19.1 The Present State of Child and Adolescent Psychiatry in Japan

Abstract

Asian Americans are known to be less likely to utilize mental health care. Although stigma is noted to be a barrier toward access to resources in Asian populations, we should pay more attention to how the country of heritage provides mental health care. This study focuses on Japan, investigating the current child and adolescent psychiatrists per youth population capita and its future projections. The Japanese board of child and adolescent psychiatry certifies by administering examinations to physicians credentialed through 4 academic societies. We calculated the number of board-eligible child and adolescent psychiatrists as the sum of credentialed physicians per society. We contacted the Japanese Society of Psychiatry and Neurology for statistical data on psychiatrists. We obtained other data from publicly available sources. We estimated the future psychiatry workforce and child and adolescent psychiatrists per capita of Japan’s youth population by Holt-Winters forecasting. We compared the number of child and adolescent psychiatrists and those per capita between Japan and the United States. The Japanese child and adolescent psychiatry board created in 2014 endorses 554 actively board-certified and 829 board-eligible physicians. Only 7.2% (829 of 11,539) of Japanese board-certified psychiatrists are board-eligible for child and adolescent psychiatry, compared to 24.2% (9956 of 41,133) of practicing US psychiatrists. The Japanese general psychiatry workforce in 2018 has increased by 167% since 1998. If child and adolescent psychiatry follows this trend, we predict a 4% to 6% annual growth of child and adolescent psychiatrists per youth population capita. Wait times were 3 to 6 months in nearly 50% of child and adolescent psychiatry institutions, according to a 2017 Japanese government study. Median wait times were 50 days in a 2015 US study. There is a lack of availability of child and adolescent psychiatrists. We assess the lack of child and adolescent psychiatrists overall and how increased median wait times contribute to stigma and low awareness in Japanese immigrants. More child and adolescent psychiatrists are needed worldwide to increase the utilization of child mental health care in those of Asian heritage.