As much as Tokyo is full of energy, life in this mega metropolis can take its toll. We might feel stressed about tragic world news, adjusting to a new job or losing a job, juggling deadlines, relationships and friendships, cultural differences and identity, it could be anything — and it might feel like a lot or too much to handle. That’s why we’ve put together a guide to English-speaking therapists and other mental health services in Tokyo.
If we’re struggling to cope in our daily lives, and especially if we notice signs of mental ill health such as constant worry or depression, that’s where mental health services can be a big help.
In Japan, as in many other countries, there’s still a way to go for tackling the stigma around mental health. There’s a culture of “gaman”, which means holding on or persevering to get through. However, seeking mental health care isn’t just reserved for traumatic life events or once things become too overwhelming.
Seeking help is not only a courageous thing to do, but can also be a fantastic way to help with finding better ways to cope or manage mental health, to stay connected, and to thrive in our own way. Here are some key resources to help you or someone you might know.
Understanding mental health services
First things first, what are mental health services and why do we need them? Mental health services can range from talk therapy or counseling, to prescriptive medication, or even dance movement therapy. Professionals who treat individuals with mental illness and who support mental health are known as mental health professionals or practitioners. Seeing a professional can make a significant difference if it feels like we’re struggling on our own.
Mental health terminology can be complicated, so without getting into all the details, here’s a quick list of definitions:
- Mental health: State of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.
- Mental illness: Disorders that affect one’s mood, thinking, and behavior such as depression, anxiety disorders, eating disorders and addictive behaviors.
- Psychiatrists: Medical doctors who can identify, diagnose, and assess mental disorders. They are capable of prescribing medication and offering comprehensive treatment plans for various and often complex mental health conditions.
- Psychologists: Experts in human behavior and mental processes, using therapy and counseling techniques to address emotional and psychological challenges. Psychologists generally have a doctorate degree (or at least a master’s degree in some countries) and license to practice.
- Counselors: Professionals trained to provide guidance and support, often through talk therapy (psychotherapy), helping individuals navigate specific issues or life transitions. Counselors may be professionally accredited counselors, social workers, or psychotherapists. However, not all those practicing counseling may have a professional accreditation.
Note: Life coaches are not licensed mental health practitioners or therapists.
When should we seek mental health help?
Figuring out when to seek mental health support can be different for each of us. We may want help for a specific challenge we’re dealing with, or we might prefer ongoing counseling to maintain overall mental well-being.
If you or someone you know is experiencing persistent stress, anxiety, depression, relationship issues, or life transitions, it might be worth considering seeing a mental health professional.
Some types of mental ill health and conditions include:
Signs and symptoms of mental disorders can include:
- Feeling sad or down
- Inability to cope with daily problems or stress
- Confused thinking or reduced ability to concentrate
- Excessive fears or worries
- Extreme mood changes of highs and lows
- Withdrawal from friends and activities
- Significant tiredness, low energy or problems sleeping
What does mental health treatment look like?
Mental health treatment and therapy can look really different depending on the individual, couple or family, the condition being treated, and the approach of the mental health professional.
In regards to talk therapy with a psychologist or counselor, there are different approaches such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Mindfulness-based therapies. For example, someone experiencing high anxiety in certain contexts may spend time with a psychologist working through why that context might be anxiety-inducing for them, how their body reacts, and how they can adapt their coping strategy.
In regards to treatment for depression, an individual may be prescribed medication by a psychiatrist to help alleviate their mood, as well as work on counseling sessions.
Things to keep in mind when seeking support
- Feeling vulnerable: Our state of mental health can change with many factors. It can feel scary to recognize when we’re not feeling our best, but it’s okay and also normal to experience mental ill health at some points in our lives.
- Cost: On average, a single session costs around ¥10,000 or more for 50-60 minutes. Some counseling centers or therapists offer sliding-scale payment systems, which means that the fee you’ll pay will be adjusted according to your circumstances.
- Coverage: As most therapy and related services are not qualified as medical services, they are unable to be covered by Japanese National Health Insurance. You may have some coverage if you have private health insurance which covers mental health services, or if you require psychiatric services.
- Licensing: While there are organizations for mental health professionals that can give members added credibility, there is no national license system for mental health counseling. So it’s important to check a therapist’s background or credibility.
- Finding the right fit for you: Even if someone is credible and professional, their style or approach may not be most suited to you. It can be worth seeing a different therapist after some time, to see if there is a better fit for you.
English-language mental health services in Tokyo
“Internationals often find mental health services either too expensive, not foreigner-friendly, or not located close to where they live. Some expats seek out therapy online with counselors in their home country, but they often mention that the therapist struggles to truly understand the special challenges that come with living in Japan.” — Diya John, therapist at Therapy Garden.
Navigating mental health resources in a foreign country can be daunting, but there are a number of resources in Tokyo to support you. This is not an exhaustive list, but some notable organizations include:
Tokyo English Lifeline (TELL)
TELL Japan offers phone, chat, and face-to-face counseling in English. As a certified not-for-profit organization, their team has been dedicated to providing support and counseling services to Japan’s international community since 1973.
TELL’s services can be broadly divided into Lifeline, Clinic, and Outreach. The Lifeline phone call connects a caller to anonymous confidential support. While they’re aiming for 24/7 availability, the hours are currently split between the phone and chat service (see below).
For face-to-face mental health counseling with a professional psychotherapist and psychological evaluations by a psychologist, there are TELL Clinics in Minami-Aoyama, Tokyo, and in Okinawa. The regular cost of a 50-minute session is ¥20,000 (plus tax), however, for households with a monthly income of ¥700,000 or less TELL offers a sliding-scale payment system. TELL also offers distance or remote counseling for those who prefer this method, or those who do not reside in Tokyo and Okinawa.
