals and those with differing education levels suggest different care patterns than their counterparts. In sum, the findings indicate unique patterns of mental health care recommendations among the Japanese public, which are culturally and socially constrained.