5-2 SCHOOL REFUSAL5-2-1 Students With School Refusal
5-2-2 Types and Causes of School Refusal
5-2-3 Supports for Students with School Refusal
5-2-4 Students with School Refusal in High School
5-2-5 Hikikomori (Social Withdrawals)
5-2-1 Students With School Refusal
The MEXT (Ministry of Education, Culture, Sports, Science and Technology) defines “non-attendance at school (futōkō)” as “the phenomenon where students do not go to school or cannot go to school, despite a desire to go to school, due to some psychological, emotional, physical and/or social factor, and environment, with the exception of illness or economic factors.” In the 1960s, those students were diagnosed as “school phobic,” based on psychiatric behavioral abnormalities. These students were distinguished from the students whose non-attendance was caused by financial and family problems (Morita 1991).
Since the 1980s, the number of students with school refusal has been increasing rapidly, and school refusal became a nationwide school problem. In 1966, the MEXT began to keep records of those students who were absent from school for 50 days or more because of “school phobia.” However, since 1991, the MEXT has counted those who were absent from school for 30 days or more in terms of school refusal. These students are called “the students of non-attendance at school (futōkōsei).” The MEXT regards school refusal as the phenomenon that any student may have.
The more neutral term “non-attendance at school” (futōkō) is generally preferred to “school refusal” (tōkōkyohi). I use the term “school refusal” only because it refers to the problem more directly in English than “non-attendance at school.”
Since the 1980s, the rising number of students with school refusal has been attributed to the “weak” and spoiled children of the “wealthy society,” and the intense pressure of the “educational credential society.” Until the 1960s, middle school students with school absenteeism were mainly students living in poverty who had to work to help support their impoverished families, or truants who were mostly from disadvantaged and poor families. As a result of the economic boom (1953-1973), almost all Japanese consider themselves middle class. Since the 1970s, they have enjoyed unprecedented material wealth. Consequently, the majority of students with school refusal no longer come from economically disadvantaged families.
Several studies suggest several reasons for the rapid increase of students with school refusal. One is that children have been overly indulged by their parents. With the prevalence of one- or two-child families, children are spoiled and have become accustomed to getting their own way. Another reason is that students are exhausted from too much schoolwork and from too many expectations from their parents (Takagaki et al. 1995; Morita 1991; Inamura 1994).
Students with School Refusal in Elementary and Middle Schools
The number of students with school refusal increased by twice from 67,000 in the 1991-92 school year to 128,000 in the 1998-99 school year and then have been around 120,000 for almost 20 years (134,000 in the 2016-17 school year). However, the percentage of students with school refusal to all students rose from 1.06% (one out of every 94) in the SY1998-99 and then 1.35% (one out of every 74) in the SY2016-17 because of the decreasing number of children.
In the SY2016-17, one out of every 213 elementary school students and one out of every 33 middle school students had school refusal (Figure 5.2.1; Figure 5.2.2; Table 5.2.1). More than half (52%) of elementary schools and 86% of middle schools have one or more students with school refusal. One fifth (21%) of elementary school students with school refusal and almost half (46%) of middle school students with school refusal were out of school for 90 days or more (Monbukagakushō 2018g). In the 2014-15 school year, more than half of students with school refusal (53%) were males (Monbukagakushō 2015f).
|Elementary school||13,000||0.14||27,000||0.36||24,000||0.36||30,000||0.47||one out of 213|
|Middle school||54,000||1.04||112,000||2.81||95,000||2.69||103,000||3.01||one out of 33|
|Total||67,000||0.47||139,000||1.23||120,000||1.17||137,000||1.35||one out of 74|
The percentage of the students with school refusal has been still increasing because those students have more choices for alternative schools, such as public “adaptation” classrooms and private free schools by now. Furthermore, school refusal has become more accepted by schools and the public than before. Medical care for children with school refusal has increased especially after 2006 when the educational supports for children with developmental disabilities (Learning Disability, Attention Deficit Hyperactivity Disorder and High-Functioning Autism) started (See 9-4 SPECIAL NEEDS EDUCATION IN RESOURCE ROOMS in details). Children with developmental disabilities tend to have school refusal more than the average. According to a survey of elementary and middle schools in Fukuoka prefecture, 20% of 984 students with school refusal have developmental disabilities, including significant difficulties in learning (7%), behavior (9%) and both learning and behavior (4%)(Harada & Matsuura 2010).
