Mental health care is close to non existent in Japan. Talking about my own experience with ADHD, autism, depression and anxiety, I don't feel that I got the help I needed so I turned to training my own service dog. Until I did that, I had such a hard time, I turned to alcohol abuse, substance abuse and even self harm.
I've also spoken to other people with mental health issues and parents of children with mental health issues and not one person I spoke to is satisfied with the help available.
Japan tends to get stuck in old ways and mental health issues often go untreated because it's seen as shameful and taboo. People with mental health issues are embarrassed and don't seek the help they need. Because of this, there is very little funding in the field, unlike issues that are just as common but not taboo like arthritis.
Other countries have researched and studied ADHD so much that 36 medications exist. You will usually work with your doctor to find the right combination and dosage which may take some time but you do it. I've been to a few clinics and hospitals in Japan for ADHD alone. Only 3 medications are available and in many clinics their policy is not to combine 2 different medications. This is about 20 years behind other countries.
In such a high stress country like Japan, mental health problems affect a very large portion of the population but people are either ashamed to seek help or don't know that they can, and when they do, they don't receive the care they need which contributes to the over 20,000 annual suicides.
Service dogs can help people with depression, anxiety, PTSD, schizophrenia, depression, bipolar disorder, autism, Down's syndrome, social anxiety, OCD and so much more.
The more people that realize that seeking help for mental health issues come forward and get help, the more the system will improve. It will be years before Japan will recognize service dogs other than guide dogs, but the more people know, the more people can take action.
Until then, emotional support dogs could make a huge difference. They don't need specialized training like working dogs or service dogs can calm and relax their owners, lower anxiety, alleviate loneliness, enhance social engagement and interaction, normalize heart rate and blood pressure, reduce pain, reduce stress, reduce depression and increase pleasure.
I know a few dog handlers including myself who have trained ESDs in Japan, and if we raise awareness, normalize this and all spread the word, countless human and shelter animals' lives could be saved.
ESDs would be a stepping stone to approving service dogs.