1. BASIC PHILOSOPHY BEHIND COMPREHENSIVE SUICIDECOUNTERMEASURES
Realizing a society in which no one is driven to take their own lifeEver since the Basic Law on Suicide Countermeasures (hereafter, the “Basic Law”)
went into effect in October 2006, it has steadily achieved results: with the widespreadrecognition that suicide, once likely to be considered a “personal problem,” is a“social problem,” the whole country has been comprehensively promoting suicidecountermeasures; as a result, the year-over-year change in the number of suicide
victims has been on a downward track. Nevertheless, since the total number ofsuicides has been accumulating at a level that exceeds 20,000 persons each year, astate of emergency still continues to exist, and the situation is one that we can by nomeans be optimistic about.
Suicide is a death to which many have been driven. In its background are notjust mental health issues; overwork, poverty, parental burnout and caregiver fatigue,
bullying and social isolation and various other social factors are known to be involved.
For that reason, suicide countermeasures shall be vigorously and comprehensively
promoted at the three levels of “personal support,” “regional cooperation” and “thesocial system” in ways that will lower the risk of suicide in society as a whole byreducing the social factors that are impediments to life (suicide risk factors) andincreasing those that enhance it (protective factors against suicide).
The aim is to “realize a society in which no one is driven to take their own life”
by once again affirming that the essence of suicide countermeasures lies in help forliving and by setting forth the philosophy that these measures “support people’s lives.”

2. THE PRESENT STATE OF SUICIDE AND THE BASIC
UNDERSTANDING BEHIND COMPREHENSIVE SUICIDECOUNTERMEASURES
Suicide is a death to which many have been driven
Suicide is not just a spur-of-the-moment act during which someone takes his/her own
life; it must be understood as a process, one in which a person is forced into asituation where s/he feels compelled to do so. The mental state that leads to suicide
can thus be seen as a process in which people are psychologically driven by various
worries and fall into a state in which they believe there is no other choice but suicide,or one in which they are driven to a breaking point because of weakening ties tosociety, a role loss that makes life seem meaningless or a sense of the excessive
onerousness of the role expected of them.
A look at the mental state of persons just prior to being driven to suicidal
behavior has clarified that the majority are psychologically driven by various worries;
as a result, they are in a depressive state or have developed a mental illness such as
depression or alcohol-dependency, under the influence of which they are incapable ofexercising sound judgment.
Thus, suicide is not the result of individual choice or free will but can be
described as a death to which many have been driven.

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The annual number of suicides is on the decline, but a state of emergency still
continues
In June 2007, the national government, in accordance with the Basic Law, drew up
the General Principles of Suicide Prevention Policy (hereafter, “the General
Principles”) as guidelines for suicide countermeasures that it ought to promote, andunder them it has been comprehensively doing so ever since.
As a result not only of these efforts by the national government but also of
various initiatives by local public entities, related organizations, private sector entities
and others, the annual number of suicides, which since the sharp increase in 1998 hadremained high at more than 30,000 per year, has been steadily declining in the sevenyears since 2010, and in 2015 it was at the level it had been before 1998. A
breakdown of the number of suicides shows no change during this period in the factthat men, particularly those middle-aged and older, account for the large percentage,
but the death rate from suicide per 100,000 population (hereafter, the “suicide rate”)
among this cohort is steadily falling, and the decline in the suicide rate among theelderly has also been striking.
It must be said, however, that a state of emergency still continues to exist.
Among young people the suicide rate for those under 20 years of age remains largely
unchanged since 1998; in addition, suicide is the number-one cause of death among
those in their 20s and 30s, and the rate of decline in the suicide rate since its peak has
also been lower for this cohort than for other age groups. Moreover, Japan’s suicide
rate is the highest among the seven leading advanced countries, and the annual
number of suicides is still in excess of 20,000 people. Many irreplaceable human lives
are being driven to suicide every day.
Promoting practical initiatives at the community level through the PDCA cycle
The aim of Japan’s suicide countermeasures is to “realize a society in which no one isdriven to take their own life,” and the purpose stipulated in the Basic Law as well is to“contribute to the realization of a society in which the people in Japan can live healthy,
meaningful lives.” In other words, promoting suicide countermeasures is regarded asa way of building communities and the society at large.
Also, when the Basic Law was revised in 2016, the tenth year after its
enactment, it stipulated that prefectures and municipalities should draw up local planson suicide countermeasures taking into consideration the General Principles and inlight of the actual situation in their respective regions. In addition, to assist local
public entities in drawing up these plans, the national government, through the Japan
Support Center for Suicide Countermeasures, classifies the prefectures andmunicipalities into types according to the characteristics of suicide in that region andprovides policy packages of suicide countermeasure programs that should be enacted
on the basis of these types; the Center also analyzes the results, etc., of each of the
programs in the policy packages that the prefectures and municipalities have enacted
and, based on the results of these analyses, makes improvements to them and delivers
back to the local public entities a policy package with a more accurate set of programs.
These efforts, in which the national government and local public entities
cooperate in this way, are promoting comprehensive suicide countermeasures that are
constantly evolving through the nationwide use of the PDCA (plan, do, check, act)
cycle.

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3. BASIC POLICIES FOR COMPREHENSIVE SUICIDECOUNTERMEASURES
1. Promoting them as comprehensive support for people’s lives
Lowering the suicide risk in society as a whole
As the World Health Organization (WHO) has clearly stated, suicide is a social
problem that is largely preventable; it is becoming common knowledge throughout
the world that suicides are deaths that can be prevented by the efforts of society.
Among the various factors that are the causes of or form the background tosuicide are economic and livelihood issues, health problems, family problems, etc.;
these problems can be solved by social initiatives such as reviewing existing systems
and practices and enhancing the counseling and support systems to deal with thesocial factors for them like unemployment, bankruptcy, multiple debts and long
working hours. Moreover, even though some factors like health or family issues may
at first glance seem to be the problems of a particular individual, here too there aremany situations in which these problems can be resolved by extending a helping handof social support in the form of professional counseling, treatment for depression, etc.
In light of the basic recognition that suicide is a death to which many havebeen driven and a social problem that can largely be prevented, suicidecountermeasures shall be deployed as comprehensive support for people’s lives fromthe stance of lowering the suicide risk in society as a whole and protecting the lives ofeach and every individual.
Decreasing the factors that impede life and increasing those that enhance it
For both individuals and society, the suicide risk goes up when the factors that impede
life (suicide risk factors) exceed those that enhance it (protective factors against
suicide). On the other hand, the suicide risk does not rise in the same way for asociety or for all the individuals in it, even though they too may be experiencing
unemployment, multiple debts, poverty, and other life-impeding factors. The risk ofsuicide increases when these factors exceed self-esteem, reliable human relationships,
the ability to avoid a crisis, etc., that count as life-enhancing factors; when these
positive factors exceed the negative ones, the suicide risk does not go up.
For that reason, suicide countermeasures need to be promoted ascomprehensive support for people’s lives by lowering the suicide risk through both
approaches, i.e., by making an effort to increase the life-enhancing factors as well as
decrease the life-impeding ones.
2. Strengthening organic coordination with related measures and dealing with itcomprehensively
Strengthening coordination in providing support for life in various areas
Suicide is related in complex ways to a variety of factors such as changes in theworkplace and the community as well as health concerns, economic and livelihood
issues and problems with personal relations, not to mention an individual’s
personality traits, family circumstances and views on life and death. In order toprevent suicide by enabling the person who is being driven to it to live safely andsecurely, a comprehensive approach is important, one that focuses not only on mental
health but also has a social and economic component. And, in order to implement this3comprehensive approach, close coordination is needed among policy measures,
people and organizations in a variety of fields.
For example, health care and medical care facilities that provide counselingand treatment to those who have previously attempted suicide, or are at high risk of
doing so, also need to deal with the social factors that are a source of their patients’emotional distress, and so they must be able to refer them to counseling centers that
handle these problems. And those in charge of counseling centers for economic andlivelihood issues are also required to have a basic knowledge of suicide prevention,such as the signs of suicide risk and methods of responding to them, as well as thelocation of health care and medical care facilities, etc., where people can receive help.
Efforts at coordination such as these are gradually expanding through practical
onsite activities, and similar efforts are also being deployed in related areas such as
poverty, child abuse, sexual violence, hikikomori (social withdrawal), sexual
minorities, etc., that are the main potential causes of suicide. Henceforth, to further
enhance the effects of coordination, it will be important that those involved inproviding assistance for everyday living in these various areas have a sharedawareness of the part they play in suicide countermeasures.
Coordination with efforts to realize an inclusive community-based society, withthe system of self-reliance support for the poor and needy, etc.
In order to detect at an early stage and provide steady support to those in thecommunity who fall through the cracks in the system or who have complex problems
and find it difficult to go for counseling, suicide countermeasures shall be coordinatedwith various policies and measures, beginning with efforts aimed at creating an
inclusive community-based society that will promote the building of a comprehensive
support system through the cooperation of local residents and related publicorganizations.
Since measures aimed at realizing such a society share many aspects withsuicide countermeasures – such as enhancing the comprehensive support system inthe municipalities, deploying it as a means of community-building in which local
residents also participate, and the importance of building a network of relatedorganizations to deal with complex problems and detect those at risk for suicide early
before the situation becomes serious – it is important to carry out both measuressimultaneously.
Moreover, since the ways of providing such assistance have many aspects incommon with the system of self-reliance support for the poor and needy, in order todeal firmly with poverty, which is also an underlying cause of suicide, it is important
to develop programs, including the abovementioned support system, in an organic,
effective and efficient way by, among other things, making ongoing efforts to referpoor and needy persons receiving counseling for suicide countermeasures to services
that offer counseling and support for self-sufficiency, and provide appropriate
assistance in cooperation with counseling services for suicide countermeasures topersons at high risk for suicide who are recognized as such at offices providing
counseling and support for self-sufficiency.
Coordinating with mental health, medical care and welfare policies andmeasures
In addition to efforts to detect at an early stage those at high risk for suicide andensure that they are referred to psychiatric care, in order to deal comprehensively withthe various problems that underlie a heightened risk of suicide such as economic and4

livelihood issues, welfare problems and family problems, increase theinterconnectedness of all policies and measures in areas such as psychiatric care,health care and welfare so that everyone can receive the appropriate services.
Also, in order to increase the interconnectedness of all these policies andmeasures, make adjustments to the social system by assigning psychiatric social
workers and other specialists to medical care facilities, etc., in the community.
3. Interconnecting policies and measures effectively at each level tailored to thestage of response
Interconnecting policies and measures at each level: personal support, regional
coordination and the social system
Individual policies and measures related to suicide countermeasures shall becomprehensively promoted, taking into consideration the following three levels andorganically interconnecting them:
1. Policies and measures to provide counseling and support that works to findsolutions for the problems of each individual (personal support level)
2. Policies and measures for practical coordination, etc., among the relatedorganizations to provide comprehensive support to persons with complex
problems (regional coordination level)
3. Policies and measures related to enhancing and revising the framework of laws,
the General Principles, plans, etc. (the social system level)
Adopting effective policies and measures for each stage of response: prevention,intervention and postvention
In addition, effective separate policies and measures for the three levels of suicidecountermeasures in the previous paragraph need to be adopted for each stage:
1. Prevention: respond at the stage when the risk of suicide is still low through publicawareness campaigns that provide a correct understanding of suicide, mental
illness, etc., and through initiatives to maintain and improve physical and mental
health;2. Intervention: intervene in the threat of suicide as it occurs and stop it fromhappening;
3. Postvention: minimize the impact on family members, co-workers and others who
have been left behind in the unfortunate event that a suicide or attempted suicide
occurs, and prevent new suicides from happening.
Promoting efforts at an even earlier stage of suicide prevention
Because many people are driven to suicide without being able to obtain support since
they do not know how to solve the problems they have and are unaware of thecounseling facilities in their community, in the schools, promote education thatteaches children specific, practical methods on how to ask for help, and from whom,
when facing a crisis in their lives or living conditions, and at the same time teaches
them it is all right to seek help at hard or difficult times (instruction on how to raise an
SOS). If children are able to equip themselves with coping strategies and sort out theirproblems, these will become life-enhancing factors (protective factors against suicide)
and are thought to be connected to the acquisition of life skills and the ability to deal
with problems facing them at school and those they will encounter later on as adults.
Also, along with teaching them how to raise an SOS, promote the creation ofplaces children can go to and feel they belong in order to prevent social isolation.

