Japan's Medical Worker Mental Health Compensation Cases Rise 3.6 Times in a Decade

Medical workers face a sharp rise in recognized mental illness

Japan's annual average of approved compensation cases for mental disorders among medical workers rose from 16.3 in fiscal 2012 to 2014 to 59.3 in fiscal 2021 to 2023, according to the government's 2026 white paper on preventing death and illness from overwork. The increase amounts to about 3.6 times the earlier level, with traumatic accidents, disasters and harassment by patients among the factors identified.

The cabinet approved the report on October 9, 2026. Across all occupations, mental disorders recognized for workers' compensation reached 1,082 cases in fiscal 2025, setting a record for the seventh consecutive year. Applications reached 4,958, also a record.

The medical worker figures measure cases accepted as related to work and eligible for compensation under public insurance. They do not represent every medical worker who experienced mental illness. Nevertheless, the increase places healthcare among the sectors where recognized cases have grown particularly quickly.

The Ministry of Health, Labour and Welfare's white paper announcement says the report examines rising compensation claims, decisions in priority occupations and industries, and worker surveys. Its findings point to several distinct pressures: exposure to traumatic events, difficult relationships at work and abusive behavior by people using services.

What the decade comparison shows

To examine occupational trends more accurately, the ministry divided fiscal 2012 through fiscal 2023 into periods of three fiscal years and calculated annual averages. This approach makes the comparison less dependent on fluctuations in a single year.

For medical workers, including nurses, the annual average increased by 43 recognized cases between the first and last periods, from 16.3 to 59.3. Calculated from those published averages, that is an increase of about 264%. The annual average for fiscal 2018 to 2020 was 30.7 recognized cases.

One account describes the increase as roughly three times, while others give 3.6 times. The underlying figures are the same: 59.3 divided by 16.3 is approximately 3.64, making 3.6 times the more precise description.

The corresponding increase was about two times in construction and about 1.5 times among motor vehicle drivers. Medical workers therefore recorded a larger proportional rise than either of those groups. The figures do not establish which occupation has the greatest risk per worker, because the comparison does not include workforce sizes.

There is also a timing distinction. Fiscal 2021 to 2023 is the latest period in this occupational comparison, whereas fiscal 2025 supplies the newer national totals. The medical average of 59.3 should not be treated as a fiscal 2025 figure.

Trauma and interpersonal conflict are different findings

Across the full period examined for medical workers, the most common factor was experiencing or witnessing tragic accidents or disasters. That finding identifies exposure to distressing events as a central part of the recognized mental health burden in medical work.

A separate result concerns the broader medical and welfare industry in fiscal 2025. In that group, interpersonal relationships were the leading category of factors associated with recognized mental disorders. This category can include trouble with supervisors and customer harassment, including abusive behavior by patients or other people using medical facilities.

These findings describe different populations and periods. Medical workers in the historical analysis are not necessarily the same group as the medical and welfare industry in the fiscal 2025 figures. The change in the leading category cannot, on its own, establish that harassment has displaced traumatic exposure as the main cause among medical workers.

No separate count is given here for cases attributed specifically to patient harassment. It would therefore be inaccurate to describe all interpersonal cases as patient abuse, or to assign a percentage of the medical worker increase to that behavior.

A national record beyond healthcare

The rise in healthcare is part of a broader increase in mental disorders recognized as related to work. In fiscal 2025, the 4,958 applications nationwide were more than three times the level a decade earlier. The 1,082 recognized cases were about twice the earlier level.

Interpersonal relationships, including conflicts with supervisors or colleagues, were the most common category nationally and accounted for approximately one fifth of the reported causes. The growing role of this category makes workplace relationships a major prevention issue alongside excessive working hours.

Applications and recognized cases measure different things. An application is a request for compensation; recognition is an administrative decision accepting a case as related to work. The annual totals should not be divided to produce an approval rate, because applications submitted during a fiscal year are not necessarily decided during that same year.

The figures also do not reveal how much of the increase reflects more illness, more applications or other changes affecting recognition. The ministry says its white paper analyzes the reasons claims have increased, but the headline totals alone cannot separate those effects.

Surveys reveal pressure within particular jobs

The white paper also examines questionnaire responses from approximately 1,200 to 1,400 workers in each of three sectors: construction, motor vehicle driving and information technology. The surveys assessed depressive tendencies and workplace stress, identifying respondents with suspected depression or anxiety disorders, including severe cases.