In the SY2016-17, the number of students with school refusal in elementary schools increased from 1,500 in the 1st grade to 9,700 in the 6th grade as they get older. The number increased almost 3 times from 9,700 in the 6th grade to 26,000 in the 7th grade when they move from elementary school to middle school. The number of students with school refusal in middle schools also increased from 26,000 in the 7th to 40,000 in the 9th as they get older (Figure 5.2.3; Table 5.2.2). The “7th-grade gap,” caused by environment changes from elementary school to middle school, is considered as one of main causes of school refusal. The newly-established “nine-year compulsory education school” system is expected to reduce the number of the 7th-grade students with school refusal.
5-2-2 Types and Causes of School Refusal
Types of School Refusal
The students with school refusal are categorized into two types:
- Those who cannot go to school because of emotional or neurotic problems.
- Those students who do not intend to go to school because of truancy.
Truants deliberately skip schools. They tend to be low-achievers, act rebelliously toward teachers, be late for school, ditch classes, and have family problems. 6% of middle school students with school refusal are truants (Monbukagakushō 2018g).
Most students with school refusal want to go to school and/or think that they should go to school, but cannot because of emotional disturbance, apathy, or some other neurotic problem. School refusal means specifically this type of student, not the truant. Two thirds of the cases of school refusal are linked to the psychoneurotic problems, such as emotional disturbance and apathy (Table 5.2.3).
These children usually stay at home and do not like to socialize. Many of the students with school refusal have sleep disorders and abnormal hormone secretion (AS July 13, 1999). To all appearances, they are ordinary children with average or above average school performances. However, they tend to be overly sensitive, anxious, serious, perfectionist, selfish, timid, and/or anti-sociable. Their parents, in particular their mothers, are likely to be overprotective and demanding (Inamura 1994).
Direct Causes of School Refusal
Teachers and schools, not students, listed the causes of school absenteeism for the students in the survey. Among the direct causes of school refusal, teachers listed “family related problem” as a main cause. “Family related problems” include such as divorce and poor relationships with parents. Among school related problems, teachers listed “friends (e.g., quarrels, except for bullying)” as the main cause of school refusal; however, very few teachers listed “bullying” or “teachers” as the causes (Table 5.2.3).
|Elementary school||Middle school||High school|
|Friends (e.g., quarrels, except bullying)||18.8||27.2||17.4|
|Teachers (e.g., punishment, scolding)||4.2||2.3||1.3|
|Poor academic performance||14.0||21.4||18.3|
|New schools, New classes, transfers||4.1||6.7||13.1|
|Family related problem||53.3||28.9||14.6|
The follow-up survey (2011-12) was made of a sample of the students who had school refusal in public middle school and graduated in March 2007. 41,000 students with school refusal graduated from public middle schools in March 2017. Among them, 2,561 agreed to joined the survey and 63% of them responded the survey. The direct causes of school refusal reported by former students with school refusal were highly related with schools, such as the relationship with friends (53%), poor academic performance (31%), teachers (26%) and friends/seniors of extra-curriculum clubs (23%). On the other hand, not many students listed home problems, such as the relationship with parents (14%) and family troubles (10%), as the direct causes of school refusal.
It is remarkable that the direct causes as reported by former middle school students with school refusal are very different from those reported by teachers. More than half of former students with school refusal listed relations with friends, especially bullying as their cause; however, only 0.5% of teachers thought bullying was a cause (Figure 5.2.4; Table 5.2.4). According to the Act for the Promotion of Measures to Prevent Bullying of 2013, each school to establish a basic policy to prevent bullying and establish an in-house organ to deal with the problem. However, many schools seem to have failed to prevent school refusal by missing bullying as a cause of school refusal.
