Japan’s September surge in student suicides: What are the key drivers?

Eri Mametsuka was 16 when she tried to take her own life at her home in Oita Prefecture.

What led there was a childhood defined by poverty, isolation and emotional abuse from her Zainichi Korean mother and Japanese stepfather. A self-described “latchkey kid,” Mametsuka initially turned to books to escape the friction at home. But by junior high, her quiet coping mechanisms gave way to self-harm.

As severe depression took hold, the walls closed in — until one morning, a fight with her mother over not getting up for school pushed her to the brink. Mametsuka jumped from their third-floor balcony, a fall that broke her neck and left her paralyzed from the chest down.

“I felt like I had no escape left,” she recalled. “When I hit the ground, I stayed conscious, and my overwhelming feeling was just relief. I thought I wanted to die, but jumping was terrifying. Once it was over, I realized I was just glad to be alive.”

Mametsuka as a high school student, during a period of severe depression before she tried to take her own life. | COURTESY OF ERI MAMETSUKA

Now 33, Mametsuka lives independently as a poet in the city of Beppu, using a wheelchair — a life rebuilt against the backdrop of a country where suicides among school-age children have climbed past 500 a year, even as adult suicide rates continue to decline.

The end-of-summer crisis

Nowhere is this strain more visible than during this time of year.

Across Japan, the seasonal surge in youth suicides is deeply embedded in the public consciousness as the “September 1st problem.” In reality, the pattern extends well beyond a single date, spanning the weeks around the new school term and driving local governments, including Tokyo, to designate September as a suicide prevention month.

“We need to watch for an increase in suicides after summer vacation,” warns Takashi Nagasawa, chief of child and adolescent psychiatry at Tokyo Metropolitan Children’s Medical Center. “With the major environmental shift of returning to school, interpersonal issues like bullying can resurface, while academic burdens and anxiety over future paths often intensify.”

Nagasawa points out that the timing also varies across the country. Nationally, student suicides begin rising as early as mid-August, with northern regions such as Hokkaido and Tohoku seeing spikes first because their school calendars begin earlier. He urges adults to remain vigilant during these periods of heightened risk.

Dr. Takashi Nagasawa, chief of child and adolescent psychiatry at Tokyo Metropolitan Children’s Medical Center, speaks on youth suicide in Japan at an international conference in Germany in July. | COURTESY OF TAKASHI NAGASAWA

This late-summer and early-fall surge is part of a broader, year-round crisis. Japan is the only Group of Seven nation where suicide, rather than accidents, is the leading cause of death among young people ages 10 to 19.

In 2025, student suicides reached a record high of 538 deaths. Police records show school-related issues accounted for nearly half of all identified motives, outpacing health and family strain. Yet in 88 cases, authorities listed the underlying cause as entirely “unknown”— a stark reflection of how silently many children carry their pain.

Nagasawa says that silence is deceptive. Even as Japan’s youth population shrinks, he notes that observable indicators of distress — including school absenteeism, reported bullying and classroom violence — have reached historic highs.

“At our hospital, we see so many children coming in with various emotional and behavioral struggles,” he said. “And what strikes me most on the front lines is that the rise in child suicide is, more than anything, the most critical issue we face.”

That crisis points to a stark paradox in Japanese society. While Japan excels in physical health — with UNICEF ranking the nation first among wealthy countries — it ranks 32nd out of 36 when it comes to mental well-being.

Nagasawa sees this reality play out every day. He cautions against reducing the rise in child suicide to any single cause, describing a web of pressures that vary by age and gender — from school and family strain to loneliness and financial stress, compounded by social media and growing global uncertainty.

Making matters worse is a deep-seated cultural demand for conformity, which can condition young people to bury their pain, convinced that showing struggle is a personal failure.

Mametsuka spent nine months in hospital, where she discovered life beyond academic and family pressures. | COURTESY OF ERI MAMETSUKA

As an adolescent, Mametsuka felt unable to ask adults for help.

“I was raised to be strong, so I hated showing any weakness,” she said. “Even when I finally squeezed out the courage to speak up, I was rejected. Eventually, I realized it was safer to stay silent.”

Systemic barriers and community care

When families do try to get professional help, they hit severe structural bottlenecks. Japan faces a severe shortage of pediatric psychiatrists, leaving entire regions under-resourced and hospital waitlists stretching for months.

Yet Nagasawa says that expanding medical capacity is only half the battle; the harder barrier is getting children to step through the door at all.

“For a struggling child, just saying the words ‘I’m in pain’ or ‘I need help’ is extraordinarily hard,” he said. “Many simply don’t trust adults and don’t want to reach out. Adding more hotlines won’t solve this. What we really need are safe places — at home, at school, in the neighborhood — and adults they feel they can actually talk to.”

To catch children before they reach a breaking point, he urges adults to intervene early rather than wait for an overt cry for help — by watching for subtle shifts in sleep, appetite, attendance, grades or friendships. When a child does express suicidal thoughts, he says, professional care should not be the first or only response.

“Instead of jumping straight to a psychiatric referral, the adults in a child’s life need to sit with them, listen, keep them safe, and then help guide them to the right care,” he said.

Ironically, it was during Mametsuka’s long recovery — nine months in a hospital ward, followed by 18 months in physical rehabilitation — that she began to see life beyond the school and family struggles that had once consumed her.

Meeting patients and caregivers from different walks of life, she began to realize that the relentless academic track that had driven her to despair was just a tiny, artificial slice of the world.

That lesson has stayed with her, informing the way she speaks about suicide prevention and the pressures young people face.

“In Japan, we aren’t taught how to draw boundaries, so asserting yourself is extraordinarily hard,” she said. “I don’t have the answer to our suicide crisis, but I know we urgently need practice in learning how to say no.”

To Mametsuka, saying “no” means realizing you can walk away from expectations — that failing a class or disappointing your parents is infinitely better than ending your life.

“You don’t have to do everything people expect of you,” she said. “You don’t have to please everyone. You just have to stay alive.”

 If you or someone you know is in crisis and needs help, resources are available. In case of an emergency in Japan, please call 119 for immediate assistance. The TELL Lifeline is available for those who need free and anonymous counseling at 0800-300-8355. For those in other countries, visit International Suicide Hotlines for a detailed list of resources and assistance.