A bill to promote the establishment of "integrated resorts" featuring casinos in Japan and championed by its backers as a "trigger for regional promotion" is set to pass the current Diet session. However, there are strong worries in Japan's psychiatric community that legalizing casinos will also result in more gambling addicts.
The bill contains a provision requiring the government to "prevent those entering casinos from taking in any bad influences," but there are no concrete measures listed to accomplish that. Furthermore, much treatment for addiction is still at the research phase, and most patients have no connection with medical institutions that could help them.
In 2013, a Ministry of Health, Labor and Welfare research team estimated that 4.8 percent of Japan's adult population, or about 5.36 million people, are "morbid gamblers" -- a high rate compared to other nations.
"In Japan, we live very close to gambling like pachinko and horse racing, and it becomes a kind of break from chores and work," said psychiatrist Hitoshi Tanabe, director of the Hokkaido prefectural mental health and welfare center. According to a study by Tanabe's center, attempted suicide and other problems accounted for about 25 percent of gambling-related trouble -- a higher rate than for divorce, unemployment or running away from home. The study also found that there are many people in the country with 5 million yen or more in gambling debt, among them "completely average salarymen, housewives, university students and pensioners," Tanabe said.
"Casinos are high-risk, high-reward places. So I'm worried that we will see even worse cases" of gambling addiction once they open in Japan, he added.
One of the hallmarks of addiction is said to be denial, the refusal of the patient to admit that they have a problem. The health ministry estimated in 2014 that less than 500 gambling addicts had been to a medical institution about the problem that year. This was due at least in part to how difficult it is for addicts to recognize that they have a psychological disorder, and the general dearth of institutions with the expertise to treat that disorder.
The health ministry has requested a five-fold increase in funding to treat addiction in the draft fiscal 2017 budget, to some 530 million yen. The ministry plans to expand the number of treatment and consultation centers from the current six -- including the National Hospital Organization's Kurihama Medical and Addiction Center in Yokosuka, Kanagawa Prefecture -- to one for every prefecture in Japan. It is also looking to promote the adoption of cognitive behavioral therapy for addicts.
"The budget for anti-addiction measures has been too low up to now," Hiroyuki Hosoda, chairman of the ruling Liberal Democratic Party's General Affairs Committee and sponsor of the casino bill, told a Dec. 6 news conference. "I think we will use this opportunity to really get to grips with these countermeasures."
Takayuki Miyake of Serenity Park Japan, an addiction recovery support organization, told the Mainichi Shimbun, "Addiction is often seen as a problem with the addict's own intentions, but if the addict or their family try to tackle the issue on their own it just makes things worse.
"We need to inform people that there are recovery and prevention techniques, and have a society where it's easy for people to talk about addiction," he added, calling for comprehensive measures that go beyond just problems stemming from casinos.