Mental Health Care in Japan: The Complete Guide for Foreign Residents
If you live in Japan, you can see a psychiatrist without a referral, Japanese health insurance covers psychiatric care, and clinics that consult in English exist, although they take some searching to find. Each step below links to a detailed guide.
How is mental health care organized in Japan?
Around three kinds of service: psychiatry, psychosomatic medicine, and counseling. Psychiatry (精神科, seishinka) is medical care from doctors who diagnose and prescribe, covered by health insurance. Psychosomatic medicine (心療内科, shinryonaika) is by definition a specialty for physical symptoms connected to stress, but clinics with this name may also treat depression, anxiety, and insomnia, and some list both names. "Mental clinic" (メンタルクリニック, mentaru kurinikku) is a name clinics choose, not a separate specialty. What each term means is covered separately.
Counseling (カウンセリング, kaunseringu) is talk therapy with a psychologist or counselor, who is not a physician. The practical difference is that psychiatric care is covered by health insurance and standalone counseling generally is not (what insurance covers). Diagnosis, medication, and certificates for work go through a psychiatrist; some people see both.
Does Japanese health insurance cover mental health?
Yes, psychiatric consultations, diagnosis, and medication are covered at the standard 30% cost-sharing for adults under 70, the same as any other medical care, if you are enrolled in National Health Insurance (国民健康保険, kokumin kenko hoken) or employee health insurance (社会保険, shakai hoken). Nearly everyone staying longer than three months is required to enroll, and nationality makes no difference to coverage. Details are in our insurance guide.
A separate subsidy, Jiritsu Shien Iryo (自立支援医療), cuts your share for ongoing outpatient psychiatric treatment from 30% to 10%, with an income-based monthly cap. You apply at your city or ward office with a doctor's certificate; the steps are in our Jiritsu Shien guide.
Do you need a referral?
No referral is needed to book a first appointment at a psychiatry clinic. The exception is large hospitals, which add a non-insured fee for unreferred first visits; a clinic is the usual starting point, and it can refer you to a hospital if that level of care is needed (how to book directly).
If you were treated in your home country, bring a summary from your previous doctor listing the diagnosis, the medications tried, and how you responded. A plain English letter or a printout of records is fine.
How does the first visit work?
You book ahead, fill in an intake questionnaire, and have a first consultation that typically runs 30 to 60 minutes. Clinics take bookings by phone or through a web form. Popular Tokyo clinics can be booked out a few weeks ahead, and more than a month at some, so do not wait for a crisis. At reception you show your My Number card registered for health insurance (マイナ保険証, maina hokensho) or, if you do not use one, the eligibility certificate (資格確認書, shikaku kakuninsho) from your insurer; the old health insurance cards expired on December 1, 2025. Then you fill in the questionnaire and see the doctor (what to expect at a first visit).
Follow-up visits are short, often five to ten minutes, built around medication reviews rather than long conversations (why, and how to use them well). A prescription from the clinic is filled at a pharmacy (調剤薬局, chozai yakkyoku) and is valid for four days including the day of issue.
Can you get the medication you took at home?
Often, yes. Most mainstream antidepressants are available in Japan under the same generic names. Some common Western drugs are not approved here, including fluoxetine (Prozac) and bupropion (Wellbutrin); a psychiatrist here can switch you to an available equivalent. See our guide to antidepressants in Japan.
ADHD medication has stricter rules: Adderall is illegal in Japan outright, and Concerta runs through a nationwide registration system that requires a Japanese doctor to confirm the diagnosis. If that is your situation, read our ADHD guide before you travel.
For the move itself, you may carry up to one month's supply of ordinary prescription medication; larger amounts need an import certificate (輸入確認証, yunyu kakuninsho, formerly called yakkan shomei) applied for in advance, and ADHD stimulants have stricter rules of their own. The health ministry publishes the general import rules in English and separate rules for controlled medicines.
Can you get care in English?
Yes, at some clinics, although finding one takes some searching. Two things to check before booking, because they are not the same:
- Does the doctor consult in English, or only read it? "English OK" on a website does not always mean the consultation itself is in English, so ask.
- Does the clinic take Japanese health insurance? A clinic outside the insurance system charges its own fees in full, which changes what you pay.
Confirm both points when you book. The directories for finding these clinics are in our resources guide.
What if you need time off work?
A medical certificate (診断書, shindansho) from a psychiatrist is the usual document for requesting leave. Leave (休職, kyushoku) is set by each company's work rules rather than by law, and the certificate is what you submit when you request it. Employees on company health insurance can generally claim a sickness allowance (傷病手当金, shobyo teate kin) of roughly two-thirds of their standard pay while off. The certificate states a diagnosis; the medical record behind it stays at the clinic. The steps are in our guides to the medical certificate and mental health leave.
Can you see a psychiatrist online?
Yes, including a first visit for most treatment. Antidepressants and most other psychiatric medicines can be started at an online first visit when the doctor has your medical background. Benzodiazepine-class medicines, zolpidem, and other controlled psychotropics cannot be prescribed online, at a first visit or a follow-up, until a doctor has examined you in person for that condition, so treatment that involves them needs at least one in-person visit. The overview is in our online psychiatry guide, and the medicine-by-medicine rules are in our telemedicine rules guide.
What if you are in crisis right now?
If you or someone with you is in immediate danger, call 119 for an ambulance or 110 for the police. To talk to someone in English, TELL Lifeline and the Yorisoi Hotline offer support in English; their current numbers and hours are on their sites, and both are listed in our guide to mental health resources. If you are safe but struggling, ask a psychiatry clinic for an urgent appointment and say when you call that it is urgent.
Frequently asked questions
This article is general information, not medical advice for your individual situation. If you're unwell, please see a doctor.
Medically reviewed by our psychiatrist (M.D.). Updated October 16, 2026.