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Expat Mental Health - Vickie Skorji From Tell Japan
Carlie: It’s tough enough sometimes, just being an expat and living away from your old network of family and friends. But when you need extra support – medical, legal services – and you’re in a foreign country, it can be a real struggle to find adequate help.
Hey, it’s Carlie, an Australian expat living in France, and my guest today on the Expat Focus podcast is Vickie Skorji, the director of TELL in Japan. This not-for-profit organization is providing vital support and counselling services to the country’s entire foreign population, and alongside that, as Vicky will explain, TELL is making a difference in the lives of expats who join them as volunteers. Vicky, it’s great to have you on the show.
Vickie: Thank you, Carlie. Thank you very much for the invitation.
Carlie: Vicky, one of the things that first struck me about TELL when I visited your website was just how comprehensive your services are. But before we get to everything you do today, can you tell me how TELL came about?
Vickie: We started in 1973. We were started by a group of churches and English missionaries to provide a support service to the foreign community. We grew out of the Inochi-no-denwa, which is a Japanese lifeline, and they started up a year before that. And what they found was that there was a number of foreigners that were calling their line and that were struggling to find services. Because as you can imagine, back in 1973, how you could find out information about doctors or lawyers or any of those things, it was incredibly difficult.
So that’s where we started, and since that time we have grown a lot. Inochi-no-denwa has grown a lot. They now have 50 branches across the country. We’re the only one in English. We are no longer just looking after the Tokyo population. We have branched out and have an office in Kansai, where we’re looking after the entire foreign population in Japan. And we’re no longer just a lifeline – we have face-to-face counselling, and in addition to that we have a range of outreach programs. So we’ve grown a lot.
Carlie: Vickie, how big is Japan’s international community?
Vickie: I think there’s around 2 million, maybe a little bit more than that, in Japan. So that’s a small percentage of the overall population, if you thought about how many foreigners there are in many other countries. But it’s growing and it’s changing. I think also, and amongst that, you have a growing number of, if you like, mixed marriages, and with that you’ll have a growing number of biracial families.
Carlie: Are there local healthcare, particularly mental healthcare, options for expats in Japan outside of TELL’s services?
Vickie: Very little. When it comes to looking at services for the foreign population, there’s not a lot. But I should also though qualify – when it comes to looking at mental health services, even for the Japanese, it’s not easy to find those services.
At the moment, in Japan, you cannot get counselling on your healthcare card. You can only get that sort of service from a psychiatrist. That then means that so many people are going to psychiatrists, and psychiatrists haven’t got time to really look after everyone, and so the waiting list there is enormous. So it’s difficult, whether you’re a foreigner or you’re Japanese, to find counselling.
Carlie: What is the conversation around mental health like in Japan? I know in Australia it’s becoming more and more open, and less and less a taboo subject. Is that the case in Japan as well?
Vickie: Well, there have been changes in that. I’ve been here working with TELL for over 10 years, and my background is in counselling. If I looked at things in Australia, they’ve been having this discussion about stigma and mental health and access to this, and having that discussion in the community for much longer, they were having it when I was there, 20 years ago. Japan is just in its infancy of discussing these things.
Carlie: How have the needs of expats in Japan changed over the years that TELL has been operating?
Vickie: I don’t think the needs have changed. I think everything’s fine if you’re an expat and things are going well. If they’re not going well, then it’s incredibly challenging. How do you find out about medical services that are available in your language? How do you find out about legal services that are available in your language? What if you come when you have a child with special needs? Is there anything in a foreign language for you? What’s available? What are your options? All of those things. Cultural adjustment happens to all of us when we move from one country to another. It can be quite challenging when you go to a country where you don’t speak the language.
So I think that it’s not any different from 30 years ago to now. It can be challenging. But I think also, too, if you come from a number of these countries, like my country Australia – our country – or the United States, perhaps you’d be expecting that there would be services. And when there are not, that can be really quite challenging.