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4. Promoting awareness-raising and practical initiatives inseparably from one
another
Fostering an awareness that suicide is a “danger that can happen to anyone”
According to a public opinion survey conducted by the Ministry of Health, Labourand Welfare in October 2016, nearly one person in 20 responded that they had
thought about suicide during the previous year. Right now suicide is not just an issue
for some people or some communities; it is becoming a serious problem that canaffect anyone in Japan.
Although being driven to suicide is a “danger that can happen to anyone,” it isa fact that the mental states and underlying circumstances of persons in crisis are hardto understand; in addition to deepening an understanding of these mental states andcircumstances, actively promote public awareness on an ongoing basis so that society
as a whole will have a shared recognition that it is appropriate for anyone in a crisis to
ask for help.
Promoting efforts to eliminate prejudice against suicide and mental illness
Because prejudice against mental illness and psychiatric treatment is strong in Japan,
many people feel a psychological resistance to consulting a psychiatrist. Middle-aged
and older men, in particular, a cohort with many suicides, in addition to being prone
to having mental problems, are said to have a tendency to make these problems worseby their psychological resistance to talking about them.
On the other hand, even those who think they want to die oscillate violently
between wanting to die and wanting to live. Many display the warning signs ofsuicide such as insomnia or poor health without any known physical cause.
Engage in public relations campaigns and educational activities so thateveryone in the country will be aware of the early signs that someone close to themperhaps is thinking of suicide, refer such persons to a psychiatrist or other specialist
and monitor them while they are receiving professional care.
Self-regulating by the mass media
Reports on suicide in the mass media, in addition to conveying the facts, can also behighly effective in providing useful information about suicide prevention, such as thesigns that indicate suicide risks and ways to deal with them; on the other hand,
however, there is also a danger that detailed reports on suicide methods or frequent
reports over a short period of time may trigger other suicides.
For that reason, in order to address the issue of the appropriate coverage ofsuicide in the news media, make the guidelines on suicide reporting widely known. It
is to be hoped that the mass media will promote voluntary efforts to provide
appropriate coverage of suicide while taking into consideration both the freedom of
the press and the public’s right to know.
5. Identifying the roles of the national government, local public entities, relatedorganizations, private sector entities, businesses and the people in Japan andpromoting cooperation and coordination among them
In order for suicide countermeasures measures in Japan to have the maximum effectand realize “a society in which no one is driven to take their own life,” the wholecountry – the national government, local public entities, related organizations, private
sector entities, businesses and the people of Japan – needs to coordinate and cooperate
in comprehensively promoting measures to combat suicide. To do so, it is important6

to identify the roles that each group ought to play, share information about those roles
and build a system of mutual cooperation and coordination.
The roles that the national government, local public entities, relatedorganizations, private sector entities, businesses and the people in Japan ought to playin comprehensive suicide countermeasures are believed to be as follows:
The national government
The national government – which has the obligation to comprehensively formulate
and implement suicide countermeasures – maintains and supports the infrastructureneeded for each group to promote these measures; advances such measures itself
through related systems and policies; and implements efficient and effective policies
and programs that it carries out for the country as a whole. It also develops and puts
into practice mechanisms to enable each group to coordinate and cooperate closelywith one another.
The national government, through the Japan Support Center for Suicide
Countermeasures and in cooperation with local public entities, has the responsibility
for promoting suicide countermeasures that are constantly evolving through thenationwide use of the PDCA cycle by, among other things, providing support so thatall prefectures and municipalities will promote suicide countermeasures tailored to thecharacteristics of each community in accordance with local plans for such measures.
Local public entities
Local public entities – who have the obligation to enact and carry out policies andmeasures tailored to local conditions – taking into consideration the General
Principles and in light of the actual situation in their community draw up local planson suicide countermeasures. As the governing body closest to individual citizens, they
promote suicide countermeasures in coordination with the national government whileworking in close coordination and cooperation with all the groups in the community.
Local support centers for suicide countermeasures set up in the prefectures andordinance-designated cities act as area managers, as it were, within their jurisdictions,
receiving support from the Japan Support Center for Suicide Countermeasures, whileproviding assistance in formulating, tracking the progress of and verifying the local
plans for suicide countermeasures of the municipalities within their jurisdiction. They
are also expected to comprehensively promote such measures as a means ofcommunity-building, by, among other things, establishing fulltime departments andassigning fulltime staff members who will have the role of coordinating suicidecountermeasures with other policies and measures.
Related organizations
Related organizations – such as universities, academic societies and professional
associations in occupations related to suicide countermeasures such as health,
medicine, welfare, education, labor and law, as well as groups such as businessorganizations that have no such direct relationship but can contribute to suchmeasures through the nature of their activities – in view of the importance of having
the whole country deal with measures to combat suicide, proactively participate insuicide countermeasures that correspond to the nature of their respective activities.
Private sector entities
Private sector entities active in the community – realizing that not just activities aimed
directly at preventing suicide but those in related areas such as health, medicine,7

welfare, education, labor and law can also contribute to suicide countermeasures –proactively participate in such measures while coordinating and cooperating withother groups and also receiving support from the national government, local public
entities, etc.
Businesses
As social entities that employ workers and engage in economic activities, businesses
are aware that they have an important role to play in suicide countermeasures by,among other things, working to maintain the mental health and ensure the physicalsafety of the workers they employ. They also know that suicides resulting from stressrelated disorders and work problems not only inflict immeasurable pain on the
persons involved and their families, they also lower corporate productivity and vitality,and proactively participate in suicide countermeasures.
The people of Japan
In addition to deepening their understanding of and concern for the conditions thatlead to suicide and the importance of measures to combat it that provide
comprehensive support for people’s lives, the people of Japan realize that being
driven to suicide is a “danger that can happen to anyone” and that it is appropriate forsomeone in such circumstances to seek help; and, in light of the fact that the mental
states and underlying circumstances of persons in crisis are hard to understand, theyshall strive to deepen an understanding of these factors, be aware of their own mental
disorder and that of those around them and be able to deal with it appropriately.
The Japanese people shall be aware that suicide is a problem for society as awhole and a matter of personal concern and shall deal with suicide countermeasureson their own initiative in order to “realize a society in which no one is driven to taketheir own life.”

4. PRESSING PRIORITY POLICIES FOR COMPREHENSIVE SUICIDECOUNTERMEASURESIn accordance with section 3 above, “Basic policies for comprehensive suicidecountermeasures,” establish the following policies as ones that must be addressed
particularly intensively in the immediate future, in tandem with the policies andmeasures that require further efforts in keeping with the aims of the revised Basic
Law, the eight basic policies stated in it and the current situation surrounding suicidein Japan.
In addition, policies newly deemed necessary because of the results of future
research and studies shall be successively enacted.
The pressing priority policies cited below are clearly ones that the national
government must concentrate its efforts on in the immediate future; they are not ones
that local public entities need to deal with all-inclusively. Local public entities should
give preference to promoting the priority policies needed to respond to the actual
conditions of suicide and the true state of affairs in their community.
1. Strengthening support for practical initiatives at the community level
With the revision of the Basic Law in April 2016, prefectures and municipalities are
required to draw up local plans on suicide countermeasures, taking into consideration
the General Principles and in light of the actual situation in their region. In addition,8

in view of the fact that the national government is required to provide advice andother assistance as necessary to local public entities so that they can meet their
responsibility to draw up and implement such policies tailored to the situation in theregion in question, it is strengthening its support for practical initiatives at thecommunity level by, among other things, providing local public entities with profilesof actual local suicide conditions as well as policy packages of local suicidecountermeasures.
(1) Preparing profiles of actual local suicide conditions
The national government through the Japan Support Center for Suicide
Countermeasures prepares profiles of actual local suicide conditions that analyze thestate of suicide in all the prefectures and municipalities and supports local public
entities in formulating local plans for suicide countermeasures. (Ministry of Health,Labour and Welfare)(2) Preparing policy packages of local suicide countermeasures
The national government through the Japan Support Center for Suicide
Countermeasures prepares policy packages of local suicide countermeasures, filledwith detailed provisions that take into consideration local characteristics, and supports
local public entities in formulating local plans for suicide countermeasures. (Ministryof Health, Labour and Welfare)(3) Supporting the formulation, etc., of local plans for suicide countermeasures
The national government supports the formulation and promotion of local plans for
suicide countermeasures by providing profiles of actual local suicide conditions andpolicy packages of local suicide countermeasures and by drawing up guidelines withwhich to formulate plans for such measures. (Ministry of Health, Labour and Welfare)(4) Drawing up guidelines for formulating local plans for suicidecountermeasures
The national government draws up guidelines for formulating local plans for suicidecountermeasures as a way of contributing to the smooth working out of such plans.
(Ministry of Health, Labour and Welfare)(5) Assisting local support centers for suicide countermeasures
The national government assists local support centers for suicide countermeasuresthrough training, etc., by the Japan Support Center for Suicide Countermeasures sothat these centers, which have been set up in the prefectures and ordinance-designatedcities, are able to provide assistance in formulating, tracking the progress of andverifying the plans for suicide countermeasures of the municipalities within theirjurisdiction. (Ministry of Health, Labour and Welfare)(6) Promoting the establishment of fulltime departments for suicidecountermeasures and the assignment of fulltime staff members to them
The national government encourages local public entities to comprehensively promotesuicide countermeasures as a means of community-building by, for example,
establishing fulltime departments and assigning fulltime staff members who will havethe role of coordinating local suicide countermeasures with other policies andmeasures. (Ministry of Health, Labour and Welfare)92. Encouraging everyone in Japan to be aware of and monitor potential suiciderisks
The revision of the Basic Law in April 2016 clearly stated as its basic philosophy that
suicide countermeasures must be implemented as “comprehensive support forpeople’s lives,” and in order to deepen the public’s awareness and understanding of
the aims of these measures, the provisions stipulating the responsibilities of the people
in Japan were also revised. In addition, since the national government and local public
entities need to take the necessary steps to deepen the understanding of suicidecountermeasures among the people of Japan, provisions for Suicide Prevention Week
and Suicide Countermeasures Strengthening Month were newly prescribed.
Because being driven to suicide is a “danger that can happen to anyone” butthe mental states and the underlying circumstances of persons in crisis are hard tounderstand, as well as deepening an understanding of such states and circumstances, itis necessary to promote public awareness that suicide is not just an issue for somepeople or some communities but is a serious problem that can affect anyone in Japan.
Also, develop public awareness programs through educational activities andpublic relations campaigns, etc., to dispel prejudice and mistaken beliefs about suicideand promote the realization that it is appropriate for anyone in a crisis that threatens
their life or livelihood to seek help, so that there will be a shared awareness that therole of each and every member of the Japanese public in suicide countermeasures is torealize there may be persons contemplating suicide among their own acquaintances, toget close to them, speak to them, listen to them, refer them to a specialist as necessary
and monitor them.
(1) Enacting Suicide Prevention Week and Suicide Countermeasures
Strengthening Month
During Suicide Prevention Week (September 10 through September 16) and Suicide
Countermeasures Strengthening Month (March), which are stipulated in Article 7 of
the Basic Law, the national government, local public entities, related organizations,private sector entities and others shall work together in promoting awareness-raising
activities focusing on the philosophy of “suicide countermeasures to support people’s
lives.” In addition, prioritize support measures so that people with problems who are
led to seek help as a result of these activities can receive the help they need. Also, aim
to have more than two out of every three persons in Japan know about Suicide
Prevention Week and Suicide Countermeasures Strengthening Month. (Ministry of
Health, Labour and Welfare; related ministries and agencies)(2) Implementing education that will contribute to suicide countermeasuresamong primary and secondary schools
In primary and secondary schools, in addition to attempting to give students a real
sense of the preciousness of life by making use of experience-based activities andintergenerational contacts with the elderly and others in the community, promote
instruction related to maintaining the mental health of children and young people andto equipping them with the skills to cope with stress and the various difficulties they
are likely to encounter in society (instruction on how to raise an SOS). In addition,encourage building an environment conducive to providing instruction that willcontribute to suicide countermeasures by increasing the life-enhancing factors among
primary and secondary school students. (Ministry of Education, Culture, Sports,
Science and Technology)

10Because suicide among those aged 18 and younger has a tendency to rise
sharply just after long vacation breaks, promote efforts such as early detection andmonitoring at elementary and secondary schools and junior and senior high schools
before, during and just after a long vacation. (Ministry of Education, Culture, Sports,
Science and Technology)
Furthermore, promote media literacy and information ethics education as wellas measures to counter harmful and illegal information. (Cabinet Office; Ministry ofInternal Affairs and Communications; Ministry of Education, Culture, Sports, Scienceand Technology)(3) Disseminating accurate information about suicide and suicide-related
phenomena
In order to heighten the response capability of every person in Japan in an emergency(techniques for getting the desired help) and dispel society’s mistaken but common
beliefs about suicide and suicide-related phenomena, promote the dissemination of
accurate knowledge about suicide through the proactive use of the Internet (including
smartphones and cellphones). (Ministry of Health, Labour and Welfare)Also, promote measures to further understanding of sexual minorities, amongwhom the percentage of those contemplating suicide has been observed to be high, inview of the fact that one of the underlying social factors for this is lack ofunderstanding and prejudice. (Ministry of Justice; Ministry of Health, Labour andWelfare)Although suicide is a death to which many have been driven, on the other
hand, also make it known that some people die by suicide suddenly and unexpectedly
as the result of illness and other reasons. (Ministry of Health, Labour and Welfare)(4) Promoting public awareness campaigns about depression
Facilitate rest, counseling and visits to a doctor at an early stage by carrying out
public awareness campaigns that provide accurate information about psychiatricdisorders such as depression and depressive states in each life stage. (Ministry of
Health, Labour and Welfare)
3. Promoting research and studies that will contribute to the promotion ofcomprehensive suicide countermeasures
While respecting the privacy of suicide victims and their surviving families, inaddition to implementing multifaceted research and studies that will contribute to thepromotion of comprehensive suicide countermeasures, verify the findings from apractical viewpoint of suicide countermeasures and promptly return the verified
results to the community to be put into practice in local suicide countermeasures.
(1) Research, studies and verification related to the actual suicide conditions andthe state of implementation of suicide countermeasures, etc.
Implement studies to obtain a multifaceted understanding of the reasons for,background to and the process that leads up to suicide, including the social factors,
and enhance individual responses and systemic improvements in areas such as health,
medicine, welfare, education and labor; also implement studies on the ongoingsupport at the community level for persons contemplating suicide, including those
who have survived a suicide attempt. (Ministry of Health, Labour and Welfare)
At the Japan Support Center for Suicide Countermeasures, in addition to
putting suicide countermeasures into practice through the necessary encouragement of