|Causes||By students||By teachers|
|Friends (e.g., bullying, quarrels)||52.9||27.7|
|Disturbance of life rhythm (e.g., unable to get up early in the morning)||34.7||-|
|Poor academic performance||31.2||21.4|
|Teachers (e.g., punishment, scolding)||26.2||2.3|
|New schools, new classes, transfer||17.0||6.7|
|Internet, mails and games||15.6||-|
|Parents (e.g., scolding, rebellion)||14.2||-|
|Family problem (e.g., quarrels between parents)||10.0||28.9|
|Change of home life (e.g., father’s transfer)||9.7||-|
|Not any special causes||5.5||-|
1. The percentage of “Friends (27.7%)” reported by teachers include “Bullying (0.5%)” and “Friends (27.2%).”
2. The percentage of “Future course (5.0%)” reported by teachers is added to “Others (24.7%).”
(Monbukagakushō 2014c; Monbukagakushō 2018g)
Causes of Continuing School Refusal
According to the follow-up survey of former students with school refusal (2011-12), the respondents continued not to attend school because they felt apathetic (44%); they had extreme anxiety and stress, though they wanted to attend school (43%); there were students who would bully them at school (41%); they could not get up early in the morning (34%); they could not keep up with study (27%); and they did not think it was really wrong not attending school (25%)(Table 5.2.5). They were supported with school counselors (34%), school teachers (30%), hospitals (24%), school nurse teachers (24%), public “adaptation” classrooms (20%) and private free schools (9%). 23% did not seek any supports when they were students with school refusal in middle schools (Monbukagakushō 2014c).
|Extreme anxiety and stress, though wanting to attend school||42.9|
|Bully at school||40.6|
|Unable to get up early in the morning||33.5|
|Unable to keep up with study||26.9|
|Not thinking it is wrong not to attend school||25.1|
Courses After Middle Schools
According to the follow-up survey, 85% (98% on the national average) went to high school and 14% (2% on the national average) dropped out from high school. At the time of survey when they were at the age of 20, they attended to universities (19%), specialized training colleges (15%), high schools, including evening high schools and correspondence high schools (9%), and junior colleges (4%). One third (35%) had work experiences as regular employees (9%), non-regular employees (32%), and self-employed/helpers of family business (3%). 20% worked while schooling, and 18% had neither worked or been to school. However, it is noted that the follow-up survey was conducted by the former students with school refusal who agreed to participate and responded the survey.
Thinking back to their own school refusal at the time of middle schools, they said:
- “I should have attended school (39%).”
- “It cannot be helped (32%).”
- “I do not care (18%).”
- “I am happy I did not attend (12%).”
Specially in the case of bullying, many thought that school refusal was a right choice (Monbukagakushō 2014c).
5-2-3 Supports for Students with School Refusal
It is important to build a support network of parents, homeroom teachers, school nurse teachers, school counselors, and physicians to help students with school refusal return to school or to find an alternative means of education. Since 1995, the MEXT has deployed school counselors to schools to consult with students, parents, and teachers regarding school refusal and bullying. School nurse teachers have taken significant roles in counseling students with school refusal in their health care rooms. The MEXT has suggested schools to make the individualized educational support plan for students with school refusal (MEXT 2016i).
Half (50%) of elementary school students and 58% of middle school students with school refusal had been absent from school since the previous school year (Monbukagakushō 2018g). The municipal board of education may allow the students to transfer another school at the request of the students and/or their parents (Monbukagakushō 2016i).
Teachers, School Nurse Teachers and Counselors
The teachers in charge of student counseling, school nurse teachers and school counselors can provide professional advices. More than half of students with school refusal (52%) were consulted and advised from school nurse teachers (22%) and/or school counselors (41%) in the SY2016-17. After the guidance and consultation, almost 30% of students with school refusal came back to school by March 2017. On the other hand, one fourth of students with school refusal (25%) never sought any consultation and advice from schools or outside of schools, such as hospitals/clinics and pubic “adaptation” classrooms (Monbukagakushō 2018g).
Teachers in elementary schools are advised to show sympathy and understanding to the family of students with school refusal so that they earn the trust from the students and their parents. It is important for 1st to 3rd graders to get involved with their classmates. But 4th to 6th graders tend to be sensitive to being involved with their classmates; therefore, teachers may avoid sending a classmate to their homes (Takagaki et al. 1995a).
Parents of Children with School Refusal
Parents can help assisting their children to return to school by being accepting and understanding. Morishita, a clinical psychiatrist who consulted more than 300 students with school refusal and established a high school for them said that children with school refusal are cured only when parents accept them and say, “You do not have to go to school. You can take a good rest at home.” It generally takes half a year for mothers to fully accept that their children have stopped going to school, and takes three years for fathers (Morishita 2000).