Carlie: It’s not just adults, but also children in Japan’s international community that TELL supports as well?
Vickie: That’s correct. That’s something that’s grown in the last ten years, the services for children and families, both from assessments, getting support for if your child needs an assessment, whether it’s educational assessment or perhaps a psychological assessment, to all of the support services that might be involved in that. We also go out and talk to schools about mental health and letting these kids know that they’re not alone, because they’re not going to have that same range of infrastructure around them, or family supports. They’re only going to come across with their mum and their dad, and they won’t have that network of people that you might have if you were in your own home country. So that makes them quite vulnerable.
So we try to sort of support them and have discussions about LGBTQ issues. Because a lot of the children can be bullied and harassed in the schools. So on a wide range of issues, we’ve started focusing on young people.
Carlie: You’re right about that support network, and I think it’s something that can be pushed aside a little bit in the excitements of being in another country, but you don’t have your friend and your family community so close to hand. And sometimes you take things for granted, that you just don’t have access to any more when you’re overseas.
Vickie: That’s right. And I think also, sometimes it’s hard for even our families back home to understand what it’s like. I think they think we’re in a foreign country and it’s all very exciting and it’s almost like a long holiday. But it’s not like that when you move to another country. You have to… initially it might be like that, but then you have to learn how to survive. And if things are not going well, and if everybody’s got an expectation on you to succeed, how do you then go about and say, “Well, I’m not doing well. And my kid’s not doing well”?
And if you don’t have that infrastructure around you and that support network around you, where do you go? It can be really isolating. And I think that’s where the lifeline is particularly valuable.
Carlie: Myself, I moved to the UK four years ago, and now, just recently, to France. And while with France there’s definitely an added difficulty with the language, I can only imagine that moving from somewhere like Australia to Japan would come with a very unique set of its own challenges. What sort of challenges are unique to Japan for expats?
Vickie: I think there’s a whole range of them, and I think it depends on your circumstances, right? So depending on your age, depending on whether you come with a company that’s going to support you in all of these things or you’re coming by yourself, if you’re coming with a family… Me, I came with a family, so getting them all settled… I also had qualifications that didn’t transfer over here. My background is in psychology and clinical neuropsychology, and I couldn’t find the support and the supervision at that point to keep my licenses going.
And I think also, as a female, in a number of Asian countries and in Japan, it can be challenging to find those opportunities to work. It could be about your age and your gender that makes things challenging. I also had a child who had some special needs, and so that was quite challenging.
I wouldn’t say that everything has been challenging, because there have been also some wonderful opportunities, and here I am, 15 years later, and running a lifeline. So there are lots of possibilities. But there are also many challenges that you face.
Carlie: Vickie, how did TELL come into your life?
Vickie: TELL came into my life when I was sending our oldest child back to Australia, and I was wondering what I would do with myself. And I was feeling very homesick and missing my daughter, and thought, well, maybe I could go and do some volunteer work. And I looked at various options and I found out about TELL. And then I started to see all the wonderful things that TELL was doing, and I’ve been here ever since, in many different capacities.
Carlie: TELL is a not-for-profit. How does the organization ensure that it has the funds and the volunteers to keep its services available?
Vickie: Oh, that’s a good question. It’s really, really challenging. In Japan, being an NPO and getting that support to run your organization is really, really challenging. The whole concept of getting grants or donations is difficult to do. Getting support from the government – this year we have got support from the Tokyo metropolitan government, which has been just wonderful. But it’s the first time in my recollection that we have got that. So just paying our bills, keeping our lights going is extremely difficult. That means it’s really hard to advertise, it’s really hard to promote awareness of your services.
So it’s word of mouth, trying to find our volunteers and trying to find innovative ways to create the training, and doing all those outreach programs. We do a range of things, from very serious things – talking about, showing documentaries on sexual assault, rape, domestic violence, holding workshops on these things – to fun things, like run-athons, to band nights. So a whole range of things to try and get that word out there, to the community, that we exist and we need help.
