Contesting the Forms of Child Psychiatric Care: Japanese Medical Doctors and the Institutionalization of Child Psychiatric Care, 1935-1980

In this paper, I examine how Japanese physicians envisioned and contested the form of child psychiatric care, and struggled to build an institutional structure, in particular for autistic children, in postwar Japan. Japan did not develop an extensive system of child surveillance and institutionalization (long-term impatient placement into institutions) before World War II, through which children considered to have some form of mental or intellectual disabilities would be screened and placed into institutions. This was unlike the case in many Western countries where postwar child psychiatric care developed in the aftermath of deinstitutionalization, reflecting the Japanese government's tendency to restrict resources for public health. Japanese child psychiatrists and pediatricians envisioned and advocated for various models of child surveillance and institutionalization with varying degrees of success from the 1930s to the 1970s. I analyze the strategies that these medical doctors employed to convince other stakeholders in realizing their visions. However, child psychiatrists were generally unsuccessful in realizing their visions. In the end, it was pediatricians who managed to shift the domain of care for autistic children into education and welfare.