Mr X is a 40-year-old man who has spent half his life—the past 20 years—barely able to leave his room in his parents’ house. For many years aside from attending a monthly outpatient appointment he was asleep while everyone else in his household was awake. And while they slept he was up: whiling away time with computer games and online shopping—the latter at one point costing the family the equivalent of many thousands of pounds.
“In Japan today, many young people are disconnecting themselves from society. They have come to be known as hikikomori (recluses), or more formally shakaiteki (social) hikikomori. Though their existence is widely recognized, their true situation is still far from being generally understood. They all have different backgrounds and circumstances and have withdrawn from society for different reasons. So, what can we say about this disparate group?
First, a definition: Hikikomori are individuals who (1) do not work or attend educational institutions, (2) are not considered to have a mental disorder, but (3) have remained at home for six months or longer without interacting personally with anyone outside their families. The third point is the most important. These people have no friends and are isolated from society, even though they may be living in the middle of a teeming city.
Some say … open access on nippon.com
This is an evaluation study of a pilot multicomponent program with animal-assisted therapy (AAT) for socially withdrawn youth with or without mental health problems in Hong Kong. There were fifty-six participants. Decreased level of social anxiety, and increased levels of perceived employability and self-esteem across two withdrawn groups were observed. When comparing those who did and did not receive the AAT component(s), however, AAT did not seem to have additional impacts on outcomes. The qualitative data collected through interviews with ten participants reflected that
the AAT component was attractive because the nonhuman animals made them feel respected and loved. This pilot study showed that a multicomponent program with a case management model correlated with increased levels of self-esteem and perceived employability, and a decreased level of social interaction anxiety. In addition, using nonhuman animals in a social service setting appears to be a good strategy to engage difficult-to-engage young people.
International Journal of Social Psychiatry
Background: Poor social interactions have been recognized as a symptom since the beginnings of psychiatry. As far as socially withdrawn youth (SWY) are concerned, studies were mostly conducted on patients seeking care. Our psychiatric outreach team called Psymobile was able to reach SWY patients who were not seeking mental health care. Aims: To identify the clinical and socio-demographic characteristics of SWY patients referred to our Psymobile unit. Method: We carried out a retrospective study on the records of patients aged 18–34years, who were referred to Psymobile for ‘withdrawal’, between April 2012 and December 2015.
Results: In total, 66 patients were included in the study. SWY are predominantly male (80%) from large families or single-parent ones. About 42% had no prior contact with a mental health professional before being referred to Psymobile. The mean duration of withdrawal is 29 months. In all, 42% of SWY use cannabis and 73% present disorders of the sleep–wake schedule. About 71% maintain relations with their families and 73% go out occasionally. They are mostly diagnosed with schizophrenia (37%) or mood disorders (23%).
Conclusion: Over one-third of Psymobile patients aged 18–34years were referred on grounds of social withdrawal. Our data may illustrate more accurately the situation of youth social withdrawal amid the general population than data from help-seeking patients or online questionnaires.
Free access to my letter to the editor of the Asian Journal of Psychiatry.
Clicks until May 05, 2017: free access to the article (No sign up or registration is needed)
- Acute social withdrawal (hikikomori) is an epidemic in Japan.
- There are three traumatic dimensions of hikikomori survivors: the trigger of bullying, the traumatic effects of social isolation, and family trauma.
- Hikikomori is a struggle inside the home and outside social institutions, against the contemporary practices of the mental health field.
In September 2016, the Cabinet Office of Japan published the results of an epidemiological survey focusing on acute social withdrawal (hikikomori). This article summarizes and assesses the major features of the survey. It aims at facilitating research and international exchanges on a mental health and social problem affecting at least 541,000 people in Japan that seems to have spread to industrialized societies.