As part of outreach efforts, TELL offers community-wide events and workshops, as well as an Employee Assistance Program and workplace training to help make mental health care more accessible for employees and employers. The range of free resources on their website include information on anxiety, depression, culture shock, and bullying.
“While intellectually we all want the past few years of COVID to be behind us, the emotional toll is still being felt in our bodies and minds. The ongoing financial challenges and increasing tensions around the world are constant reminders that the world is not the same. To help with these challenges, TELL has increased the hours of our Lifeline aimed at helping more people in crisis connect with someone. We have also increased the amount of subsidized care we offer through our clinic helping families and individuals in need access mental health care.” — Vickie Skorji, TELL’s Lifeline director.
TELL Lifeline and Chat
Hours: Available from Saturday 9 a.m. – Monday 11 p.m. (continuous service), Tuesday – Thursday 9 a.m. – 11 p.m., and Friday 9 a.m. – 2 a.m. See here for weekly hours.
Outreach community events
Upcoming events and workshops are posted here.
This is a free telephone line providing consultations in English as well as a number of other languages. Yorisoi Hotline is a subsidy project by Japan’s Ministry of Health, Labor and Welfare.
Phone: 0120-279-338 (*Press 2 for non-Japanese speakers)
Hours: 10 a.m. – 10 p.m. everyday (accessible from anywhere within Japan)
Tokyo Mental Health (TMH)
Tokyo Mental Health provides evidence-based services including therapy, psychiatric services and psychological assessment tailored to the foreign and Japanese returnee community.
Counseling services are available in-person and online for adults, children, families, and couples in native English, as well as Spanish, and Japanese. Through American Clinic Tokyo, psychiatrist Dr Andrew Kissane provides psychiatric treatment focused around psychopharmacology for patients with depression, anxiety disorders, and other common mental health problems. They can issue sick notes and official doctor reports if required.
At Tokyo Mental Health, fees are ¥22,000 (tax included) for a 60 minute individual therapy consultation and ¥25,000 (tax included) per hour of the psychologist’s time for psychology services. TMH offers 90 minute appointments for couples and families priced at ¥33,000 (tax included). See their FAQ page for more on costs, as well as discounted prices for eligible clients.
TMH also offers a number of service packages such as Employee Assistance Program and services for international schools.
Tokyo Mental Health Shintomi Therapy Office
Address: 6F Urbane Mitsui Building, Shintomi 2-4-6, Chuo-ku, Tokyo
Hours: 9 a.m. – 8 p.m. on weekdays, 9 a.m. – 7 p.m. weekends
Psychiatry Clinic At American Clinic Tokyo
Address: No.1 Niikura Building 3F, 1-7-4 Akasaka, Minato-ku, Tokyo
Hours: Monday, Thursday, Friday: 9 a.m. – 12 p.m., 3 p.m. – 6 p.m.
BONDS Tokyo Counseling Services
Located close to Shimokitazawa Station, BONDS offers individual counseling, family therapy, couples counseling, and group therapy by clinical psychologists and certified public psychologists.
While some psychologists only offer services in Japanese, there are a number of clinicians who provide therapy in English, both Japanese and English (for example, for couples therapy), or other languages such as Korean, Mandarin, and German.
Fees are ¥11,000 for individual counseling (50 minutes~), and ¥16,500 ~ for couples or family counseling sessions.
Clinic: Ma Maison Daizawa 202, 2-30-21 Daizawa, Setagaya-ku, Tokyo 155-0032
Meguro Counseling Center is a counseling and psychology mental health service offering online or in-clinic consultation for English psychotherapy by American therapists professionally trained in the United States.
International Mental Health Professionals Japan (IMHPJ)
IMHPJ is not a clinic, but a network which helps connect individuals providing mental health care or therapy services to anyone living in Japan. You can use their searchable database to find a mental health care provider filtering for location or languages spoken.
Therapy Garden (Diya John)
Therapy Garden is an online therapy service provided by therapist Diya John (B.A. Psychology, M.S. Psychology). Her aim is to make evidence-based mental health care more accessible for expats of different nationalities in Japan, for people in cross-cultural relationships, for Japanese returnees, and for expats living outside Japan.
Therapy Garden offers one-on-one counseling at ¥12,000/session, with a free 50 minute initial consultation. See here for alternative pricing packages and for more information on sessions with Diya.
Beyond counseling: Other resources
Given the costs that come with one-on-one consultations and therapy, it might not always be the most accessible option. It’s worth knowing there are also online tools and apps such as Calm, Headspace, and a set of mindful frameworks known as The Tools (created by psychiatrist Phil Stutz) which may be useful for helping to maintain your mental health on a day-to-day basis.
There are also community workshops such as Creative Arts Therapy by TELL, support groups, and events in Tokyo which aim to highlight the importance of mental health in our lives. A good dose of exercise, spending time with family or friends, and making time for self-care can also be incredibly important, although sometimes easier said than done.
While there are a variety of resources, there’s still a way to go in making mental health services more accessible. Increasing awareness about mental health, reducing stigma, and expanding resources for specific groups, such as English speakers or non-native English speakers, are areas where Tokyo’s mental health support system could evolve.
Remember, mental health is an ongoing journey for every one of us, there’s no one-size-fits-all, and you’re never alone.
While we do our best to ensure it’s correct, information is subject to change. This article was originally written by Tiffany, and was first published in November 2017. Last updated in November 2023.