11and research into the policy-making process at each step of the PDCA cycle for suchmeasures as a whole, promote an Innovative Research Program on Suicide
Countermeasures based on a grand research design to collect the necessary data andscientific evidence. (Ministry of Health, Labour and Welfare)Also, promote the collection and provision of information so that the results ofstudies made by local public entities, related organizations, private sector entities andothers in order to shed light on the actual conditions of suicide will be put to use inpolicy-making. (Ministry of Health, Labour and Welfare)(2) Making use of the results of research, studies and verification
In order to contribute to the planning and drawing up of suicide countermeasures at
the national and local level, promptly put to use the results of information on suchmeasures that the Japan Support Center for Suicide Countermeasures has collected,
organized and analyzed, such as foreign and domestic research and studies on suicide
and on actual suicide conditions. (Ministry of Health, Labour and Welfare)(3) Collecting, organizing and providing information on progressive local
approaches
Promote the provision by the Japan Support Center for Suicide Countermeasures ofnecessary information, such as profiles of actual suicide conditions and policy
packages of local suicide countermeasures (including examples of progressive
approaches organized by the size, etc., of local public entities), so that local public
entities can plan, draw up and implement measures tailored to the actual conditions ofsuicide and the true state of affairs in their community. (Ministry of Health, Labourand Welfare)(4) Studying suicide among children and young people
Analyze the distinctive features of, trends in, background to, particulars of, etc.,
suicide among primary and secondary school students and carry out research andstudies on ways to prevent it. (Ministry of Education, Culture, Sports, Science andTechnology)
Also, when carrying out detailed studies of suicide among students at primaryand secondary schools, in situations that require a high degree of expertise inanalyzing and evaluating the facts, or in situations in which the surviving family
members do not want the study to be conducted by the school or the Board of
Education, promote fact-finding studies by a third party as necessary. (Ministry of
Education, Culture, Sports, Science and Technology)
In view of the fact that suicide countermeasures among the younger generation
are becoming an issue, support studies that also provide direct assistance to young
people in regard to suicide and the difficulties in their lives. (Ministry of Health,Labour and Welfare)(5) Shedding light on actual suicide conditions in conjunction with the system toinvestigate cause of death
For a multifaceted understanding of the actual conditions of suicide, such as thereasons for it including the social factors, background to it and the process that led up
to it, strengthen the interconnectedness with policies to promote investigations into
the causes of death including the use of information obtained from them, based on thePlan to Promote Investigations into Causes of Death and Other Matters (Cabinet
decision of June 13, 2014). (Cabinet Office; Ministry of Health, Labour and Welfare)12At local support centers for suicide countermeasures, promote coordination
tailored to local conditions with public health centers and with the councils to
promote such investigations set up in the prefectures based on the above Plan; thecareful examination and analysis of death certificates in accordance with theprovisions of Article 33 of the Statistics Act; and their use for an understanding of theactual conditions of local suicides. (Cabinet Office; Ministry of Health, Labour andWelfare)Promote nationwide Child Death Reviews with regard to the total incidents ofdeath among children (including suicide), efforts at which are already being made inadvanced areas, in order to be able to put them to use in understanding the actual
conditions of suicide among children. (Ministry of Health, Labour and Welfare)(6) Conducting interdisciplinary research to clarify the pathology of depression
and other forms of mental illness, develop methods of treatment and makeongoing improvements to community-based care systems
In addition to clarifying the pathology of depression and other forms of mental illness
and developing methods to treat them, both necessary steps in advancing suicidecountermeasures, promote interdisciplinary research to develop a system whereby
those suffering from depression can receive ongoing care in their communities, anddisseminate the results. (Ministry of Health, Labour and Welfare)(7) Expediting the use and application of existing data
Promote the collection and provision of information from the suicide statistics andother related data which the police and fire departments have, as well as other relevant
data in the possession of related organizations, in order to use them in advancing local
suicide countermeasures. (National Police Agency; Ministry of Internal Affairs andCommunications; Ministry of Health, Labour and Welfare)
In order to contribute to the planning and formulating of evidence-basedsuicide countermeasures for the national government, local public entities and others,in addition to foreign and domestic research and studies on suicide and the actual
conditions of suicide at the Japan Support Center for Suicide Countermeasures, incoordination with the Council for the Promotion of Evidence-Based Policy Making(provisional name), to be newly established as a cross-sectional government agency
under the Strategic Conference for the Advancement of Utilizing Public and Private
Sector Data, establish an onsite facility to safely collect, organize and analyze
information from highly confidential administrative records and existing government
statistical micro data that can contribute to suicide countermeasures, and promote theprovision of the results of such analyses to local public entities and policy
departments. In addition, promote collecting the relevant data that municipalities andlocal private sector entities have, providing the results of analyses, supporting theapplication and use of such results and disseminating nationwide progressive
community-based approaches to encourage efforts tailored to actual local conditions
and the true state of suicide in a community. (Ministry of Internal Affairs andCommunications; Ministry of Health, Labour and Welfare)
4. Recruiting, training and improving the quality of personnel engaged in suicidecountermeasures
In addition to recruiting, training and improving the quality of personnel directly
engaged as specialists in suicide countermeasures, implement education about andtraining in such measures in a wide range of fields in light of the fact that it is13becoming important to recruit and train specialists, their aides and others who provide
comprehensive support for people’s lives in many different areas, as personnel
involved in suicide countermeasures. Also, train personnel to disseminate accurate
knowledge about suicide and suicide-related phenomena and assume the role ofgatekeepers who will recognize the signs of suicide risk, speak to people with suchsigns, listen to them, refer them to a specialist as necessary and monitor them. By
taking advantage of Suicide Prevention Week, Suicide Countermeasures
Strengthening Month and other opportunities and making this training widely known,
aim to have more than one out of every three people in Japan learn about gatekeeping.
In addition, train personnel who will have the role of coordinating these local humanresources and building comprehensive support networks.
(1) Promoting education about suicide countermeasures in coordination with
universities and special vocational schools
When advancing suicide countermeasures as comprehensive support for people’s
lives, since it is important to recruit, train and improve the quality of personnel
involved in dealing with such measures and with the risk factors for suicide, promote
education about suicide countermeasures in coordination with universities, special
vocational schools and related organizations that train specialists in medicine, healthand welfare, psychology, etc. (Ministry of Education, Culture, Sports, Science andTechnology; Ministry of Health, Labour and Welfare)(2) Training personnel in charge of coordinating suicide countermeasures
In order to facilitate coordination among related facilities and organizations, private
sector entities, specialists and other gatekeepers in the community, promote thetraining and placement of personnel who will be responsible for coordinating all thoseconcerned. (Ministry of Health, Labour and Welfare)Promote the training of personnel responsible for personalized support who
will get close to persons at risk for suicide and accompany them until the risk ofsuicide subsides, while coordinating with specialists and related organizations in thecommunity to help to solve their problems. (Ministry of Health, Labour and Welfare)(3) Improving the skills of family doctors and other primary care providers toevaluate and respond to suicide risks
Because many patients with depression and other forms of mental illness also havephysical symptoms and many of them also consult their family doctors or otherprimary care providers, during clinical training and other stages of the doctors’
training process and through opportunities for lifelong learning, etc., improve doctors’
understanding of and response to depression and other mental illnesses and their skill
at being able to evaluate their patient’s suicide risk accurately taking into
consideration the underlying social factors, and disseminate knowledge to them aboutcommunity-based suicide countermeasures, counseling services in various areas andsupport measures. (Ministry of Health, Labour and Welfare)(4) Awareness-raising for school staff
By preparing and distributing teaching materials, support efforts to train school staff
such as classroom teachers and school nurses who are in contact with students on adaily basis, as well as faculty members at universities and elsewhere engaged in
student counseling, in order to implement awareness-raising not only about teaching
children how to raise an SOS but also about how to heighten the sensitivity of the14

adults around them to recognize the SOS a child has sent and how to respond to it.
Implement training, etc., to improve the quality of school staff in charge ofeducational counseling, including care for the child of a suicide victim. Also, promote
understanding among school staff of sexual minorities, among whom the percentageof those contemplating suicide has been observed to be high, in view of the fact that
one of the social factors behind this is prejudice and lack of understanding. (Ministryof Education, Culture, Sports, Science and Technology)(5) Improving the quality of care from community health staff and occupational
health staff
In order for local public entities to improve counseling services related to mental
health issues at local mental health and welfare centers, public health centers andelsewhere, the national government in cooperation with local support centers for
suicide countermeasures supports the implementation of training for public healthnurses and other local health staff to improve the quality of mental health promotion
and suicide countermeasures in the relevant areas. (Ministry of Health, Labour andWelfare)Also, in order to promote mental health measures in the workplace, enhance
training, etc., to improve the quality of occupational health staff. (Ministry of Health,Labour and Welfare)(6) Training for long-term-care support specialists and others
Disseminate information on suicide countermeasures and mental health promotion
through opportunities to train long-term-care support specialists, care workers, social
workers and others employed in long-term-care services. (Ministry of Health, Labourand Welfare)(7) Training for district welfare commissioners, commissioned child welfare
volunteers and others
In order to support community-based monitoring activities aimed at detecting those atrisk for suicide, implement training in policies related to mental health promotion andsuicide countermeasures for district welfare commissioners, commissioned childwelfare volunteers, and others. (Ministry of Health, Labour and Welfare)(8) Improving the quality of counselors with reference to social factors
Promote the dissemination of accurate knowledge on mental health and local suicidecountermeasures among counselors at multiple-debt counseling services run by
consumer affairs centers, local public entities and others, the business counselingservices of the Societies of Commerce and Industry and the Chambers of Commerceand Industry, counseling services at Public Employment Security Offices (HelloWork), caseworkers at welfare offices, and support staff at services that provide
counseling and support for poor and needy persons to become self-sufficient.
(Financial Services Agency; Consumer Affairs Agency; Ministry of Health, Labourand Welfare; Ministry of Economy, Trade and Industry; related ministries andagencies)(9) Improving the quality of personnel at public agencies who deal with bereaved
family members and others
Promote the dissemination of knowledge about how to deal appropriately withbereaved family members and others among those engaged in suicide-related work in15

the police and fire departments and other public agencies. (National Police Agency;
Ministry of Internal Affairs and Communications)(10) Training gatekeepers in various fields
Facilitate efforts to train gatekeepers by providing the necessary support to relatedorganizations, such as providing information conducive to disseminating knowledgeof mental health and local suicide countermeasures for occupations which, by thenature of their work, can be expected to play the role of gatekeeper, such as lawyers,
persons qualified to prepare legal documents, and other professionals who deal withlegal matters such as multiple-debt problems; pharmacists who have many
opportunities to learn about the health status of local residents through the dispensing
or sales of drugs; and barbers and others who are likely to notice changes in theircustomers’ health because they have many opportunities to meet with them on aregular basis or during a given period of time. (Ministry of Health, Labour andWelfare; related ministries and agencies)
Disseminate the necessary basic knowledge so that everyone in Japan can act
appropriately as a gatekeeper when s/he becomes aware of an abnormal change insomeone close by. (Ministry of Health, Labour and Welfare)(11) Promoting mental care for those engaged in suicide countermeasures
For those engaged in suicide countermeasures, including those involved in theactivities of private sector entities and the work of local public entities, in addition topromoting the creation of mechanisms to maintain their mental health, even whensomeone they had counseled attempted suicide, disseminate support methods thatmake use of mental health expertise. (Ministry of Health, Labour and Welfare)(12) Assisting those who provide support including family and friends
So that not only persons with problems but also those who support them, including
family and friends, do not feel isolated, promote assistance for family members andothers. (Ministry of Health, Labour and Welfare)(13) Developing training materials
In order to support training provided by the national government, local public entities
and others to educate and improve the quality of a variety of personnel involved in thesuicide countermeasures, in addition to promoting the development of training
materials, sponsor training programs for public organizations and private sector
entities at the Japan Support Center for Suicide Countermeasures. (Ministry of Health,Labour and Welfare)
5. Advancing the promotion of mental health and providing a supportive
environment for it
In regard to the various kinds of stress that can become causes of suicide, encouragesystemic improvements in schools, the community and the workplace to maintain andadvance mental health by, for example, responding appropriately to stress andreducing stress factors, and improve the workplace environment through measures tocounteract harassment and overwork.
(1) Promoting mental health measures in the workplace
In order to create a society where deaths from overwork are eliminated, where there isa good work-life balance, and where it is possible to keep working in a healthy and16fulfilling manner, promote measures to prevent deaths from overwork throughresearch and studies, awareness-raising, improvements to the counseling system, andsupport for the activities of private sector entities, based on the General Principles
Regarding Measures to Prevent Death from Overwork and Other Issues. (Ministry of
Health, Labour and Welfare)Also, in order to promote improvements to mental health measures in theworkplace, in addition to designing public-awareness campaigns about the Guidelines
for Maintaining and Improving Workers’ Mental Health on an ongoing basis, work tofurther disseminate mental health measures in the workplace through a thoroughimplementation of the stress-check system that was launched in December 2015 withthe revision of the Industrial Safety and Health Act. In addition, since, in accordancewith the aims of the stress-check system, improvements to the workplace environment
ought to be planned from the perspective of checks not only on long working hours
and other quantitative workloads, but also on qualitative stress factors such as humanrelations and the lack of supportive relationships in the workplace, promote mental
health measures there by supporting subsidies and other financial aid to collect, shareand implement good examples of initiatives to improve the workplace environment inlight of company-wide analyses that make use of the results of stress checks.
(Ministry of Health, Labour and Welfare)
Moreover, in addition to providing comprehensive information andimplementing email and telephone counseling on a mental health portal site forworking people, at prefectural occupational health support centers, carry out
awareness-raising seminars for business people, training for human resource
managers and occupational health staff in the workplace as well as training to prevent
mental health disorders in young workers and supervisors through personal visits toworkplaces. (Ministry of Health, Labour and Welfare)Because the safety and health management systems at small workplaces are
not always adequate, local offices of occupational health support centers will carryout counseling for workers who are experiencing mental health disorders duringpersonal workplace visits, etc., and strengthen mental health measures in small
workplaces through subsidies and other financial aid to implement stress-checks insuch workplaces. (Ministry of Health, Labour and Welfare)
Moreover, in accordance with the Action Plan for the Realization of Work
Style Reform (March 28, 2017 decision of the Council for the Realization of Work
Style Reform) and the Healthcare Policy (Cabinet decision, July 22, 2014), in addition
to implementing various measures such as strengthening occupational healthfunctions and those of occupational health physicians, rectifying the practice of long
working hours, tightening the enforcement of laws and regulations and promoting thewider adoption of health management, etc., advance these measures in a unified way
by making them interconnected. (Ministry of Health, Labour and Welfare; Ministry of
Economy, Trade and Industry)Also, through the portal site and corporate seminars, continuously encourage
specific initiatives by labor and management, publicize them and make them widely
known to workers, employers and the people of Japan. In addition to implementing
new training for personnel who can lead efforts to prevent power harassment inbusinesses, intended for specialists and others in personnel management and mental
health measures, provide guidance on measures to combat power harassment whenproviding guidance on mental health measures. (Ministry of Health, Labour andWelfare)17