Carlie: You said that TELL came into your life and you volunteered. How easy is it for the expat community in Japan to join TELL as a volunteer, and what do they get out of it?
Vickie: It’s so easy to come and join us and be a volunteer. It requires around three months of training, but that can be done online. The training is a few hours each week. At the end of that time, what we ask for is 10 hours a month, so not a lot. There are a couple of shifts a month, and that can be done in Tokyo or it can be done in Kansai. And later this year, we’re opening up a chat line, so that can be even done from home, overnight. Those two four-hour shifts can be done at times that work with you. So once you’ve got the training out of the way, it’s really quite doable.
And I think anybody that undertakes our training, the skills that you learn on our lifeline, they will help you to be a better person – a better partner, a better friend, a better co-worker. You have a lot of skills that will help you in lots of different aspects of your life. As well as you’ll be helping people and making a real difference in their lives, and saving lives.
Carlie: I think it can make a real difference in the life of an expat, especially if you’re in the situation where your skills may not translate so well, you may be limited in opportunities, and you’re just looking for something to fill time and have meaning.
Vickie: Absolutely. And more than that, I think sometimes you find like-minded people. You make some great friendships. And we also have a lot of people who use it as a stepping stone to later on, and say, “I really like this. I think maybe I’m going to be a social worker or a therapist.” And we do lots of recommendation letters, and they all do well.
Carlie: Vicky, we all remember the devastation caused by the 2011 earthquake and tsunami in Japan. What impact did it have on TELL?
Vickie: Well, I was here that day, and that’s… that day and the weeks that followed are ones that will be with us for a long time. It impacted us in lots of different ways. Many of our volunteers left the country within a week, because either their family or their work made them return home. That made it really difficult for us to keep our lifeline operating. We did manage to keep it operating. I had people doing multiple shifts. We kept it going all that time, for the first couple of months, non-stop. The people that stayed and rallied around it were amazing.
But also, following that, a lot of companies pulled out of Japan. So that made donations really difficult. A lot of people didn’t come back. And it did hurt our numbers. And it has taken us until this year to really get our numbers above those pre-earthquake years.
Carlie: I can only imagine the demand for calls and for services at that time from the international community that remained in Japan would have been quite high as well.
Vickie: It was. The other thing that you have to realize, that in a disaster, often your phone lines are jammed. So that was making it also quite frustrating. And I think in the future, if we’ve got other ways of communication and getting those messages out… we did have our website up and running, and giving information. But I think some of the things that we’ve got coming up in place with our chat line give you extra opportunities. Because you’re right – it’s really challenging when all your networks are jammed, when you’ve got power shortages, when maybe the internet’s not operating. How do you communicate?
Carlie: What would you say to someone who might be needing services from TELL but isn’t quite sure where to start?
Vickie: Just pick up that phone and call us, talk to us. You will find only the most caring, non-judgmental person on the other end of the line. You don’t have to be alone. There’s someone to talk about whatever it is that you’re concerned about, and they can link you in to a wealth of resources that are out there. You’re not alone.
Carlie: Vickie, how can we support TELL?
Vickie: There’s lots of ways to support us. You can make a donation. You can help us keep our lights going. You can help us be a volunteer, you can help with any of our events. There’s lots of different ways. You can help spread the word that our services exist. Go and look at our website – there’s many different ways. And it’s all there, and it’s all appreciated.
Carlie: Thanks so much for chatting with me, Vickie. It’s been so insightful to learn about TELL’s work in Japan with the international community.
Vickie: Thank you, Carlie. It’s been very nice to speak to another Australian and another Melbournian.
Carlie: That’s it for today. If you’d like to discuss this episode or ask questions, please head over to expatfocus.com and follow the links to our forums or Facebook groups. You can check out our previous episodes at expatfocus.com/podcast. They’re also on iTunes. And I’ll catch you next time.
End of Transcript
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