Mental Health and Stress Check System in Japan: What Are Employers' Legal Obligations?

Workplace mental health (メンタルヘルス - mentaru herusu) has become a significant focus globally, and Japan is no exception. Recognizing the impact of work-related stress on employee well-being and productivity, Japanese law, particularly the Industrial Safety and Health Act (ISHA), mandates specific measures for employers. A cornerstone of this approach is the mandatory "Stress Check System" (ストレスチェック制度 - sutoresu chekku seido), designed to promote early awareness of stress levels among employees and encourage proactive interventions by both individuals and organizations.

Employer's General Duty of Care for Employee Mental Health

Beyond specific statutory requirements, employers in Japan have a general "duty of care" (安全配慮義務 - anzen hairyogimu) towards their employees, as established under Article 5 of the Labor Contract Act. This duty obligates employers to take necessary measures to ensure the safety and health of their workforce, a responsibility that unequivocally extends to mental health. Historically, there might have been a tendency in some Japanese workplaces to view mental health issues as stemming from an individual's personal disposition ("気の持ち方" - ki no mochikata, or one's way of thinking) or personality. However, there is now a much stronger legal and societal recognition of the employer's role in identifying and mitigating workplace stressors that can contribute to mental health problems.

The Industrial Safety and Health Act (ISHA) and Mental Health Framework

The ISHA (労働安全衛生法 - Rōdō Anzen Eisei Hō) is the primary legislation governing workplace safety and health in Japan. It underpins many of the specific obligations related to mental well-being. For instance, workplaces with 50 or more regularly employed individuals are required to appoint an industrial physician (産業医 - sangyōi), who plays a key role in employee health management, including mental health.

The Mandatory Stress Check System: A Key Initiative

Introduced through amendments to the ISHA (Article 66-10) and effective since December 1, 2015, the Stress Check System is a significant legal obligation for many employers in Japan.

Purpose of the System:
The primary aims of the Stress Check System are:

1. Primary Prevention for Employees: To help employees become aware of their own stress levels, encouraging them to seek early consultation or care if needed, thereby preventing mental health issues from worsening.
2. Workplace Environment Improvement: To enable employers to use aggregated, anonymized stress check data to identify stressors within specific departments or workgroups and take steps to improve the overall working environment.

Applicability and Frequency:

• The system is mandatory for all workplaces (事業場 - jigyōjō) that regularly employ 50 or more workers.
• For workplaces with fewer than 50 regular employees, implementing the Stress Check System is currently a "duty to endeavor" (努力義務 - doryoku gimu), meaning employers are strongly encouraged but not legally mandated to conduct it.
• Stress checks must be conducted at least once a year.

Covered Employees:
The system targets "regularly used employees" (常時使用する労働者 - jōji shiyō suru rōdōsha). Generally, this includes employees who have been employed for one year or more (or are expected to be) and whose scheduled working hours are at least three-quarters of the scheduled hours for full-time employees at that workplace. This aligns with the criteria for employees eligible for regular annual health checkups. While the employer must offer the stress check, an individual employee's participation in completing the questionnaire is voluntary.

The Stress Check Process:

