Anti-stigma efforts have been made to address mental illnesses in Japan and abroad, but based on the negative images still held against certain mental illnesses today and from the low rate of mental health care-seeking behavior in Japan, the stigma remains. Lack of educational involvement in addressing mental health is partially to blame for the current situation. With emphasis on mental health literacy in school education, it is important to refer to mental health as well as mental illnesses in textbooks, which are critical for learning, in order to expand literacy regarding mental health. According to Nakane et al., mental illnesses were described as incomprehensible, scary conditions or as potentially very burdensome to children and society until almost 1965. Shortly after, they started to be seen as something to approach without discrimination. However, mental illnesses were seldom mentioned after the late 1980 s, and their comprehensive descriptions disappeared. With the recent revision of the school curriculum guidelines, especially for high schools, "prevention of and recovery from mental illnesses" has received attention, with mention of specific mental illnesses such as depression, schizophrenia, anxiety disorders and eating disorders. The new guidelines aim to inform students that anyone can have a mental illness, that the onset is often in adolescence or early adulthood, and that recovery and improved quality of life are possible as long as appropriate interventions are provided. To implement anti-stigma strategies in the framework of school health care, it may be useful as an educational approach to combine the provision of appropriate information regarding "mental health" and "mental illnesses" based on mental health literacy with discussion of case materials, including case vignettes. Lively discussions are expected to take place regarding educational methods in the future.
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