Furthermore, see to it that thorough guidance is provided by the Employment
Environment and Equality Division (Office) of the prefectural Labour Bureaus so thatmeasures are taken to clarify the policy that sexual harassment and harassment related
to pregnancy or childbirth is not to be tolerated at any business establishment, makethe policy widely known and set up counseling services, etc., so that, at workplaces
where an incident of such harassment occurs, efforts are made to deal with theaftermath appropriately and prevent it from happening again. (Ministry of Health,Labour and Welfare)(2) Improving the system for furthering mental health promotion in thecommunity
In addition to improving counseling capabilities related to mental health issues, andthe social and other problems that may underlie them, at mental health and welfare
centers, public health centers and other health facilities, promote coordination amongcommunity health and occupation health and their related counseling facilities inregard to promoting mental health. (Ministry of Health, Labour and Welfare)Also, by enriching the activities at social and educational facilities such ascommunity centers and elsewhere, promote the creation of places in the community
where different generations can interact with one another. (Ministry of Education,
Culture, Sports, Science and Technology)
In addition, promote improvements to places where local residents can gather
and relax, by, for example, upgrading parks and playgrounds with a view tomaintaining and enhancing mental and physical health. (Ministry of Land,
Infrastructure, Transport and Tourism)
In addition to promoting welfare measures for the elderly in farming villages,
promote the creation of a safe and pleasant living and working environment by,among other things, providing facilities that can give the elderly a sense of purpose inlife. (Ministry of Agriculture, Forestry and Fisheries)(3) Improving the system for furthering mental health promotion in the schools
In addition to promoting health counseling carried out by school nurses throughmaking more open use of the school infirmary, counseling room and elsewhere, see toimproving the counseling system in schools by assigning school counselors, social
workers, etc., and encouraging efforts to make them fulltime employees. Also,
provide training to improve the quality of these school staff members. And, atuniversities and other places of higher education, strive to promote efforts aimed atfaculty members to deepen their understanding of the issues and needs of theirstudents relative to mental health problems and personal development and referstudents and others with mental problems to the help they need. (Ministry of
Education, Culture, Sports, Science and Technology)
Also, through cooperation between schools and the community, promote
efforts to increase the number of adults in the community students feel close to andwho know how to respond when a youngster sends an SOS. (Ministry of Education,
Culture, Sports, Science and Technology; Ministry of Health, Labour and Welfare)
In addition, promote occupational health and safety measures in schools as
workplaces. (Ministry of Education, Culture, Sports, Science and Technology)18

(4) Promoting mental care for and rebuilding the lives of victims of large-scaledisasters
Because the victims of large-scale disasters are likely to have a variety of stressfactors, in addition to mental care and the prevention of isolation, rebuilding theirlives and other mid- and long-term reconstruction-related measures, tailored to eachstage in the recovery process, need to be taken from the time that the disaster occurs.
Mental care is also necessary for those who assist them. Thus, in addition to
encouraging on an ongoing basis an understanding of the mental health status of thevictims of the 2011 Tohoku earthquake and tsunami and the causes of suicide among
them and studying and implementing measures to deal with these issues, make surethat the understanding gained from this process is reflected in future disasterprevention measures. (Cabinet Office; Reconstruction Agency; Ministry of Health,Labour and Welfare)
For victims of the Tohoku earthquake and tsunami and the accident at
TEPCO’s Fukushima Daiichi Nuclear Power Station, in order to reduce the various
stress factors caused by changes in their living environment at each stage of thereconstruction process, as well as by the discrimination and prejudice that has
accompanied their evacuation, through the coordinated efforts of the national
government, local public entities, private sector entities and others, implement
ongoing reconstruction-related measures, aimed among other things at rebuilding theirlives, in addition to human rights counseling, mental care and the prevention of social
isolation through monitoring and other activities. (Ministry of Justice; Reconstruction
Agency; Ministry of Education, Culture, Sports, Science and Technology; Ministry of
Health, Labour and Welfare)Also, in addition to improving and enhancing the victims’ mental care support
programs and expanding studies and research about mental care, carry out meticulous
mental care for the victims, as well as those who assist them, by strengthening
coordination between professional mental care and counseling and practical support
with regard to the various worries and concerns in their lives. (Reconstruction
Agency; Ministry of Health, Labour and Welfare)As the risk that large-scale disasters may occur increases, in order to be able tocarry out appropriate disaster-related health and medical assistance activities in theaffected areas, strengthen human resource development and improve the Disaster
Psychiatric Assistance Team (DPAT) system, taking into consideration issues that
arose during the Kumamoto earthquake of 2016, and proceed immediately to setting
up psychiatric hospitals at the disaster scene. Also, because those engaged in disaster
relief efforts, such as members of DPAT and others working in the affected areas,
may suffer from critical incident stress, take steps, such as prior arrangements withlocal public entities and related organizations that make up DPAT, on support
methods including measures to combat critical incident stress. (Ministry of Health,Labour and Welfare)
6. Seeing to it that the appropriate mental health, medical care and welfare
services are received
Together with working toward the early detection of persons with a high risk ofsuicide and ensuring they are referred to psychiatric care as necessary, enhance thepsychiatric care system so that such people can receive the appropriate treatment.
Also, since it is likely that in many cases dealing with a situation does not necessarily
end simply by referring a person to psychiatric care, even after doing so, it will benecessary to deal comprehensively with the concerns that person has, namely the19various problems that underlie his/her heightened risk of suicide, such as economic
and livelihood issues, welfare-related problems and family problems. For that reason,
reinforce the interconnectedness of each program, psychiatric care, health care,welfare, etc., so that everyone is able to receive the appropriate mental health, medicalcare and welfare services.
(1) Improving the interconnectedness of each program, psychiatric care, healthcare, welfare, etc.
Taking into account the mental health and welfare measures and policies in plans
related to health, medicine and welfare that each of the prefectures has prescribed,
encourage the building of a network of related groups and organizations in the areasof health, medicine, welfare, education, labor, law, etc., that would include psychiatriccare facilities in the community. In particular, improve the interconnectedness among
psychiatric care, health care and welfare. (Ministry of Health, Labour and Welfare)Also, promote improvements to a multi-institutional coordination system tolink together counseling facilities in various fields and a medical care coordination
system so that those diagnosed with depression by their family doctor or otherprimary care provider in the community can be referred to a specialist. (Ministry of
Health, Labour and Welfare)(2) Enhancing the psychiatric care system by training personnel responsible formental health, medical care and welfare services
In addition to carrying out training for psychologists and others engaged in psychiatriccare on the appropriate ways to deal with psychiatric disorders and educating
psychologists and others who can support psychiatrists, in order to disseminate highly
effective treatment methods for ameliorating depression such as cognitive behavioral
therapy and reduce the number of those suffering from depression by doing so,
implement training mainly in mental health care for those professionally involved intreating persons with depression. (Ministry of Health, Labour and Welfare)
In order to encourage equal access to and the further dissemination of
cognitive behavioral therapy and other medical care provided by psychiatrists with thesupport of psychologists and others, study measures and policies to improve thepsychiatric care system including strengthening and upgrading cognitive behavioral
therapy training programs, developing human resources and building a system tocoordinate them and the handling of such treatments in the medical treatment fee
system. (Ministry of Health, Labour and Welfare)Also, in addition to the diffusion of appropriate drug therapies and thethorough enforcement of measures against drug overdoses, disseminate knowledge
about adjustments that may need to be made to the patient’s living environment.
(Ministry of Health, Labour and Welfare)(3) Assigning specialists to increase the interconnectedness of mental health,
medical care and welfare services
Taking into account the mental health and welfare measures and policies in plans
related to health, medicine and welfare that each of the prefectures has prescribed,
encourage the building of a network of related groups and organizations in the areasof health, medicine, welfare, education, labor, law, etc., that would include psychiatriccare facilities in the community. In particular, improve the interconnectedness among
psychiatric care, health care and welfare. Also, in order to increase theinterconnectedness of these measures and policies, encourage efforts to assign

20psychiatric social workers and other specialists to medical facilities, etc., in thecommunity. (Ministry of Health, Labour and Welfare) (see beginning of 4.6 (1)above)(4) Improving the skills of family doctors and other primary care providers toevaluate and respond to suicide risks
Because many patients with depression and other forms of mental illness also havephysical symptoms and many of them also consult their family doctors or otherprimary care providers, during clinical training and other stages of the doctors’
training process and through opportunities for lifelong learning, etc., improve doctors’
understanding of and response to depression and other mental illnesses and their skill
at being able to evaluate their patient’s suicide risk accurately taking into
consideration the underlying social factors, and disseminate knowledge to them aboutcommunity-based suicide countermeasures, counseling services in various areas andsupport measures. (Ministry of Health, Labour and Welfare) (see 4.4 (3) above)(5) Improving the system to provide mental health, medical care and welfare
services to children
Promote improvements to the mental care system for children by encouraging studies
of a diagnostic model different from that of adults and promoting the training ofdoctors and others who can deal with children’s mental problems. (Ministry of Health,Labour and Welfare)
Increase the number of medical facilities capable of treating small children,
including emergency hospitalization, and recruit personnel to do so. (Ministry of
Health, Labour and Welfare)
In addition to seeing to the functional enhancement of child consultation
centers and municipal child-counseling-related facilities, work to strengthen theircoordination with related organizations involved in the care and education of disabledchildren such as mental health and welfare centers and municipal welfare departmentsfor persons with disabilities. (Ministry of Health, Labour and Welfare)
Furthermore, through the coordination of medical facilities with schools andrelated organizations involved in the care and education of disabled children, improvethe environment so that all children, no matter what their home environment may be,
can receive appropriate mental health, medical care and welfare services. (Ministry of
Health, Labour and Welfare)(6) Implementing screening for depression and other mental illnesses
Promote identifying those in the community who may be depressed by making use ofopportunities such as health education and health consultations, home-visits andguidance and medical check-ups at public health centers, municipal health centers andother facilities. (Ministry of Health, Labour and Welfare)Because there is a need to prevent the elderly in particular from becoming
depressed or reclusive from the perspective of long-term-care prevention, it isimportant to promote community-building so that the elderly can live in theircommunities with a sense that they have a role to play and a purpose in life. For thatreason, promote, primarily at the municipal level, efficient and effective long-termcare-prevention initiatives tailored to actual local conditions, such as creating various
places where people can go to in order to promote social participation and careprevention among the elderly. (Ministry of Health, Labour and Welfare)21

