The mentally disabled living alone can hardly reintegrate into society without public financial support.
This was the heartfelt scream I wrote in the article: In Japan, It Has Become Extremely Difficult for Only the Mentally Disabled to Receive Disability Pension Benefits Since September 2016.
Almost three years have passed since this article was published. And now the world has been hit by the COVID-19 recession, and I find myself in a dire economic situation that reminds me of these words again and again.
Even in such difficult times, I have to pay the rent, utilities, and other living expenses. To add insult to injury, social insurance premiums are getting higher every year in Japan. Cash spreads its wings and flies away without mercy. Even if I starve, I must force myself to work in order to secure a place to live. However, the overwork doesn't last long, and the disease re-worsens. The tragedy repeats over and over again. Things haven't changed at all during the last three years.
What Is Disability Pension?
Disability pensions are benefits provided to people with disabilities who are unable to work as well as healthy people or have difficulty working. It is not an old-age pension, so age does not matter.
In Japan, disabilities are classified into three categories:
- Physical disability
- Intellectual disability
- Mental disability
Persons with disabilities in any of these categories can apply for it. Naturally, the more severe their disability, the more benefits they will receive. In the case of the mentally disabled, the amount of benefits is said to be as shown in the table below.
Reference: The Ministry of Health, Labour and Welfare, 2014 “Survey of Pension Systems”
By the way, in Japan, disability pension benefits are paid in even-numbered months. So twice the monthly amount in the table above is actually paid at one time.
A Single Lie Destroyed My Life
As for Grade 3, it is relatively easy to be approved. You can easily receive benefits of 50,000 to 60,000 JPY per month.
One day, Seishinshogaisha-koyo-totaru-sapota (Total supporter of employment of the mentally disabled) told me so. I took him at his word and applied for the disability pension in November 2016.
But he was totally a liar.
The Guidelines Were Changed for the Worse on September 1, 2016
My application was rejected.
Just two months before my application, on September 1, 2016, The New Grade Determination Guidelines for Mental Disorders came into effect. And the traditional comprehensive grading system, which took into account both the severity of the disability and difficulties in social life, had been abolished before we knew it.
There used to be a "certification criteria” chart. But it has disappeared.
Ruthless Point Rating System
Under the current grading system, the patient's “ability to perform activities of daily living” is first evaluated on a 1 to 4 scale. Then, based on that Score as well as Level (severity), the grade of disability pension is determined.
The Score is the average of the ratings of Daily Living Skills in seven categories. For example, 1 point is given if the patient can perform basic daily activities by him/herself. The details of the points are as follows:
3 pt : Given advice and support, he/she can perform them
2 pt : He/she can perform most things, but sometimes needs advice and support
1 pt : He/she can do them by him/herself
And the seven categories are as follows:
2. Keep him/herself and his/her surroundings clean: washing his/her face, washing his/her hair and taking a shower or bath
3. Proper money management and shopping
4. Visiting hospital regularly and taking medication as instructed
5. Communications and relationships with others without problems
6. Maintaining personal safety and responding to a crisis appropriately
7. Social life: withdrawals and deposits at bank and using public facilities by him/herself
In reality, the mentally disabled already living alone can perform basic daily activities, such as eating properly, keeping themselves clean, and shopping by themselves. This means that in most categories, they can earn only 1 pt (“Can do them by him/herself”). So, inevitably, their Score of “ability to perform activities of daily living” becomes below 1.5. Definitely, their applications will be rejected.
However, the evaluation method of how well a person can perform “basic activities of daily living” on his/her own is almost the same as the certification method of the level of care needed by the elderly. It's quite beside the mark.
No Benefits, as Long as They Live Alone
As a depressed patient myself, I can assure you that the mentally disabled who have lived alone for many years can perform daily activities (eating, shopping, etc.) by themselves as long as they go to the hospital and take their medication appropriately. In other words, as long as they go to the hospital and take their medication as instructed, their “ability to perform activities of daily living” remains high. For this reason, their applications will be rejected eternally.
But in the first place, the mentally disabled living alone have no family or roommate to help them with their daily activities. So, they have no choice but to perform their daily chores on their own, regardless of their suffering and difficulties.
In this vicious cycle, if they miss the timing of their doctor's appointment or taking medication, the risk of suicide grows exponentially, especially for those who are depressed. Can depression go into remission under these circumstances?
Japan Pension Service Is a Tyrant
Nowadays, it is said that the new grading guidelines tend to be interpreted expansively to further disadvantage people with mental disabilities. For example, some mental patients' applications were suddenly rejected simply because they were living alone, even though they had always been certified as Grade 2.
The patients, who should have been certified as Grade 2, actually have very serious medical conditions and difficulties in social life. How on earth could such things happen? Isn't it too ruthless?
There used to be a "certification criteria” chart. But it has disappeared.
Some other unreasonable cases are listed in the table below.
Persecution in Japan
As just mentioned, even the current grading guidelines are no longer fair and reliable. So to speak, the mentally disabled are living in a state of lawlessness. The officials persecute the mentally disabled in an unreasonable and brutal way. That is, the mentally disabled are persecuted simply because they live alone. It's an persecution based on household structure.
In another case, an application was rejected simply because “the amount of medication was small.” Under the new grading guidelines, patients will be graded solely on their “ability to perform activities of daily living.” The dosage has nothing to do with “ability to perform activities of daily living” at all.
Crazy, Japan Pension Service. Why do they hate people with mental disabilities so much?