The Associations of Parents of Students with School Refusal provide an opportunity for these parents to learn how to accept their children, and encourage each other to overcome their hardships. In 1984, parents of students with school refusal founded the “Concerned Society for School Refusal,” which developed into a nationwide “Network for Parents Who Have a Child with School Refusal” in 1990. The support networks have summer camps, group counseling, and meetings to find the best solution for their children.
Public “Adaptation” Classrooms
As the number of students with school refusal has rapidly increased since the 1980s, public “adaptation” classrooms and private “free schools” have been established specifically for them. The prefectural board of education operates “adaptation” classrooms. Most of these classrooms are located in community centers, not in schools. Attendance in the “adaptation” classroom is counted as school attendance. The students study and play freely with other students with school refusal under the supervision of teachers, and prepare to return to school. Most students with school refusal syndrome stay at home; therefore, attending an “adaptation” classroom is their first “stepping stone.”
In the 2016-17 school year, the number of students who attended public “adaptation” classrooms was 16,630 students, 12% of all students with school refusal in the nation (Monbukagakushō 2018g). According to the Education Opportunity Securing Law (enforced in 2017), the government expects public “adaptation” schools to take a core role to support children with school refusal.
Private Free Schools
Since 1992, the MEXT has allowed the prefectural board of education to count attendance in private “free schools” as regular school attendance, after the permits of principals of elementary and middle schools. Since 2009, the attendance in private free schools has been also accepted by principals of high schools. According to a 2015 survey, at least 4,196 students (1,833 elementary school students and 2,363 middle school students), 2% of all students with school refusal, attended 474 private free schools. The monthly tuition differs from free to more than 50,000 yen. 38% of private free schools cost 10,000-30,000 yen a month, and another 36% cost 30,000-50,000 yen (NKS August 6, 2015; Monbukagakushō 2017d).
The National Association for Home Schooling promotes home schooling for children with school refusal as an alternative to school education. In the 2016-17 school year, 16 elementary school students and 142 middle school students studied at home through IT (Information Technology)(Monbukagakushō 2018g).
5-2-4 Students with School Refusal in High School
Students with school refusal confront problems during the high school admission process because of their chronic absenteeism and poor grades. High schools select applicants based on the test scores on high school entrance exams, and their attendance, grades, conduct and extracurricular activities. Students with school refusal have poor attendance and consequently poor grades.
The MEXT has suggested that the prefectural boards of education consider special treatment for students with school refusal who are applying to public high school. Some prefectures exempt their poor attendance. For example, beginning in 1997, Kagawa prefecture set up a 5% quota for students with school refusal who can be judged only by the test scores of their entrance examination (AS April 8, 1999).
Students with school refusal may attend correspondence schools or evening high schools if they are not ready to return to regular daytime high schools. They may study at home and take high school equivalency examinations. In recent years, many students who had school refusal attend daytime courses of evening high schools where the students stay in school for shorter amount of time, and the environment is more casual.
Number of High School Students with School Refusal
Since 2004, the MEXT started to publish the data about high school students with school refusal. In the 2016-17 school year, the number of high school students with school refusal amounted to 49,000, one out of every 68 students, and 1.5% of all high school students. Its number has decreased from 68,000, one out of every 55 students and 1.8% of all high school students in the 2004-05 school year.
Among 49,000 students with school refusal, almost 60% of them have psychoneurotic problems, such as apathy (33%) and emotional disturbance (26%) and 8% were truants. The direct causes of school refusal as reported by schools are “poor academic performance (18%),” “friends (e.g., quarrels, except bullying)(17%)” and “family related problem (15%)” (Table 5.2.3).
One third of students (30%) came back to school after the guidance and supports from school nurse teachers (22%), school counselors (28%) and/or hospitals/clinics (12%). Almost half of students with school refusal (42%) were out of schools since the previous school year. One fourth (26%) dropped out from high school and 8% repeated the same grade again. High school education is not compulsory and students can drop out easily (Monbukagakushō 2018g).
5-2-5 Hikikomori (Social Withdrawals)
Since attendance at high school is not compulsory, there are no public facilities specifically for high school students with school refusal. Prolonged school-refusal behavior in teenagers may evolve into social withdrawal. In fact, there are many young adults, called “hikikomori (social withdrawal)” who confine themselves in their homes and isolate themselves from the society for six months or more.