Also, ascertain the physical and mental health status and living environment of
nursing mothers soon after childbirth through postnatal health check-ups from theperspective of preventing post-partum depression, and strengthen the support for themat an early stage after childbirth. (Ministry of Health, Labour and Welfare)In the Project for Visiting All Families with a Baby (the Hello Baby Project)
to visit all homes that have babies up to four months old, in addition to providing thenecessary information on parenting support, in cases where families are found to needhelp including the prevention of post-partum depression, refer them to the appropriate
support. (Ministry of Health, Labour and Welfare)(7) Promoting measures for those at high risk for psychiatric illnesses other thandepression
For illnesses other than depression such as schizophrenia, alcohol-related healthproblems, drugs, gambling and other addictions that are risk factors for suicide, in
addition to promoting efforts in accordance with the Basic Law on Measures toPrevent Damage to Health Due to Alcohol and other related laws, as well as researchand studies in view of the relation of these disorders to debt, family problems, etc.,
improve the system to provide ongoing treatment and support, build a network of
related groups and organizations in the areas of health care, medicine, welfare,education, labor and law including local medical facilities, and provide support toself-help programs. (Ministry of Health, Labour and Welfare)Also, for those in adolescence or young adulthood who have mental healthissues, who repeatedly engage in self-mutilation or who have severe difficulties in life
due to past experiences of bullying or abuse, taking into full consideration
environmental factors, especially livelihood conditions such as poverty and the
difficulties young people face in becoming self-supporting, promote efforts to detect
those who need support and intervene at an early stage by, among other things,
helping them to be able to utilize the appropriate medical and counseling facilities bybuilding a network of related groups and organizations in areas such as health care,
medicine, welfare, education, labor, law, etc., including local emergency medical
facilities, mental health and welfare centers, public health centers, educational
institutions, etc. (Ministry of Health, Labour and Welfare)(8) Supporting cancer patients and the chronically ill
Build a system focused on cancer counseling and support centers and make its
existence widely known so that cancer patients can be referred as necessary toprofessional psychiatric care. (Ministry of Health, Labour and Welfare)
See to establishing a system capable of providing psychological care by, forexample, training nurses who can reply appropriately to queries from patients
suffering from serious chronic illnesses. (Ministry of Health, Labour and Welfare)
7. Lowering the risk of suicide in society as a whole
Suicide countermeasures need to be implemented in ways that will lower the risk ofsuicide in society as a whole by decreasing the social factors that impede a person’slife (suicide risk factors) and increasing those that enhance it (protective factors
against suicide). To do so, promote efforts in various areas to decrease the lifeimpeding factors and increase the life-enhancing ones.

22

(1) Improving counseling systems in the community and transmitting easily
understandable information on support policies, counseling services, etc.
Provide assistance to local public entities to produce and distribute pamphlets andother awareness-raising materials that list suicide-prevention-related counselingservices, etc., tailored to the needs of the persons for whom they are intended, andencourage the authorities to improve the system so that local counseling services will
be easy for residents to use. (Ministry of Health, Labour and Welfare)Also, as reliable places where people with problems can seek advice anywhereat any time and receive prompt and appropriate assistance, in addition to setting up
toll-free telephone counseling services (Yorisoi Hotline) available 24 hours a day, 365
days a year, having the telephone counseling provided by local public entities sharethe same telephone number nationwide (Mental Health Counseling Hotline), andproviding the use of said services on an ongoing basis, aim to have more than two outof every three people in Japan learn about them by taking advantage of Suicide
Prevention Week, Suicide Countermeasures Strengthening Month and otheropportunities and making them widely known. (Ministry of Health, Labour andWelfare)In addition, strengthen the consolidation and provision of information oncomprehensive support for people’s lives through search mechanisms that make useof the Internet (including smartphones and cellphones) and make this widely known
so that those who need help can easily access information on the appropriate support
measures. (Ministry of Health, Labour and Welfare)
As measures and policies aimed at realizing an inclusive community-basedsociety, in order to detect at an early stage and provide steady support to those in thecommunity who fall through the cracks in the system or who have complex problems
and find it difficult to go for counseling, encourage the creation of a comprehensive
support system through the cooperation of local residents and related public agencies.
(Ministry of Health, Labour and Welfare)(2) Improving counseling services related to multiple debts and increasing safetynet loans
See to the improvement of safety-net loans and the counseling system for those withmultiple debts based on the Program to Remedy the Multiple Debt Problem.
(Financial Services Agency; Consumer Affairs Agency; Ministry of Health, Labourand Welfare)(3) Improving counseling services for the unemployed
In addition to promoting employment measures of all kinds for the unemployed, suchas support for early reemployment, carry out meticulous vocational counseling at
Public Employment Security Offices (Hello Work) and elsewhere as well as
providing counseling for various problems in daily life such as the mental anxietiesthat arise when facing unemployment; in addition, promote comprehensive support
for the unemployed through close coordination with local public entities and others.
(Ministry of Health, Labour and Welfare)Also, at local youth support stations, coordinate with related organizations in
the community to provide individualized, ongoing and comprehensive support toenable unemployed young people and others to achieve occupational self-sufficiency.
(Ministry of Health, Labour and Welfare)23

(4) Implementing counseling programs for business owners
In coordination with the Societies of Commerce and Industry, Chambers ofCommerce and Industry, etc., promote on an ongoing basis counseling programs
aimed at small and mid-sized enterprises (SMEs) facing a management crisis as wellas counseling programs to deal with general business advice for SMEs. (Ministry of
Economy, Trade and Industry)Also, through SME Revitalization Support Councils being set up in all theprefectures, provide small and mid-sized business owners who have financial
problems with assistance in revitalizing their businesses such as help in drawing up
revitalization plans including mediating with financial institutions and counseling andsupport at counseling offices. (Ministry of Economy, Trade and Industry)
Furthermore, in addition to thoroughly and constantly making it clear tofinancial institutions that as a general rule they are not to ask for personal guarantees
from a third party other than business owners when making loans, strive todisseminate and make widely known the Guidelines for Personal Guarantees Provided
by Business Owners in order to even further encourage loans that do not depend on an
owner’s personal guarantee. (Financial Services Agency; Ministry of Economy, Tradeand Industry)(5) Improving the provision of information to resolve legal problems
Improve the provision of information for resolving legal problems through the Japan
Legal Support Center (Legal Terrace) and make the Center known among the peopleof Japan. (Ministry of Justice)(6) Regulating dangerous places, drugs, etc.
See to it that the safety of places where suicides have repeatedly occurred isthoroughly maintained, post information on where to get help, etc., and encourage theinstallation of platform doors and gates in train stations. (Ministry of Health, Labourand Welfare; Ministry of Land, Infrastructure, Transport and Tourism)
Also, in addition to seeing to it that regulations on the dispensing of dangerous
drugs are widely known and obeyed, make ongoing efforts to find missing persons
who, it is feared, may commit suicide. (National Police Agency; Ministry of Health,Labour and Welfare)(7) Strengthening suicide countermeasures that make use of information andcommunications technology (ICT)Strengthen the consolidation and provision of information on support measuresthrough search mechanisms that make use of the Internet (including smartphones andcellphones) so that those who need help can easily access information on theappropriate support measures. (Ministry of Health, Labour and Welfare) (see 4.7 (1)above)In order to heighten the response capability of every person in Japan in an
emergency and dispel society’s mistaken but common beliefs about suicide andsuicide-related phenomena, promote the dissemination of accurate knowledge aboutsuicide through the proactive use of the Internet (including smartphones andcellphones). (Ministry of Health, Labour and Welfare) (see 4.2 (3) above)
Although young people tend to be less likely to seek help or counseling of
their own accord, on the other hand, they are also said to have a tendency to drop
hints about suicide on the Internet or social networking sites or search the Internet for
suicide methods, etc. For that reason, strengthen not just activities such as home visits24and speaking to them in public, but also outreach measures for young people thatmake use of information and communications technology. (Ministry of Health,Labour and Welfare)(8) Promoting measures to deal with suicide-related information on the Internet
Request site administrators and others to delete suicide-related information on theInternet. (National Police Agency)
Also, promote measures like making the filtering of content harmful tochildren and adolescents widely available as a way to deal with information that
introduces suicide methods, etc., that might inflict injury on third parties. (Ministry ofInternal Affairs and Communications; Ministry of Education, Culture, Sports, Scienceand Technology; Ministry of Economy, Trade and Industry)In addition to encouraging efforts prescribed under the Act on Development of
an Environment that Provides Safe and Secure Internet Use for Young People, andseeing to it that the above filtering is widely available under the Basic Plan of thesame Act, promote public awareness activities and education on the appropriate use of
the Internet. (Cabinet Office; Ministry of Education, Culture, Sports, Science andTechnology; Ministry of Economy, Trade and Industry)(9) Dealing with suicide notices on the Internet
Implement on an ongoing basis prompt and appropriate responses to notices on theInternet of the intention to commit suicide. (National Police Agency)
Also, make filtering software widely available to deal with suicide notice sites
on the Internet and with illegal and harmful information, such as a posting thatslanders or maligns a particular individual on an electronic bulletin board, andimplement support for voluntary measures against such sites taken by service
providers. (Ministry of Internal Affairs and Communications; Ministry of Economy,
Trade and Industry)(10) Improving support for caregivers
In order to lighten the burden of those caring for the elderly, strive to implement thenecessary support by recruiting personnel engaged in counseling services andimproving their quality, etc., so that a system of coordination and cooperation among
local comprehensive support centers and other related organizations is put in place
and that counseling for caregivers is smoothly implemented. (Ministry of Health,Labour and Welfare)(11) Improving support for hikikomori (social recluses)
At local hikikomori support centers, which function as primary counseling services
specializing in those suffering from acute social withdrawal, in coordination withrelated organizations in areas such as health care, medicine, welfare, education andlabor, provide support and counseling from an early stage to such people and theirfamilies and promote measures to deal with the condition. In addition, provide support
and counseling for them and their families from doctors, public health nurses,
psychiatric social workers, and social workers at mental health and welfare centers,
public health centers and child consultation centers. (Ministry of Health, Labour andWelfare)25

(12) Improving support for victims of child abuse, sex crimes and sexual violenceChild abuse has a serious impact on personality formation in children and on theirmental and physical development; it can also be a risk factor for suicide. In order tofurther strengthen a series of measures that range from preventing abuse fromoccurring to helping a child who has been abused become self-sufficient, in addition
to enhancing the counseling and support system in municipalities and at childconsultation centers, see to improving social protective care. (Ministry of Health,Labour and Welfare)Also, carry out vigorous publicity and awareness-raising campaigns about 189,
the telephone number for child consultation centers across the country, primarily
during Child Abuse Prevention Month every November, so that when someone
encounters a child who seems to have been abused, s/he can unhesitatingly report thisto a child consultation center and seek advice. (Ministry of Health, Labour andWelfare)Also, in many cases, children raised in social protective care are unable toreceive support from their guardians and others once they leave care facilities and areon their own; as a result, many have a variety of problems. For that reason, in order toeffectively support these children in their efforts to become self-sufficient, continue toassist them even after they leave care facilities by, for example, not cutting off support
at the time they go to college or seek employment, and improve back-up support.
(Ministry of Health, Labour and Welfare)To reduce the psychological burden on victims of sex crimes and sexual
violence, in addition to strengthening the gathering of information the victims needand enhancing the coordination of support with the related organizations, promote
improvements to the counseling system and to interviews, questioning, etc., that willtake the victims’ feelings into account. (Cabinet Office; National Police Agency;
Ministry of Health, Labour and Welfare)Also, in order to strengthen coordination with suicide countermeasures, inaddition to increasing the coordination of assistance provided by private sector
support groups that conduct suicide-prevention-related telephone counselingprograms, promote the creation of places where victims can go and feel safe.
(Ministry of Health, Labour and Welfare)
In addition, in order to promote support for women who have problems suchas victims of sex crimes and sexual violence, encourage efforts to assist them such as
outreach programs and the creation of places where they can go and feel safe throughcoordination among private sector support groups, women’s consultation offices andother related organizations. (Ministry of Health, Labour and Welfare)
The prevalence of psychiatric disorders such as post-traumatic stress is highamong victims of sex crimes and sexual violence, because coordination between
health care and medical care in dealing with measures to counter PTSD is noticeably
inadequate. For this reason, conduct the research and studies needed to implement
evidence-based measures from the perspective of appropriately providing support tovictims of sex crimes or sexual violence. (Ministry of Health, Labour and Welfare)(13) Improving support for the poor and needy
In view of the fact that many poor people who have multiple problems are suicide
risks, in addition to providing comprehensive assistance through independence
support consultation support programs in accordance with the Law on Self-Reliance
Support for Poor and Needy People, coordinate closely with related organizations, etc.,
in the area of suicide countermeasures and provide efficient and effective assistance.

