Selective Mutism and Hikikomori (2)

I think this description is significance, because it is written clearly in MHLW guideline that selective mutism is not only a childhood problem but can have lasting effects as Hikikomori. In fact, I hear not negligible number of Japanese people who suffered (or suffer) from selective mutism become Hikikomori. One Japanese support group for children with selective mutism claims that some children with selective mutism become Hikikomori later.

I don't know what evidence the authors of the guideline have. There are few studies on long term outcome of selective mutism also in Japan. But I guess several Hikikomori cases that have the experience of selective mutism are reported among institutions for Hikikomori people, such as Mental Health and Welfare Center, Public Health Center, etc..

It is interesting to note that the guideline mentions the relationship between school refusal and selective mutism. Traditionally it has been thought that Japanese children with selective mutism in general don't suffer from school refusal, because it's conspicuous to miss school for a long time. Children with selective mutism tend to avoid being conspicuous.

Although the guideline only make passing reference to selective mutism, I want many professionals to read the sentences about the disorder. That can help to raise awareness of selective mutism.

Last but not least, please note that not all Japanese children with selective mutism become Hikikomori later.

Index of SM in Japan

Selective Mutism and Hikikomori (1)

Hikikomori is a serious social problem in Japan.

What is Hikikomori? Ministry of Health, Labour and Welfare defines Hikikomori as "A phenomenal concept which means avoiding social participation (e.g. school attendance including compulsory education, entering the workforce including part-time job and associating with somebody outside the home) and generally remaining at home for 6 month and over in principle (including going outside without associating with somebody). Moreover, although as a general rule we define Hikikomori as nonpsychotic phenomenon excluding social withdrawal based on a positive and negative symptom of schizophrenia, keep in mind that it's not uncommon that Hikikomori includes schizophrenia before a definite diagnosis is made."

MHLW revised a guideline for assessment and support for Hikikomori people on May 19. It is thought that professionals who help Hikikomori people read the guideline.

* Here's a link to MHLW's web page on the guideline *

http://www.mhlw.go.jp/stf/houdou/2r98520000006i6f.html
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The guideline refers to selective mutism as "mental disorders that are strongly related to Hikikomori and their features."

According to the guideline, some children with selective mutism become Hikikomori: 'Some children who didn't speak at kindergartens or schools in early childhood such as selective mutism gradually become school refusal and then become Hikikomori. Others remain at home after graduating from high schools without determining their course.'

(To be continued)

Index of SM in Japan