1. Conducting the Stress Check (Questionnaire):
   • Employees are provided with a standardized questionnaire designed to assess their stress levels. The MHLW recommends using its "Brief Job Stress Questionnaire" (BJSQ), which typically includes 57 items covering job stressors (e.g., workload, control, interpersonal relations), stress responses (e.g., psychological and physical symptoms), and buffering factors (e.g., support from supervisors and colleagues).
   • The questionnaire can be administered on paper or electronically.
2. Evaluation of Results by Implementers:
   • The completed questionnaires are collected and analyzed by designated "implementers" (実施者 - jisshisha). Implementers must be physicians (typically the industrial physician), public health nurses, or other qualified professionals (e.g., specially trained nurses or mental health social workers) specified by MHLW ordinance.
   • The implementers evaluate the individual stress levels based on the questionnaire responses.
3. Notification of Results Directly to the Employee:
   • Crucially, the individual stress check results are notified directly to the employee by the implementer.
   • The employer must not be provided with an employee's individual stress check results without that employee's explicit and informed consent. This is a vital confidentiality safeguard.
4. Identifying High-Stress Individuals and Recommending Medical Interviews:
   • Based on the evaluation, the implementer identifies employees who are considered "high-stress individuals" according to criteria set by the MHLW or the workplace's Health Committee.
   • If an employee is identified as high-stress and the implementer deems a medical interview with a physician necessary, this recommendation is communicated to the employee along with their results.
5. Employee Request for a Medical Interview:
   • An employee who receives a recommendation for a medical interview (or any employee who wishes to, even if not flagged as "high-stress," though the employer's obligation to provide it is tied to the recommendation for high-stress individuals) can request an interview with a physician.
6. Arranging and Conducting the Medical Interview:
   • Upon receiving a request from an eligible employee (i.e., one identified as high-stress and recommended for an interview), the employer is obligated to arrange for a physician (usually the industrial physician) to conduct the interview without undue delay.
7. Physician's Opinion and Employer's Subsequent Measures:
   • After the medical interview, the physician provides their opinion to the employer regarding any necessary measures to improve the employee's working conditions. This sharing of information with the employer (specifically, information relevant to workplace adjustments) requires the employee's consent.
   • Based on the physician's opinion, the employer is legally obligated to take appropriate measures, which could include reducing working hours, changing job duties or workplace, providing more support, or other actions to mitigate the employee's stress and improve their working environment. The employer must discuss these measures with the employee.
8. Collective Analysis (集団分析 - Shūdan Bunseki) and Workplace Improvement:
   • Employers are under a "duty to endeavor" to have the implementers conduct an aggregated analysis of stress check results (e.g., by department, work group, or demographic characteristics). This analysis must be done in a way that does not identify individuals (e.g., requiring a minimum group size of 10 for analysis).
   • The results of this collective analysis should be used by the employer to understand stress trends and identify specific workplace stressors. Based on these findings, employers are expected to take measures to improve the overall work environment and reduce stress at a systemic level.

Employer Responsibilities Regarding Cost and Non-Retaliation:

• The employer bears the full cost of conducting the stress checks and any subsequent medical interviews requested by eligible employees.
• The MHLW suggests that time spent by employees completing the stress check questionnaire should ideally be treated as paid working time to encourage participation, though this is generally decided through labor-management consultation.
• Employers are strictly prohibited from subjecting employees to any disadvantageous treatment (e.g., dismissal, demotion, pay cuts, unfavorable transfers, harassment) for reasons such as requesting a medical interview, not consenting to the employer receiving their individual results, or providing information to the physician during an interview.

Confidentiality:
Strict confidentiality of individual stress check results and medical interview details is paramount. Implementers, physicians, and any company personnel involved in handling data are subject to confidentiality obligations. Individual results cannot be used for performance evaluations or other personnel decisions without explicit employee consent for that specific purpose.

Integrating the Stress Check System with Broader Mental Health Strategies

The Stress Check System is a vital component but not the entirety of an employer's responsibility towards workplace mental health. It complements other ISHA requirements, such as providing medical interviews for employees working excessive overtime. Ideally, the system should be integrated into a comprehensive workplace mental health program that includes:

• Raising awareness about mental health.
• Training for managers on identifying and supporting employees experiencing stress.
• Providing access to counseling services.
• Promoting a positive and supportive work culture.
• Addressing identified workplace stressors through concrete improvement measures based on collective analysis.

Challenges and Considerations

Effective implementation of the Stress Check System requires:

• Building employee trust to ensure honest participation and willingness to seek follow-up interviews.
• Ensuring the competence and neutrality of implementers.
• Translating collective analysis results into meaningful and tangible workplace improvements.
• Adapting the system for diverse work arrangements, including remote work.

Conclusion

The mandatory Stress Check System in Japan represents a significant legislative commitment to preventative mental health care in the workplace. For employers with 50 or more employees, it is a non-negotiable legal obligation that requires careful planning, execution, and follow-through. Beyond mere compliance, the system offers an opportunity for organizations to gain insights into workplace stressors, foster a culture where employee well-being is prioritized, and proactively address mental health challenges. By embracing both the letter and the spirit of this system, and integrating it into a broader strategy for mental wellness, employers can contribute to a healthier, more resilient, and more productive workforce.