26

Also, to advance this sort of coordination on site in the community, promote aframework for policy coordination by, among other things, making widely known
specific practical examples of such coordination and exploring ways to refer a poorand needy person who visits a suicide-prevention-related counseling office to themeasures s/he needs. (Ministry of Health, Labour and Welfare)
Moreover, build mechanisms to increase interconnectedness between suicidecountermeasures and the system to support the self-sufficiency of the poor and needy
by, among other things, providing joint training, including case studies, for counselors
at related organizations and making use of a common consultation questionnaire thattakes into consideration promoting coordination among related organizations in thatsystem. (Ministry of Health, Labour and Welfare)(14) Improving counseling services for single-parent families
Many single-parent families, in which one person has sole responsibility for bothchild-rearing and financially supporting the family, experience various difficulties. In
order to assist such families, encourage the assignment of employment support
specialists as well as single-parent self-sufficiency support staff at counseling services
for single-parent families that are operated by local public entities and provide onestop counseling on everything from matters related to child-rearing and everyday
living to employment; in addition, promote inclusive comprehensive support byreferring them as necessary to other support facilities. (Ministry of Health, Labour andWelfare)(15) Improving support for expectant and nursing mothers
In order to strengthen support for pregnant women who require assistance during
pregnancy and with postnatal child care, women who have had no prenatal healthcheck-up before giving birth and other pregnant women who are deemed to needsupport for child care, promote coordination with related organizations and enhance
support for such women. (Ministry of Health, Labour and Welfare)Also, ascertain the physical and mental health status and living environment of
nursing mothers soon after childbirth through postnatal health check-ups from theperspective of preventing post-partum depression, and strengthen the support for themat an early stage after childbirth. (Ministry of Health, Labour and Welfare) (see 4.6(6) above)
In the Project for Visiting All Families with a Baby (the Hello Baby Project)
to visit all homes that have babies up to four months old, in addition to providing thenecessary information on parenting support, in cases where families are found to needhelp including the prevention of post-partum depression, refer them to the appropriate
support. (Ministry of Health, Labour and Welfare) (see 4.6 (6) above)
For those who have physical or mental disorders after childbirth or anxieties
about child-rearing, in addition to providing child-care support and mental andphysical care for mothers immediately after they leave the hospital and ensuring that
there is a support system that enables them to feel comfortable about taking care of
their baby, explore legal mechanisms for postnatal care programs taking into accountthe implementation status of the programs in the future. (Ministry of Health, Labourand Welfare)(16) Improving support for sexual minorities
Provide counseling at legal affairs bureaus, district legal affairs bureaus, their branch
offices or special human rights counseling offices. When a case of suspected human27rights violation, such as harassment on account of sexual orientation or gender
identity, has been identified through human rights counseling or other means,
investigate it as a case of human rights violation and take appropriate measures as thesituation demands. (Ministry of Justice)
Because sexual minorities sometimes have suicidal thoughts as a result ofsocial factors such as prejudice and lack of understanding by the community or bysociety at large, in addition to promoting understanding of sexual minorities among
teaching staff, encourage the implementation of the appropriate educationalcounseling in schools. (Ministry of Education, Culture, Sports, Science andTechnology)
In addition to setting up toll-free telephone counseling services (Yorisoi
Hotline) available 24 hours a day and 365 days a year as a place to turn to for those
who have weak social ties, including those because of their sexual orientation orgender identity, implement support through interviews, counseling and accompanying
them as necessary and provide sympathetic support leading to specific solutions.
(Ministry of Health, Labour and Welfare)
Since power harassment can be carried out against the background of a lack ofunderstanding about sexual orientation and gender identity, make this fact more
widely known in manuals introducing measures to combat power harassment
distributed to prefectural Labour Bureaus; in addition, in pamphlets aimed at businessowners in regard to fair employment selection, state clearly and make the principle
widely known that they are not to exclude certain people such as sexual minorities.
Also, make it known on an ongoing basis that sexual harassment in the workplace canbe applicable no matter what a person’s sexual orientation or gender identity may be.
(Ministry of Health, Labour and Welfare)(17) Strengthening outreach and ensuring a diversity of counseling methods
At counseling programs offered by the national government, local public entities andprivate sector entities, in order to make counseling as available as possible even incircumstances where counseling over the telephone or in person is difficult because of
the special nature of a disability, etc., see to ensuring diverse methods ofcommunication such as faxes, emails and social networking services. (Ministry of
Health, Labour and Welfare)
See to creating a counseling system for children that makes use of social
networking services by, among other things, supporting initiatives by local public
entities. (Ministry of Education, Culture, Sports, Science and Technology)
In order to promote support for women who have problems such as victims ofsex crimes and sexual violence, encourage efforts to assist them such as outreachprograms and the creation of places where they can go and feel safe throughcoordination among private sector support groups, women’s consultation offices andother related organizations. (Ministry of Health, Labour and Welfare) (see 4.7 (12)above)
Although young people tend to be less likely to seek help or counseling of
their own accord, on the other hand, they are also said to have a tendency to drop
hints about suicide on the Internet or social networking sites or search the Internet for
suicide methods, etc. For that reason, strengthen not just activities such as home visitsand speaking to them in public, but also outreach measures for young people thatmake use of information and communications technology. (Ministry of Health,Labour and Welfare) (see 4.7 (7) above)28

(18) Making well known information sharing mechanisms necessary for
coordination among related organizations
In order to be able to smoothly provide comprehensive support for people’s lives
through various kinds of back-up in the community, collect examples of initiatives
pertaining to information sharing mechanisms necessary for coordination among
related organizations and make them known to local public entities and others toenable them to share information about a counseling client that is needed for organic
coordination, while respecting the client’s wishes. (Ministry of Health, Labour andWelfare)(19) Promoting the creation of places to go to that contribute to suicidecountermeasures
In order to prevent social isolation from occurring, promote the creation of places forpeople to go to who may be at risk of social isolation, such as those who find life
difficult, young people with low self-esteem, elderly persons who have lost theirspouse through death or divorce and middle-aged and older men who are retired andhave lost their role in life, so that they can reconnect to the community and to the
support they need before they feel isolated. (Ministry of Health, Labour and Welfare;related ministries and agencies)
Promote comprehensive support for people’s lives that combines assistancefor activities at the abovementioned places that increase the life-enhancing factors(factors protective against suicide) by raising a counseling client’s self-esteem, withpersonalized support that reduces the life-impeding factors (suicide risk factors) by
specifically solving the problems s/he has. (Ministry of Health, Labour and Welfare)(20) Making the WHO guidelines known to the news media
In order to address the issue of appropriate coverage of suicide in the news media,
make known to all media companies the WHO’s suicide prevention guidelines,“Preventing Suicide: A Resource for Media Professionals,” as well as the guidelines
on suicide reporting that Japanese media organizations voluntarily have drawn up, andappeal to the media to make use of them. (Ministry of Health, Labour and Welfare)
Carry out research and studies on the impact of suicide reporting and on
media-related measures taken abroad, etc., that will contribute to voluntary measurestaken by the Japanese mass media. (Ministry of Health, Labour and Welfare)
8. Preventing repeat suicide attempts
Strengthen measures to prevent repeat suicide attempts in light of the accumulated
results of various experimental approaches that have been developed in all parts of thecountry, such as verifying the benefits of multimodal case management forindividuals who have attempted suicide and have been brought to emergency facilities,
and testing efforts to help such individuals through coordination between medical
facilities and local public entities. Also, improve assistance for family members andother close supporters in their efforts to monitor a person who has survived a suicide
attempt.
(1) Equipping medical facilities responsible for the core functions of supporting
individuals in the community who have survived a suicide attempt
In order to prevent repeat suicide attempts, there need to be medical facilities that will
become the focal point for improving the ability to respond to and support individuals
in the community who attempt suicide, by, for example, appropriately intervening on29

an ongoing basis even after such a person is released from the emergency medical
facility to which s/he has been taken, making case studies of difficult cases, andtraining health professionals in the community; in addition to strengthening support
for these initiatives, aim to disseminate model approaches to other medical facilities
to be deployed under similar circumstances. (Ministry of Health, Labour and Welfare)(2) Upgrading the medical care system provided by psychiatrists at emergency
medical facilities
In addition to upgrading the psychiatric emergency medical system, by assigningmental health professionals such as psychiatric social workers at emergency andcritical care centers and elsewhere, improve the emergency care system so that those
who have been treated after a suicide attempt can have their need for psychiatric careevaluated, be diagnosed by a psychiatrist as necessary and receive care from a mental
health specialist. (Ministry of Health, Labour and Welfare)Also, in order to provide the appropriate support to survivors of a suicide
attempt, see to the dissemination of guidelines for the care and treatment of such
persons by, for example, training those involved in emergency medicine. (Ministry of
Health, Labour and Welfare)(3) Strengthening comprehensive support for those who have attempted suicide
by promoting coordination between medical care and the community
Taking into account the mental health and welfare measures and policies in plans
related to health, medicine and welfare that each of the prefectures has prescribed,
encourage the building of a network of related groups and organizations in the areasof health, medicine, welfare, education, labor, law, etc., that would include psychiatriccare facilities in the community. Promote seamless, comprehensive, ongoing
assistance by having medical facilities and local public entities coordinate theirsupport for survivors of a suicide attempt. And, in order to increase this coordination,encourage efforts to assign specialists such as psychiatric social workers to thecommunity, beginning at medical facilities. (Ministry of Health, Labour and Welfare)(see 4.6 (1) above, in part)
Also, promote improvements to a multi-institutional coordination system tolink together counseling facilities in various fields and a medical care coordination
system so that those diagnosed with depression by their family doctor or otherprimary care provider in the community can be referred to a specialist. (Ministry of
Health, Labour and Welfare) (see 4.6 (1) above)(4) Providing support through interconnectedness with measures to create places
to go toIn order to prevent social isolation from occurring, promote the creation of places forpeople to go to who may be at risk of social isolation, such as those who find life
difficult, young people with low self-esteem, elderly persons who have lost theirspouse through death or divorce and middle-aged and older men who are retired andhave lost their role in life, so that they can reconnect to the community and to the
support they need before they feel isolated. (Ministry of Health, Labour and Welfare;related ministries and agencies) (see 4.7 (19) above)
Promote comprehensive support for people’s lives that combines assistancefor activities at the abovementioned places that increase the life-enhancing factors(factors protective against suicide) by raising a counseling client’s self-esteem, withpersonalized support that reduces the life-impeding factors (suicide risk factors) by30specifically solving the problems s/he has. (Ministry of Health, Labour and Welfare)(see 4.7 (19) above)(5) Providing assistance to family members and other close supporters
Improve the counseling system for those who have survived a suicide attempt asprovided by public health nurses at mental health and welfare centers and publichealth centers by building a network of counseling facilities of all kinds related to thesocial factors that may become causes of suicide. In addition, improve support for thevictim’s family members, friends and other close supporters in their efforts to monitor
him/her after being released from hospital by encouraging even greater improvements
to the system to provide ongoing care by building a network of related groups andorganizations in the fields of health care, medicine, welfare, education, labor, law, etc.,that would include psychiatric care facilities in the community. (Ministry of Health,Labour and Welfare)Also, in light of reports of empirical studies conducted outside of Japan that
suicide-related behaviors and feelings of depression have changed for the better insurvivors of suicide attempts who have subsequently received support from family
members and others, and that depression and suicidal ideation have also changed forthe better in the families themselves, provide training to those who would like toprovide support to family members and friends who act as day-to-day supporters of
someone who has attempted suicide or who are concerned about such a person.
(Ministry of Health, Labour and Welfare)(6) Encouraging post-crisis response in schools and workplaces
In the event of a suicide attempt at a school or workplace, bring about the appropriate
post-crisis response by distributing manuals at the workplace and reference materials
for teaching staff at the school immediately after a suicide attempt has occurred sothat psychological care can be appropriately provided to classmates or co-workers.
(Ministry of Education, Culture, Sports, Science and Technology; Ministry of Health,Labour and Welfare)

9. Improving support for the bereaved
The purpose provision of the Basic Law stipulates that the aim of this law is toprevent suicide and enhance support for the relatives, etc., of suicide victims bycomprehensively promoting suicide countermeasures. In addition to providing prompt
assistance to persons bereaved by suicide, enhance support by, among other things,
promoting the provision of information so that such persons, no matter where in Japanthey may be, can receive the information they need about available assistanceincluding related measures. Also, support the activities in the community of self-helpgroups, etc., for bereaved families.
(1) Supporting the operations of self-help groups for bereaved families
In addition to support to make bereaved families and others aware of counselingfacilities and the operations of self-help groups for them in the community, improvethe counseling system provided for them by public health nurses and other healthprofessionals at mental health and welfare centers and public health centers. (Ministryof Health, Labour and Welfare)31

(2) Encouraging post-crisis response in schools and workplaces
In the event of a suicide at a school or workplace, bring about the appropriate postcrisis response by distributing manuals at the workplace and reference materials forteaching staff at the school immediately after a suicide has occurred so thatpsychological care can be appropriately provided to classmates or co-workers.
(Ministry of Education, Culture, Sports, Science and Technology; Ministry of Health,Labour and Welfare)(3) Promoting the provision of information relating to the comprehensive
support needs of bereaved families and others
Have the Japan Support Center for Suicide Countermeasures play a central role inseeing to it that bereaved families and others anywhere in the country can receive theinformation they need about available assistance including related measures. Also, inview of the likelihood that such persons have comprehensive support needs, so thatthey can promptly receive useful information as necessary, promote the provision of
information on the support measures they may need while taking into consideration
their privacy and that of the suicide victim, by, among other things, drawing up
pamphlets that provide information about the general mental and physical impact ofsuicide, things to keep in mind, various formalities, the activities of self-help groups,
the location of counseling services offered by private sector entities and local public
entities, and other necessary information, and by ensuring they are distributed atrelated organizations that are likely to be in frequent contact with the bereaved.
(Ministry of Health, Labour and Welfare)Study the problems, including legal problems, that bereaved family members
and others are likely to encounter, such as demands for vacancy damages forstigmatized property where a suicide has occurred. (Ministry of Health, Labour andWelfare)(4) Improving the quality of personnel at public agencies who deal with bereaved
family members and others
Promote the dissemination of knowledge about how to deal appropriately withbereaved family members and others among those engaged in suicide-related work in
the police and fire departments and other public agencies. (National Police Agency;
Ministry of Internal Affairs and Communications) (see 4.4 (9) above)(5) Supporting bereaved children
In addition to supporting efforts to make local counseling facilities and the operationsof self-help groups for bereaved children in the community widely known to suchchildren and their guardians, improve the counseling system for them primarily byteaching staff at their schools who have many opportunities to be in contact with theirstudents on a daily basis, as well as by public health nurses at child consultation
centers, mental health and welfare centers and public health centers. (Ministry of
Education, Culture, Sports, Science and Technology; Ministry of Health, Labour andWelfare)Implement training, etc., to improve the quality of school staff in charge ofeducational counseling, including care for bereaved children. (Ministry of Education,
Culture, Sports, Science and Technology) (see 4.4 (4) above)32