The term “hikikomori” describes both the phenomenon and the person suffering from it (Saitō & Angles 2013). After school refusal and/or failing in employment, young adults neither work nor attend educational institutions, but rather cut off contact with society and confine their lives mainly to the family home, neither supporting themselves financially nor functioning independently for six months or more. 70% of hikikomori are males, and many come from middle-class homes. Longer they have been hikikomori, harder they can come out from the house and participate in the society again.
The first hikikomori book was published in 1998 by Tamaki Saitō as a therapist in the hospital. The term “hikikomori” was popularized by several well-publicized murder cases committed by hikikomori in 1999 and 2000. In one case, a 37-year-old recluse kidnapped a girl and kept her confined to his home for nine years, a home that he shared with his mother (AS January 29, 2000). Many specialists claim that the number of hikikomori may have reached one million (Morishita 2000:220; Saitō 2003:56).
School Refusal and Hikikomori
The rapid increase of students with school refusal in the 1980s caused the phenomenon of hikikomori in the 1990s. The majority of hikikomori were teen-aged former students with school refusal who continued confining themselves to their house after the graduation of middle schools or the withdrawal of high schools. Since attendance at high school is not compulsory, there are no public facilities specifically for high school students with school refusal. Prolonged school-refusal behavior in teenagers may evolve into social withdrawal.
The number of middle school students with school refusal increased from 54,000 (1.04% of all middle school students) in the 1990-91 school year to 103,000 (3.01%) in the 2016-17 school year (Monbukagakushō 2018g). According to the 1998 follow-up survey of the students with school refusal, 23% of them had neither worked or been to school for 5 years after the graduation in 1993 (Kōseirōdōshō 2003). Almost half of the persons in hikikomori had experienced school refusal (Kōseirōdōshō 2016d).
Non-Working Youths and Hikikomori
Since the mid-1990s when the long-term economic recession (1993-2002 & 2009-2012) started, many new graduates from high schools and those from colleges lost an opportunity to obtain regular employment right after the graduation and ended in non-regular employment or non-employment. Some young adults in their 20s and even their 30s became hikikomori after quiting a job and/or failing to find a job.
The number of non-working youths, the NEETs (“Not in Education, Employment or Training”) in the age of 15-34 increased from 400,000 in 1993 to 630,000 in 2012 (Kokudokōtsūshō 2013). Many non-working youths live with their parents and among them those who are introverted and unsociable may have become hikikomori. The parents take care of their adult children with no jobs at home economically.
Approximately half of the NEETs are hikikomori. According to a 2006 survey, NEETs experienced:
- Being bullied in school (55%)
- Quitting a company (55%)
- Having school refusal (36%)
- Being hikikomori (50%)
- Having mental or psychosomatic treatments (50%)
- Having trouble with colleagues at work (41%)
- Being forced to quite his/her company (18%)(Kōseirōdōshō 2007a).
Hikikomori and Psychiatric Diagnosis
Hikikomori is defined as a social phenomenon and an individual who is not considered to have a mental disorder. Hikikomori may have a psychiatric diagnosis such as obsessive symptom, regression, fear of people, domestic violence, etc. as secondary disorder after being hikikomori for a long time. However, as the research of hikikomori made progress, many hikikomori have schizophrenia and developmental disorder. The 2010 Guideline for Evaluating and Supporting hikikomori added that hikikomori may be patients of schizophrenia (Kōseirōdōshō 2010). Medical professional still question whether hikikomori should be classified as a social phenomenon, a psychological pathology, such as schizophrenia, developmental disorders, stress related disorders, or combination of both.
Lifetime Prevalence of Hikikomori
The study for lifetime prevalence of hikikomori (2002-2006) confirms that 1.2% of community residents aged 20–49 years and 0.5% of households in Japan have had hikikomori in their houses. It is estimated that 232,000 people currently suffer from hikikomori [based on the total number of households in Japan (46 million) and the total population (128 million) in 2003]. The actual number was in fact higher because participation in the investigation was voluntary (Koyama et al. 2010).
Hikikomori in the Age of 15-39
According to a 2015 survey (out of 5,000 with 62% response rate), the estimated number of hikikomori young adults (ages 15-39) amounts to 541,000 (1.57% of all youths aged 15-39), including those who rarely go out from the house (176,000; 0.51% of all youths aged 15-39), and those who go out only for their own hobby related matters (365,000; 1.19%)(Table 5.2.6). More than 70% come from middle-class or upper-class homes where parents are able to support their hikikomori children.