The shares were 32% in construction, 31% among motor vehicle drivers and 25% in information technology. These are survey findings about suspected conditions, not counts of clinical diagnoses or approved compensation cases.

Within construction, site supervisors had the highest share, at 46%. Other technical workers and office workers each recorded 31%. The gap between supervisors and those two groups was 15 percentage points, suggesting that the industry average conceals substantial differences between roles.

A ministry official suggested that site supervisors' responsibility and long working hours may have contributed. Their work places them between their company and the tradespeople carrying out construction. That explanation was presented as a possibility, not a demonstrated cause of the survey results.

Among drivers, 43% of bus drivers and 35% of taxi drivers showed signs of possible depression or anxiety disorders. The eight percentage point difference highlights variation even between two occupations involving passenger contact. The surveys do not establish how much passenger behavior contributed to either result.

What the white paper covers

The white paper is an annual report submitted to Japan's parliament under the Act on Promotion of Measures for Prevention of Karoshi, etc. The ministry describes the 2026 edition as the 11th report. Its formal scope includes the situation in fiscal 2025 and government measures taken to prevent death and illness associated with excessive work demands.

The term karoshi is often associated with death from overwork, but the ministry's definition is broader. It includes deaths from cerebrovascular or heart disease caused by excessive workloads, suicide associated with mental disorders caused by severe psychological pressure at work, and cases of those illnesses that do not result in death.

That distinction matters here: recognized mental disorder cases should not be read as a count of deaths. The report addresses serious damage to health as well as fatal outcomes.

Healthcare is one of eight priority occupational or industry groups, alongside motor vehicle drivers, teachers, information technology, restaurants, construction, media, and arts and entertainment. The analysis follows the government's prevention policy outline approved on August 2, 2024.

Key dates behind the findings

The report brings together historical occupational comparisons, newer compensation totals and the government's policy framework. Keeping their dates separate helps explain what each finding measures.

• Fiscal 2012 to 2014: Medical workers averaged 16.3 recognized mental disorder compensation cases annually.
• Fiscal 2021 to 2023: The corresponding annual average reached 59.3, about 3.6 times the earlier figure.
• August 2, 2024: The cabinet approved the policy outline guiding measures to prevent death and illness from overwork.
• Fiscal 2025: Nationwide mental disorder applications reached 4,958 and recognized cases reached 1,082.
• October 9, 2026: The cabinet approved the 2026 white paper.

The historical medical worker comparison ends before the fiscal 2025 national results. It establishes a substantial increase over the period studied, but does not provide a current annual total for medical workers alone.

Prevention commitments and unanswered details

The ministry says it will promote better working environments and consider responses suited to the characteristics of individual industries. It is also urging companies to carry out measures such as stress checks to help protect employees' mental health.

The white paper describes government activity on reducing long working hours, mental health measures, harassment prevention, public awareness and support for private organizations. It also presents examples of workplace changes in priority industries, including efforts to improve productivity and working conditions.

Health, Labour and Welfare Minister Kenichiro Ueno addressed the issue at a press conference after the cabinet meeting. In translation, he said:

People must not lose their lives or damage their health through work. I want to devote every effort to measures to prevent death from overwork.

The findings support attention to both traumatic exposure and workplace relationships, but they do not specify how many medical cases involved each type of harassment, which medical occupations accounted for most of the increase, or how the figures vary between facilities.

The announcement does not set out a new healthcare measure with a specific implementation deadline. The immediate commitment is to continue prevention efforts and examine responses by industry. Measuring progress will require keeping survey indicators, compensation applications and recognized cases distinct.

Key Points

• Medical workers' recognized mental disorder cases averaged 59.3 annually in fiscal 2021 to 2023, compared with 16.3 in fiscal 2012 to 2014.
• Traumatic accidents and disasters were the leading factor across the historical medical worker analysis.
• Interpersonal relationships led the fiscal 2025 findings for the broader medical and welfare industry.
• Nationwide recognized cases reached a record 1,082 in fiscal 2025, the seventh consecutive annual record.
• Surveys found suspected depression or anxiety disorders among 46% of construction site supervisors and 43% of bus drivers.
• The government promises continued prevention efforts, but no new healthcare implementation deadline is specified.