10. Strengthening coordination with private sector entities
The activities of private sector entities have a very important role to play in national
and local suicide countermeasures. Many private sector entities, however, haveproblems with organizational management, human resource development, securing
funding, etc. In light of these circumstances, with the revision of the Basic Law inApril 2016, the national government and local public entities are authorized to offer
advice and take financial and other necessary measures to support the activities ofprivate sector entities.
(1) Supporting human resource development at private sector entities
Support the training of those responsible for counseling at private sector entities, andof coordinators to promote coordination with other organizations. (Ministry of Health,Labour and Welfare)Support human resource development at private sector entities by, among
other things, developing educational materials to train gatekeepers in every field ofactivity, supporting the development of such materials, the taking of training courses,
etc. (Ministry of Health, Labour and Welfare)(2) Establishing a community coordination system
In addition to encouraging the establishment of a practical coordination system among
public organizations, private sector entities and others in the community engaged incarrying out suicide countermeasures, support the provision of information on bestpractices so that the system will function smoothly. (Ministry of Health, Labour andWelfare)In order to contribute to resolving consumer problems as well as detecting thesigns of suicide before it occurs and strengthening coordination among relatedorganizations, support the building of a monitoring network to prevent damages
suffered by consumers at high risk of encountering trouble (the elderly, those whohave previously experienced such damages, etc.). (Consumer Affairs Agency)(3) Supporting counseling programs by private sector entities
Implement ongoing support for counseling programs aimed at suicidecountermeasures conducted by private sector entities. (Ministry of Health, Labour andWelfare)Also, implement ongoing support to provide the information they need for thehuman resource development of counselors. (Ministry of Health, Labour and Welfare)(4) Supporting pioneering and experimental approaches by private sector
entities as well as their efforts in places where multiple suicides have occurred
To advance efforts in the community and the entire country, support pioneering andexperimental suicide countermeasures carried out by private sector entities, as well as
studies of them, etc. (Ministry of Health, Labour and Welfare)Also, support the provision of the information needed to make it easier for
private sector entities to undertake pioneering and experimental measures against
suicide. (Ministry of Health, Labour and Welfare)Support private sector entities in places where multiple suicides have occurred.
(Ministry of Health, Labour and Welfare)3311. Promoting suicide countermeasures among children and young people evenfurther
Although in recent years the suicide rate in Japan has on the whole been trending
downward, for those under 20 years of age it remains largely unchanged since 1998,
and the rate of decline since its peak is lower among those in their 20s and 30s thanfor any other age group. And, since suicide ranks high as a cause of death among theyoung, suicide countermeasures for this cohort are becoming an issue. In addition,
because the promotion of education in schools on how to raise an SOS wasincorporated in the April 2016 revision of the Basic Law, suicide countermeasures
aimed at young people in particular will be promoted even further.
It is important to widen the scope of support so that young people are notexcluded from the help they need, but since the circumstances in which they findthemselves differ – life stage (grade in school), situation (existence of ties to schooland society or the lack thereof) – as do the reasons they are driven to suicide, it isnecessary to implement policies tailored to the circumstances in which each groupfinds itself.
(1) Preventing suicide in children who are victims of bullying
In addition to promoting initiatives laid down in the Act on Promotion of Bullying
Prevention Measures and the Basic Policy for Bullying Prevention (October 11, 2013
decision of the Minister of Education, Culture, Sports, Science and Technology),
make it thoroughly known that bullying is under no circumstances permissible andthat it can occur to any child at any school; instruct all educators on how to recognize
the signs of bullying as early as possible and respond rapidly; and, when a problem
with bullying occurs, it must not be covered up, but the school, the Board of
Education, the family and community must work together to deal with it. (Ministry of
Education, Culture, Sports, Science and Technology)
In addition to supporting local public entities with their telephone counselingsystems for bullying and other problems through a 24-hour nationwide hotline system(24-hour SOS Helpline) so that children can confide their anxieties and uncertainties
at any time, encourage the development of a community-wide system so that theschool, the community and the family can work together to detect bullying in its earlystages and deal appropriately with it. Also, see to creating a counseling system forchildren that makes use of social networking services by, among other things,
supporting initiatives by local public entities. (Ministry of Education, Culture, Sports,
Science and Technology) (see 4.7 (17) above)
Also, continuously implement measures to protect the human rights ofchildren through Children’s Rights SOS Mini Letters, etc., that provide intimate
insight into children’s worries through exchanges of letters with human rights
consultants in the community. (Ministry of Justice)In order to promote an understanding of the immensity of the impact thatbullying has on a person, work to provide opportunities in the schools for children andeducators to hear firsthand accounts from those who have experienced bullying andfrom family members whose children died by suicide after suffering from it. (Ministryof Education, Culture, Sports, Science and Technology)(2) Improving support for elementary school children and junior and senior highschool students
Because suicide among those aged 18 and younger has a tendency to rise sharply justafter long vacation breaks, promote efforts such as early detection and monitoring at

34

elementary schools and junior and senior high schools before, during and just after along vacation. (Ministry of Education, Culture, Sports, Science and Technology) (see
4.2 (2) above)
In addition to promoting health counseling carried out by school nurses
through making more open use of the school infirmary, counseling room andelsewhere, see to improving the counseling system in schools by assigning school
counselors, social workers, etc., and encouraging efforts to make them fulltime
employees. Also, provide training to improve the quality of these school staff
members. And, at universities and other places of higher education, strive to promote
efforts aimed at faculty members to deepen their understanding of the issues andneeds of their students relative to mental health problems and personal development
and refer students and others with mental problems to the help they need. (Ministry of
Education, Culture, Sports, Science and Technology) (see 4.5 (3) above)
In addition to promoting initiatives laid down in the Act on Promotion of
Bullying Prevention Measures and the Basic Policy for Bullying Prevention, make itthoroughly known that bullying is under no circumstances permissible and that it canoccur to any child at any school; instruct all educators on how to recognize the signsof bullying as early as possible and respond rapidly; and, when a problem withbullying occurs, it must not be covered up, but the school, the Board of Education, thefamily and community must work together to deal with it. (Ministry of Education,
Culture, Sports, Science and Technology) (see 4.11 (1) above)
In addition to supporting local public entities with their telephone counselingsystems for bullying and other problems through a 24-hour nationwide hotline system(24-hour SOS Helpline) so that children can confide their anxieties and uncertainties
at any time, encourage the development of a community-wide system so that theschool, the community and the family can work together to detect bullying in its earlystages and deal appropriately with it. Also, see to creating a counseling system forchildren that makes use of social networking services by, among other things,
supporting initiatives by local public entities. (Ministry of Education, Culture, Sports,
Science and Technology) (see 4.11 (1) above)
Also, continuously implement measures to protect the human rights ofchildren through Children’s Rights SOS Mini Letters, etc., that provide intimate
insight into children’s worries through exchanges of letters with human rights
consultants in the community. (Ministry of Justice) (see 4.11 (1) above)
As support for children who refuse to go to school, in addition to promoting
effective initiatives for providing assistance at an early stage through coordination
among related organizations including private sector entities, see to improving thecounseling system both in the schools and outside them. (Ministry of Education,
Culture, Sports, Science and Technology)
For high-school dropouts and those who graduate without deciding what to do
next, try to understand the actual conditions related to their dropping out or their postschool circumstances and share that information, so that Public Employment Security
Offices (Hello Work), local youth support stations, schools and other relatedorganizations can coordinate and work together to provide effective support.
(Ministry of Education, Culture, Sports, Science and Technology; Ministry of Health,Labour and Welfare)(3) Promoting instruction on how to raise an SOS
In schools, in addition to attempting to give students at primary and secondary schoolsa real sense of the preciousness of life by making use of experience-based activities

35

and intergenerational contacts with the elderly and others in the community, promote
instruction related to maintaining children’s mental health and to equipping them withthe skills to cope with stress and the various difficulties they are likely to encounter insociety (instruction on how to raise an SOS). In addition, encourage building anenvironment conducive to providing instruction that will contribute to suicidecountermeasures by increasing the life-enhancing factors among primary andsecondary school students. (Ministry of Education, Culture, Sports, Science andTechnology) (see 4.2 (2) above)
By preparing and distributing teaching materials, support efforts to train
school staff such as classroom teachers and school nurses who are in contact withstudents on a daily basis, as well as faculty members at universities and elsewhere
engaged in student counseling, in order to implement awareness-raising not only
about teaching children how to raise an SOS but also about how to heighten thesensitivity of the adults around them to recognize the SOS a child has sent and how to
respond to it. Implement training, etc., to improve the quality of school staff in chargeof educational counseling, including care for the child of a suicide victim. Also,
promote understanding among school staff of sexual minorities, among whom thepercentage of those contemplating suicide has been observed to be high, in view ofthe fact that one of the social factors behind this is prejudice and lack ofunderstanding. (Ministry of Education, Culture, Sports, Science and Technology) (see4.4 (4) above)(4) Improving support for children
So that the various problems which children living in poverty have cannot develop
into suicide risk factors, deepen coordination between suicide countermeasures andmeasures that have been implemented in compliance with the Act on Promotion ofChild Poverty Measures. (Cabinet Office; Ministry of Health, Labour and Welfare)
In accordance with the Law on Self-Reliance Support for Poor and Needy
People, in addition to implementing learning support programs, including the creationof places that children from poor households can go to, promote the creation of places
where children in single-parent families, who find themselves in economically or
emotionally unstable circumstances after the loss of a parent by death or divorce, cango to discuss their problems, acquire basic lifestyle habits and receive learning
support. (Ministry of Health, Labour and Welfare)Child abuse has a serious impact on personality formation in children and on
their mental and physical development. In order to further strengthen a series ofmeasures that range from preventing abuse from occurring to helping a child who has
been abused become self-sufficient, in addition to enhancing the counseling andsupport system in municipalities and at child consultation centers, see to improvingsocial protective care. (Ministry of Health, Labour and Welfare) (see 4.7 (12) above)
Also, in many cases, children raised in social protective care are unable toreceive support from their guardians and others once they leave care facilities and areon their own; as a result, many have a variety of problems. For that reason, in order toeffectively support these children in their efforts to become self-sufficient, continue toassist them even after they leave care facilities by, for example, not cutting off support
at the time they go to college or seek employment, and improve back-up support.
(Ministry of Health, Labour and Welfare) (see 4.7 (12) above)36

(5) Improving support for young people
At local youth support stations, coordinate with related organizations in thecommunity to provide individualized, ongoing and comprehensive support to enable
unemployed young people and others to achieve occupational self-sufficiency.
(Ministry of Health, Labour and Welfare) (see 4.7 (3) above)
At local hikikomori support centers, which function as primary counselingservices specializing in those suffering from acute social withdrawal, in coordination
with related organizations in areas such as health care, medicine, welfare, educationand labor, provide support and counseling from an early stage to such people and theirfamilies and promote measures to deal with the condition. In addition, provide support
and counseling for them and their families from doctors, public health nurses,
psychiatric social workers, and social workers at mental health and welfare centers,
public health centers and child consultation centers. (Ministry of Health, Labour andWelfare) (see 4.7 (11) above)
To reduce the psychological burden on victims of sex crimes and sexual
violence, in addition to strengthening the gathering of information the victims needand enhancing the coordination of support with the related organizations, promote
improvements to the counseling system and to interviews, questioning, etc., that willtake the victims’ feelings into account. (Cabinet Office; National Police Agency;
Ministry of Health, Labour and Welfare) (see 4.7 (12) above)
Also, in order to strengthen coordination with suicide countermeasures, inaddition to increasing the coordination of assistance provided by private sector
support groups that conduct suicide-prevention-related telephone counselingprograms, promote the creation of places where victims can go and feel safe.
(Ministry of Health, Labour and Welfare) (see 4.7 (12) above)
In addition, in order to promote support for women who have problems suchas victims of sex crimes and sexual violence, encourage efforts to assist them such as
outreach programs and the creation of places where they can go and feel safe throughenhanced coordination among private sector support groups, women’s consultation
offices and other related organizations. (Ministry of Health, Labour and Welfare) (see
4.7 (12) above)
For those in adolescence or young adulthood who have mental health issues,
who repeatedly engage in self-mutilation or who have severe difficulties in life due topast experiences of abuse, etc., promote efforts to detect those with psychiatricdisorders and intervene at an early stage by, among other things, providing support sothat they can utilize the appropriate medical care and counseling facilities by building
a network of related groups and organizations in areas such as health care, medicine,
welfare, education, labor, including local emergency medical facilities, mental healthand welfare centers, public health centers, educational institutions, etc. (Ministry of
Health, Labour and Welfare) (see 4.6 (7) above)(6) Improving support for young people tailored to their special traits
Although young people tend to be less likely to seek help or counseling of their own
accord, on the other hand, they are also said to have a tendency to drop hints aboutsuicide on the Internet or social networking sites or search the Internet for suicide
methods, etc. For that reason, strengthen not just activities such as home visits andspeaking to them in public, but also outreach measures for young people that makeuse of information and communications technology. (Ministry of Health, Labour andWelfare) (see 4.7 (7) above)37