Two thirds (63%) of hikikomori are males. However, the number of female hikikomori is underestimated in the number. Many unmarried female hikikomori can be counted as “domestic servants,” and did not counted as hikikomori. Hikikomori have been aging and been in the self-imposed isolation for a longer time. Hikikomori are in their 10s (10%), 20s (49%) and 30s (41%). They started to confine themselves in their 10s (43%), 20s (43%) and 30s (14%) and have been self-isolated for less than 3 years (24%), 3-5 years (29%), 5-7 years (12%) and 7 years or more (35%). The rate of hikikomori who have been confined themselves for 7 years or more (35%) increased from the 2010 survey (17%)(Naikakufu 2016b).
|Going out from their own room, but not going out from the house or rarely going out from their own room||55,000||0.16|
|Usually staying in the house, but going out to a nearby convenience store.||121,000||0.35|
|Sub-total Hikikomori (narrow sense)||176,000||0.51|
|Usually staying in the house, but going out for their hobbies||365,000||1.06|
1. The persons with physical disabilities, the persons with schizophrenia, housewives/househusbands, and the persons engaged in housework/childcare are excluded in the calculation.
2. Estimated number is based on the population of persons in the age of 15-39 in 2015.
The direct causes of hikikomori have been mainly school refusal since the 1990s when the hikikomori became social problem. 31% of hikikomori had experienced of school refusal in elementary/middle schools and 18% said the direct cause of the current hikikomori was school refusal.
During the long-term recession (1993-2002 & 2009-2012), more adults in their 20s and even their 30s became hikikomori after quiting a job and/or failing to find a job. Almost half of hikikomori reported that the direct causes of hikikomori were work-related problems (Table 5.2.7).
|School refusal (at elementary, middle, and/or high school)||19.0|
|Could not get used to the place of work||16.5|
|Failed to find a job||15.2|
|Did not get along with others at work||12.0|
|Failed entrance examination (of high school/college)||3.2|
|Failed at college||1.9|
Supports for Hikikomori
Public supports for young adults with psychological and psychiatric problems are needed. Regional hikikomori support centers, public health centers, mental health welfare centers and NPOs have provided psycho-social supports, including personal counseling. The centers also provide the consultation and supports for parents who have troubles with their hikikomori children, such as domestic violences.
The MHLW (Ministry of Health, Labour and Welfare) has operated a regional hikikomori support center in each prefecture since 2009 and an outreach-style program that supporters visit the households with hikikomori since 2011. The centers open for 8 hours a day for 5 days a week. Hikokomori support coordinators (2 persons or more) provide telephone consultation to struggling families and in-person psychiatric, counseling, and home visits. The centers also support hikikomori to join in group work for social participation such as volunteer activities, work experiences, and part-time jobs. Furthermore, the centers help hikikomori to find jobs through the system of registered companies for hikikomori (Kōseirōdōshō 2016d).
Hikikomori in the Age of 40-64
The first generation of hikikomori who have been living with their parents since the 1990s and 2000s are in their 40s and 50s. As their parents age and pass away, many hikikomori would lose their financial supports. They would become destitute unless parents leave considerable assets behind, such as inherited savings in the bank.
The government conducted a nation-wide survey of hikikomori in the age of 40-64 in 2018 for the first time. They visited 5,000 households with the person(s) in the age of 40-64 and found 47 hikikomori. The estimated number of the hikikomori adults in the age of 40-64 amounted to 623,000, 1.5% of all adults aged 40-64. It is more than 541,000 hikikomori youths in the age of 15-39, 1.6% of all youths aged 15-39 in 2015. The total number of hikikomori is estimated to more than one million. 77% of them are males and almost half (47%) have been hikikomori for 7 years or more.
One third of them (30%) make their own living while the others are supported by parents (34%) and a spouse (17%). They became hikikomori because of the retirement (36%), troubles with colleagues at work etc. (21%), sickness (21%) and not being able to get used to the workplace (19%). It is noted that 57% of them became hikikomori after the age of 40. Among those in the age of 40-44, one third of them became hikikomori in the age of 20-24. It suggests that they became hikikomori at the time of searching a job during the economic recession (SS March 30, 2019; MS April 3, 2019).
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