Tokyo CNN  — 

Eriko Kobayashi has tried to kill herself four times.

The first time, she was just 22 years old with a full-time job in publishing that didn’t pay enough to cover her rent and grocery bills in Tokyo. “I was really poor,” said Kobayashi, who spent three days unconscious in hospital after the incident.

Now 43, Kobayashi has written books on her mental health struggles and has a steady job at an NGO. But the coronavirus is bringing back the stress she used to feel.

“My salary was cut, and I cannot see the light at the end of the tunnel,” she said. “I constantly feel a sense of crisis that I might fall back into poverty.”

Experts have warned that the pandemic could lead to a mental health crisis. Mass unemployment, social isolation, and anxiety are taking their toll on people globally.

In Japan, government statistics show suicide claimed more lives in October than Covid-19 has over the entire year to date. The monthly number of Japanese suicides rose to 2,153 in October, according to Japan’s National Police Agency. As of Friday, Japan’s total Covid-19 toll was 2,087, the health ministry said.

Japan is one of the few major economies to disclose timely suicide data – the most recent national data for the US, for example, is from 2018. The Japanese data could give other countries insights into the impact of pandemic measures on mental health, and which groups are the most vulnerable.

“We didn’t even have a lockdown, and the impact of Covid is very minimal compared to other countries … but still we see this big increase in the number of suicides,” said Michiko Ueda, an associate professor at Waseda University in Tokyo, and an expert on suicides.

“That suggests other countries might see a similar or even bigger increase in the number of suicides in the future.”

Eriko Kobayashi has struggled with her mental health in the past. She says the pandemic has brought back intense fears of falling into poverty.

Covid’s toll on women

Japan has long struggled with one of the highest suicide rates in the world, according to the World Health Organization. In 2016, Japan had a suicide mortality rate of 18.5 per 100,000 people, second only to South Korea in the Western Pacific region and almost double the annual global average of 10.6 per 100,000 people.

How to get help

  • In the US, call the National Suicide Prevention Lifeline at 1-800-273-8255.
  • The International Association for Suicide Prevention and Befrienders Worldwide also provide contact information for crisis centers around the world.

    While the reasons for Japan’s high suicide rate are complex, long working hours, school pressure, social isolation and a cultural stigma around mental health issues have all been cited as contributing factors.

    But for the 10 years leading up to 2019, the number of suicides had been decreasing in Japan, falling to about 20,000 last year, according to the health ministry – the lowest number since the country’s health authorities started keeping records in 1978.

    The pandemic appears to have reversed that trend, and the rise in suicides has disproportionately affected women. Although they represent a smaller proportion of total suicides than men, the number of women taking their own lives is increasing. In October, suicides among women in Japan increased almost 83% compared to the same month the previous year. For comparison, male suicides rose almost 22% over the same time period.

    There are several potential reasons for this. Women make up a larger percentage of part-time workers in the hotel, food service and retail industries – where layoffs have been deep. Kobayashi said many of her friends have been laid off. “Japan has been ignoring women,” she said. “This is a society where the weakest people are cut off first when something bad happens.”

    In a global study of more than 10,000 people, conducted by non-profit international aid organization CARE, 27% of women reported increased challenges with mental health during the pandemic, compared to 10% of men.

    Compounding those worries about income, women have been dealing with skyrocketing unpaid care burdens, according to the study. For those who keep their jobs, when children are sent home from school or childcare centers, it often falls to mothers to take on those responsibilities, as well as their normal work duties.

    Increased anxiety about the health and well-being of children has also put an extra burden on mothers during the pandemic.

    Akari, a 35-year-old who did not want to use her real name, said she sought professional help this year when her premature son was hospitalized for six weeks. “I was pretty much worried 24 hours,” Akari said. “I didn’t have any mental illness history before, but I could see myself really, really anxious all the time.”

    Her feelings got worse as the pandemic intensified, and she worried her son would get Covid-19.

    “I felt there was no hope, I felt like I always thought about the worst-case scenario,” she said.

    “A Place for You”

    In March, Koki Ozora, a 21-year-old university student, started a 24-hour mental health hotline called Anata no Ibasho (A Place for You). He said the hotline, a nonprofit funded by private donations, receives an average of over 200 calls a day, and that the vast majority of callers are women.

    “They lost their jobs, and they need to raise their kids, but they didn’t have any money,” Ozora said. “So, they attempted suicide.”

    Most of the calls come through the night – from 10 p.m. to 4 a.m. The nonprofit’s 600 volunteers live around the world in different timezones and are awake to answer them. But there aren’t enough volunteers to keep up with the volume of messages, Ozora said.

    University student Koki Ozora started a 24-hour mental health hotline staffed by volunteers in March. They now get more than 200 calls a day.

    They prioritize the texts that are most urgent – looking for keywords such as suicide or sexual abuse. He said they respond to 60% of texts within five minutes, and volunteers spend an average of 40 minutes with each person.

    Anonymously, over online messaging, people share their deepest struggles. Unlike most mental health hotlines in Japan, which take requests over the phone, Ozora says many people – especially the younger generation – are more comfortable asking for help via text.