Lost Opportunities
Whether they can receive disability pension benefits or not is, of course, a matter of life and death. If they cannot, they will suffer an economic loss of more than 50,000 JPY or about US$470 per month. Naturally, this issue will greatly affect their life planning.
For example, in my case, if my application for a disability pension had been approved back in November 2016, I would have chosen a career as an employee with a disability instead of a temporary worker disguised as a healthy person.
Wages for Disabled People Are Low
However, wages for employees with disabilities are very low in Japan. This tendency is stronger for persons with mental disabilities. Working more than 30 hours a week, they can earn only about 189,000 JPY (about $1,800) a month.
On the other hand, persons with physical disabilities earn on average about 248,000 JPY (about US$2,350) a month. There is a wage disparity of 60,000 JPY (about US$565) between the two. This is one of the biggest reasons why the disability pension or other public financial support is vitally necessary for people with mental disabilities.
Moreover, from their low wages, social insurance premium and withholding taxes are deducted.
In this chart, social insurance premiums are defined as the sum of health insurance and employees' pension premiums. Source: Please tell me how I can save on social security premiums | tax accountant office best balance
The take-home pay of the mentally disabled is probably around 150,000 JPY (about US$1,400). As mentioned earlier, the mentally disabled living alone have to pay the house rent. The rent for a single person in the Tokyo metropolitan area is probably in the 50,000-65,000 JPY range (about US$470-$610). Moreover, they have to pay utility bills which are probably around 10,000 JPY (about US$94) every month.
In short, it is virtually impossible for the mentally disabled living alone to maintain their livelihood without disability pensions.
So without disability pensions, they have no choice but to find a full-time job to make a living. In order to get that job, they must hide the fact that they are mentally disabled. As a result, they have to work as hard as healthy people. However, the overwork doesn't last long, and the disease re-worsens. The tragedy repeats over and over again.
Robbed of Opportunities to Reintegrate Into Society
Once again, if I had been eligible for a disability pension, I would have willingly worked as an employee with a disability. This way of working was the best way to balance earning an adequate income with proper disease treatment.
It is not the economic loss that makes me despair. Rather, it is very little possibility of returning to society that drives me to despair.
To make up for the financial loss due to the cutoff of disability pension, I start to work full-time as a healthy person for a while. Then suddenly the disease worsens, and before long I become jobless. When the conditions become better, I force myself to work again. On the surface, I may appear to be moving from job to job. I am like a desperado. But in reality, I am just seriously fighting against severe relative poverty.
Why should I suffer so extremely, while having lingering depression? Is it simply because I am living alone?
You better let somebody love you
(Let somebody love you)You better let somebody love you
Before it's too late
The final lyrics from The Eagles' signature song Desperado.
I was not able to receive disability pension benefits, i.e., public support. It was too late.
We would like to feel Love through private support.
Before it's too late.
Disability Pension Funded by Donation
The Japanese government no longer has a human mind and cannot provide loving support to the mentally disabled living alone any longer. So instead, I've started to accept donations from warm-hearted citizens. I believe this will greatly help us make up for the lost disability pension benefits and facilitate our reintegration into society. This is the aim of our donation campaign.
So to speak, it is a Private Disability Pension System funded by donations.
Hand-to-mouth life. Eagerly I wanna escape from this hopeless life right away.
Aside from being now-now, I'd like to dream about tomorrow and the future. This is not just my wish. It's also the wish of all the mentally disabled living alone who can no longer receive disability pension benefits due to the inhuman guidelines reform on September 1, 2016.
If this fund-raising is successful, I would like to share the warm-hearted support with persons in the same boat. I want to help them. It's my dream.
How to Donate
This is the actual donation form. You can donate through this form. It is powered by Donorbox. No extra fees. Simple and easy. Major credit cards available. Donation can be made in 4 currencies: US Dollars (USD), British Pound Sterling (GBP), Euros (EUR), and Japanese Yen (JPY). Note that this is not a tax-deductible donation. For more information, please see the Basic Donation Guide.
Victims of This Unfair Society
To tell the truth, I had used PayPal Donation for about four years until Shikin-kessai-ni-kansuru-horitsu (Act on Settlement of Funds) came into effect in 2010.
But in the end, no donations were made at all. I think It was mainly due to the poor contents on my website. However, this bitter experience has made me painfully aware that Japanese people really do not donate.
As a side note, PayPal Donation is no longer available in Japan. Perhaps the Act on Settlement of Funds prevented them from continuing the service.
There are only a few cases where Japanese people make donations. They tend to donate only when catastrophes occur that are beyond the control of the victims, such as major natural disasters.
There were huge donations for 2011 Great East Japan Earthquake relief. Source: Japan Relief Fund: Japan Society
Somehow, the Japanese seem to have a strong resistance toward donation. This may be similar to the way Westerners feel about wearing masks.
I know it very well. And I feel it's a very reckless plan to ask Japanese people for donations. But looking at reality, there are so many mentally disabled people living alone who are starving to death right now. Furthermore, the mentally disabled have the highest percentage of those living alone.
The root cause of their severe poverty is the unreasonable nature of the new grading guidelines. Under the new grading system, as long as they live alone, they cannot receive disability pension benefits, no matter how serious their illness is or how difficult their social life is.
And because the revision of the guidelines was done in secret, the mentally disabled living alone never knew what had happened. Nonetheless, it suddenly caused them deadly financial damage. In Japan, such despicable administrative acts against the mentally disabled are not uncommon. This is why we seriously need your support, not public support. Even a small donation is greatly appreciated. I hope you will join in our campaign, Private Disability Pension Funded by Donations.
Thank you.