Strengthen the consolidation and provision of information on support
measures through search mechanisms that make use of the Internet (including
smartphones and cellphones) so that those who need help can easily accessinformation on the appropriate support measures. (Ministry of Health, Labour andWelfare) (see 4.7 (7) above)
In view of the fact that suicide countermeasures among the younger generation
are becoming an issue, support studies that also provide direct assistance to young
people in regard to suicide and the difficulties in their lives. (Ministry of Health,Labour and Welfare) (see 4.3 (4) above)(7) Supporting their friends and acquaintances
Young people, it is said, tend to consult friends and others close to them throughpersonal connections rather than go to counseling services at support organizations.
And situations are also said to occur in which the close friends to whom they haveconfided their worries and sought advice become anxious about how to respond andare themselves placed under considerable pressure, and they and their friends come togrief together. Therefore, for those engaged in suicide countermeasures, including
those involved in the activities of private sector entities as well as family members,
friends and other supporters of someone who is in distress, in addition to promoting
the creation of mechanisms to maintain their mental health, even when someone they
had counseled attempted suicide, disseminate support methods that make use ofmental health expertise. (Ministry of Health, Labour and Welfare) (see 4.4 (11)above)

12. Promoting suicide countermeasures for work-related problems even further(1) Rectifying the practice of long working hours
To rectify the practice of long working hours, revise the Labor Standards Act asprescribed in the Action Plan for the Realization of Work Style Reform; limit inprinciple the permitted hours of overtime work over 40 hours per week to 45 hours
per month and 360 hours per year; and impose penalties for violations except in thespecial cases. As a special case, the maximum hours of overtime work shall be 720
hours a year (=60 hours per month on average), which cannot be exceeded even incases where an agreement has been concluded with the consensus of labor andmanagement on temporary and special situations. In addition, within this 720 hours
per year, establish a minimal limit that cannot be exceeded for a case involving atemporary increase in the workload. (Ministry of Health, Labour and Welfare)On the other hand, in view of the fact that both labor and management reacheda consensus on the point that efforts are required to avoid concluding agreements
involving overtime work close to the maximum limits, in order to further shorten
overtime working hours as much as possible, create new rules that will set up
guidelines within the Labor Standards Act. (Ministry of Health, Labour and Welfare)Also, in order to prevent suicides and deaths from overwork (so-calledkaroshi), with a view to preventing the health hazards that overwork causes, inaddition to strengthening supervision and guidance by Labor Standards Inspection
Offices, including thorough supervision and guidance in workplaces where employees
work long hours, promote enhancements to the work environment aimed at improving
the setting of work hours in order to reduce long working hours for all workers

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including those employed at small workplaces and non-regular employees. (Ministryof Health, Labour and Welfare)
Moreover, in order to thoroughly ensure an accurate understanding of working
hours, make the new guidelines on working hours for businesses widely known.
(Ministry of Health, Labour and Welfare)Also, in order to create a society where deaths from overwork are eliminated,
where there is a good work-life balance, and where it is possible to keep working in ahealthy and fulfilling manner, promote measures to prevent deaths from overwork
through research and studies, awareness-raising, improvements to the counselingsystem, and support for the activities of private sector entities, based on the General
Principles Regarding Measures to Prevent Death from Overwork and Other Issues.
(Ministry of Health, Labour and Welfare) (see 4.5 (1) above)(2) Promoting mental health measures in the workplace
In order to create a society where deaths from overwork are eliminated, where there isa good work-life balance, and where it is possible to keep working in a healthy andfulfilling manner, promote measures to prevent deaths from overwork throughresearch and studies, awareness-raising, improvements to the counseling system, andsupport for the activities of private sector entities, based on the General Principles
Regarding Measures to Prevent Death from Overwork and Other Issues. (Ministry of
Health, Labour and Welfare) (see 4.5 (1) above)
Also, in order to promote improvements to mental health measures in theworkplace, in addition to designing public-awareness campaigns about the Guidelines
for Maintaining and Improving Workers’ Mental Health on an ongoing basis, work tofurther disseminate mental health measures in the workplace through a thoroughimplementation of the stress-check system that was launched in December 2015 withthe revision of the Industrial Safety and Health Act. In addition, since, in accordancewith the aims of the stress-check system, improvements to the workplace environment
ought to be planned from the perspective of checks not only on long working hours
and other quantitative workloads, but also on qualitative stress factors such as humanrelations and the lack of supportive relationships in the workplace, promote mental
health measures there by supporting subsidies and other financial aid to collect, shareand implement good examples of initiatives to improve the workplace environment inlight of company-wide analyses that make use of the results of stress checks.
(Ministry of Health, Labour and Welfare) (see 4.5 (1) above)
Moreover, in addition to providing comprehensive information andimplementing email and telephone counseling on a mental health portal site forworking people, at prefectural occupational health support centers, carry out
awareness-raising seminars for business people, training for human resource
managers and occupational health staff in the workplace as well as training to prevent
mental health disorders in young workers and supervisors through personal visits toworkplaces. (Ministry of Health, Labour and Welfare) (see 4.5 (1) above)
Because the safety and health management systems at small workplaces are
not always adequate, local offices of occupational health support centers will carryout counseling for workers who are experiencing mental health disorders duringpersonal workplace visits, etc., and strengthen mental health measures in small
workplaces through subsidies and other financial aid to implement stress-checks insuch workplaces. (Ministry of Health, Labour and Welfare) (see 4.5 (1) above)
Moreover, in accordance with the Action Plan for the Realization of Work
Style Reform and the Healthcare Policy, in addition to implementing various

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measures such as strengthening occupational health functions and those ofoccupational health physicians, rectifying the practice of long working hours andpromoting the wider adoption of health management, advance them in a unified way
by making them interconnected. (Ministry of Health, Labour and Welfare; Ministry of
Economy, Trade and Industry) (see 4.5 (1) above)(3) Measures to prevent harassment
In regard to the prevention of power harassment, in view of the fact that the Action
Plan for the Realization of Work Style Reform states that “within a discussion withattendance of both labor and management, [the government] will discuss [the]enhancement of measures against power harassment in workplaces,” in addition toholding review meetings of representatives from labor and management and experts
and ascertaining the actual state of and issues involved in power harassment in theworkplace, carry out studies to strengthen measures against it. (Ministry of Health,Labour and Welfare)Also, through the portal site and corporate seminars, continuously encourage
specific initiatives by labor and management, publicize them and make them widely
known to workers, employers and the people of Japan. In addition to implementing
new training for personnel who can lead efforts to prevent power harassment inbusinesses, intended for specialists and others in personnel management and mental
health measures, provide guidance on measures to combat power harassment whenproviding guidance on mental health measures. (Ministry of Health, Labour andWelfare) (see 4.5 (1) above)
Furthermore, see to it that thorough guidance is provided by the Employment
Environment and Equality Division (Office) of the Prefectural Labour Bureaus so thatmeasures are taken to clarify the policy that sexual harassment and harassment related
to pregnancy or childbirth is not to be tolerated at any business establishment, makethe policy widely known and set up counseling services, etc., so that, at workplaces
where an incident of such harassment occurs, efforts are made to deal with theaftermath appropriately and prevent it from happening again. (Ministry of Health,Labour and Welfare) (see 4.5 (1) above)
5. NUMERICAL GOALS FOR SUICIDE COUNTERMEASURESWith the revision of the Basic Law in April 2016, meeting the goal of realizing asociety in which no one is driven to take their own life is regarded as an importanttask. Consequently, although the ultimate goal is to realize such a society, theimmediate goal is to reduce the suicide rate to the present levels in advanced countries,
specifically to more than 30 percent below 2015 levels by 2026.1

1

According to the WHO Mortality Database, the suicide rate in advanced countries
was 15.1 per 100,000 in France (2013), 13.4 in the United States (2014), 12.6 inGermany (2014), 11.3 in Canada (2012), 7.5 in Great Britain (2013) and 7. 2 in Italy(2012).
Because the suicide rate in Japan in 2015 was 18.5, a reduction of more than
30 percent would equate to less than 13 per 100,000. According to the moderate-range
projections of the National Institute of Population and Social Security Research (2017
estimates), the total population of Japan is expected to be 123,000,000 in 2025; inorder to achieve this goal, the number of suicide deaths will need to fall below 16,000.
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Furthermore, strive to achieve this goal as rapidly as possible, and, in the eventthat the goal is achieved, regardless of the timeframe for reviewing the General
Principles, review the numerical goal including what it ought to be.
6. PROMOTION SYSTEMS, ETC.
1. Promotion systems at the national level
In order to comprehensively and effectively promote policies in accordance with the
General Principles, see to it that there is close mutual coordination and cooperation
among the related administrative agencies under the leadership of the Minister of
Health, Labour and Welfare by, among other things, flexibly holding meetings
primarily of the Suicide Countermeasures Council, or by some of its members asnecessary and, in addition, ensure that policies are fully coordinated with one another.
Moreover, the Ministry of Health, Labour and Welfare, where the secretariat
for the said Council is located, in addition to encouraging and supporting measurescarried out by the related ministries and agencies, will draw up guidelines on
formulating local suicide countermeasures plans, support local public entities informulating such plans and implement comprehensive suicide countermeasures forthe country as a whole. In addition to improving the reporting system when a specificcase occurs, it will quickly hold an emergency liaison conference of the related
ministries and agencies and respond to that case appropriately.
It will also establish mechanisms for the national government, local public
entities, related organizations, private sector entities and others to coordinate andcooperate with each other so that suicide countermeasures can be promoted by thecountry as a whole.
Furthermore, it will coordinate closely with, and promote measures andpolicies in, related areas, such as health care, medicine, welfare, education, labor,
gender equality, the aging society, the low birthrate, youth development, persons withdisabilities, support for victims of crime, etc., the realization of an inclusive
community-based society, support for the poor and needy and other related policies
and measures.
Also, as the focal point for the parties concerned to work together in dealing
with the PDCA cycle for suicide countermeasures, the Japan Support Center for
Suicide Countermeasures, from not only a mental health perspective but also aninterdisciplinary one involving such fields as sociology, economics and applied
statistics, shall provide evidence-based policy support so that the national government
can implement the PDCA; and, from the perspective of supporting community-based
initiatives, it shall strengthen practical and pragmatic support to approaches at themunicipality level, including those of private sector entities, provide information anddevelop mechanisms (human resource training, etc.) so that a community can come togrips with suicide countermeasures tailored to actual local conditions.
2. Promoting systematic suicide countermeasures in the community
Suicide countermeasures are profoundly related to all aspects of society – home,school, workplace and community – and in order to promote comprehensive measures
to combat suicide, it is important to ensure the coordination and cooperation of thevarious local parties concerned and promote policies with a high degree ofeffectiveness tailored to a community’s special features.
To do so, the national government draws up and provides guidelines forformulating local plans for suicide countermeasures, profiles of actual suicide

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conditions and policy packages, and supports the prefectures and ordinancedesignated cities in setting up local support centers for suicide countermeasures sothat these centers will draw up, track the progress of and verify the local plans for
suicide countermeasures of the municipalities within their jurisdiction. Also, it shallactively appeal to the prefectures and ordinance-designated cities to promote thesetting up forums to study measures formulated by Suicide Countermeasures Liaison
Committees consisting of related groups and organizations in various fields andhaving the said Committees work out community-based plans for suicidecountermeasures; and it shall offer the appropriate support by providing information,etc., for them to do so. It also shall work actively to see to it that fulltime departments
responsible for suicide countermeasures are set up in the municipalities and fulltime
workers assigned to them who will have the role of coordinating suicidecountermeasures with other measures and policies. Furthermore, it shall offer theappropriate support such as providing information for efforts to coordinate among
multiple local public entities. And it shall appeal to local public entities to further
increase the participation of private sector entities and others in these community
efforts.
3. Policy evaluation and management
In addition to ascertaining the implementation status of policies based on the General
Principles and the extent to which they have achieved their goals and evaluating theresults, the Suicide Countermeasures Council shall review and improve policies inlight of this evaluation.
To do so, under the Minister of Health, Labour and Welfare, it shall establish
mechanisms from a position of neutrality and fairness to verify the implementation
status of policies based on the General Principles and the extent to which they haveachieved their goals and to evaluate these policies’ effectiveness, etc., and promotesuicide countermeasures effectively.
4. Review of the General Principles
The General Principles shall be reviewed roughly every five years, in light of changes
in socio-economic conditions, changes in the circumstances surrounding suicide,progress made in implementing policies based on the General Principles, the status ofachieving the policies’ goals, etc., taking into consideration the nature of theguidelines for suicide countermeasures that the national government ought to promote.

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