The state, family, and the insane in Japan, 1900–1945

A brief look at the history of psychiatric confinement in Japan from the Meiji Restoration (1868) to the Japanese experience of the Second World War (1941–5) must give a sense of déjà-vu to those familiar with its European counterparts in the nineteenth century. A cause célèbre of wrongful confinement led modern Japan to the Mental Patients' Custody Act (1900), its first national legislation for regulating the confinement of lunatics. In 1919, the effort of a few eminent psychiatrists, as well as the initiative of health officials at the central government, led to the Mental Hospitals Act (1919), which promoted hospital-based provision for the insane. Under these two acts, psychiatric provision in pre-war Japan expanded rapidly in the first four decades of the twentieth century, just like its empire in the Far East. Especially when compared with the situation in England in the late eighteenth and early nineteenth century, one is struck by the similarities. When the two countries started to confine the insane on a large scale, with an interval of about one century, they were both in the turmoil of industrialization, which perhaps acted as a kind of predisposing condition to the rise of asylum. Moreover, England and Japan shared three important factors in their creation of asylum-based psychiatric provision: the impetus given by exposé of the abuse of psychiatric confinement, the initiative taken by the central government, and the establishment of a psychiatric profession.