Introduction

"I've never been fond of non-egalitarian individuals; pretending to love someone who doesn't resonate with me feels like deceiving both myself and them, so I've never done it."

This sentiment is echoed by CC, a man in his thirties who reached out to us after our project became visible through social media, identifying himself as hikikomori. In his email, he passionately discusses how societal norms, particularly rigid gender roles, exacerbate social isolation and mental health issues not only in Japan but globally. CC argues that pressures for “men to be assertive” and “women to be passive” deeply influence interpersonal dynamics, contributing significantly to phenomena like hikikomori. His reflections blend personal observations with societal critiques, underscoring the urgent need for greater equality and a reevaluation of these entrenched norms.

When we first began our work, we had concerns about whether the term and concept of 'hikikomori' would resonate within our communities, as we thought it was quite unfamiliar. Our primary audience was educators, our goal was to hear and understand their insights, experiences, and needs. However, we were uncomfortable reducing the experiences of hikikomori individuals to mere cases. Therefore, this email emphasized the importance of raising awareness about the concepts of social isolation and social withdrawal, whether we call it 'hikikomori' or not, and greatly encouraged us.

Hikikomori

Background

The term "Hikikomori" is a Japanese word that is derived from two verbs "Hiku" which means to pull back and "Komoru" which means to withdraw and can be translated as "to stand apart, to isolate oneself” (Magila, 2020). The term entered psychiatric discourse in the late 1990s when Saito (1998) initially defined the concept, and it was introduced to Western psychology by Jonathan Watts in 2002 in the article, titled "Public Health Experts Concerned about Hikikomori in Tokyo” (Watts, 2002).

Watts highlights how young people withdrawing into their homes cast a shadow over Japan's most vibrant celebration in the calendar, the Coming-of-Age Day festivities. Watts begins his article by noting that in Japan, the traditional Coming-of-Age Day, intended to celebrate young adults entering society, has increasingly brought attention to a concerning trend: the emergence of hikikomori, a condition characterized by severe social withdrawal. Watts' article highlights that despite the festive atmosphere, recent years have seen heightened security due to disruptions linked to young adults who shun societal responsibilities.

Watts indicated that nearly a million young people in Japan were living in similar circumstances, withdrawing into their homes. This phenomenon, which emerged in the late 1990s, has sparked debates in Japan, questioning whether it is a lifestyle or a disease, based on the high number of reported cases. During this period, it has been more frequently discussed and debated in the media than in health circles.

While the high numbers suggest a lifestyle choice, researchers, psychiatrists, and government agencies have started investigations focusing on young people who have been in similar situations for more than six months. Watts argues that these figures may only represent the tip of the iceberg, as hikikomori, by its definition, involves individuals reluctant to seek treatment and families often hesitant to seek counseling that might imply dysfunctionality.

By 2010, Teo and Gaw argued that there couldn't be a unified definition of hikikomori and as a part of everyday Japanese, this word can express either the patient (i.e., the person or the people) or the phenomenon (i.e., the sign of the decline) (Teo and Gaw, 2010). However, Japanese psychiatrists have been developing more specific and functional definitions (. Japan's Ministry of Health Labor and Welfare (MHLW), referencing Saito's work, initially defined the criteria as follows:

• A home-centered lifestyle (most often a single room).
• The lack of interest in school or work.

It is a prerequisite that symptoms persist for at least six months and that there are no apparent psychological or mental disorders. Additionally, individuals who maintain personal relationships are not included in this definition.

Due to Japan's psychosocial history, family relationships, and socioeconomic status, Japanese parents support their children by staying at home and living off their parents' income until their 30s. Additionally, it is believed that prosperity, technology, and the comfort of modernity encourage hikikomori. However, a similar situation is observed among young people in the UK, albeit for different reasons but reminiscent of hikikomori behaviorally. This condition, referred to as NEET (Not in Education, Employment, or Training), identifies young people who are neither in formal education nor employed (Suwa and Hara, 2007).

Socioeconomic Factors

Research has shown that hikikomori, a condition marked by prolonged social withdrawal, is closely linked to socioeconomic factors like unemployment and household income. Over the past two decades, this phenomenon has been a significant concern in Japan, impacting individuals' mental and physical health negatively. Similar patterns have been observed in other countries, indicating its global relevance. For instance, studies have highlighted that economic instability, such as job loss, can significantly increase the likelihood of hikikomori onset. However, recent data suggests that while unemployment rates and household incomes were correlated with hikikomori cases in the earlier years studied (2010-2015), this association weakened in more recent years. These findings underscore the complex interplay between societal factors and mental health, emphasizing the need for tailored interventions and further research to better understand and address this challenging issue (Nonaki and Sakai, 2021).

Society and Culture

Hikikomori, marked by severe social withdrawal and self-confinement, highlights deeper cultural and social issues within Japanese society. This phenomenon primarily affects young individuals and is influenced by Japan's collectivist culture, societal norms, and historical economic challenges. Understanding hikikomori requires examining these cultural factors, including high power distance, group loyalty, and employment expectations. This section explores how these elements contribute to hikikomori and emphasizes the need for further research to better understand and address this issue.

Hikikomori reflects the broader issues in Japan's collectivist culture, which emphasizes societal norms, group acceptance, and identity, often leading to social exclusion for non-conforming individuals. The cultural context includes high power distance, masculinity, and uncertainty avoidance, stressing obedience and politeness. Historical factors, such as the economic downturn in the 1990s, exacerbated unemployment and societal pessimism, influencing the hikikomori phenomenon.

Additionally, the masculine ideal of the "salaryman" has been challenged, with hikikomori seen as a rejection of these traditional roles. Peer rejection, bullying, and familial neglect further contribute to the social withdrawal of young hikikomori. Some researchers argue that hikikomori may represent a form of rebellion against societal expectations. While the review suggests that collectivist cultural values are a common rationale for hikikomori, it highlights the need for more quantitative research to validate these sociological theories and explore the phenomenon in different cultural contexts (Guo, 2022).

The article by Naveed (2019) identifies factors related to culture-bound theory in the socio-demographic orientation of hikikomori and the physical manifestation of ‘opting out’ by ‘shutting in’. It compares these factors with the social expectation withdrawal of runaways, using Japan’s position in Hofstede's cultural value indices: individualism (IDV), power distance (PDI), and uncertainty avoidance (UAI). The analysis suggests that cultural values, along with educational norms, peer behaviors, and employment expectations, influence how social withdrawal presents itself. Hikikomori, a phenomenon still prevalent in Japan, is analyzed in this context. The term ‘culture-bound’ refers to social behaviors or trends triggered by a country's culture, and identifying these trends can help trace causes and potentially find solutions. The article does not offer solutions but explores societal factors contributing to hikikomori, contrasting it with runaway behavior in other cultures. Japanese young people’s withdrawal into their rooms is seen as a reaction to the pressures of a collectivist, high power distance, and high uncertainty avoidance society, where social withdrawal is influenced by group loyalty, peer pressure, and employment stability expectations (Naveed, 2019).

The OUTSIDE Project

The OUTSIDE Project was created to address an issue that has been a focal point in the school and youth sector for several years: the phenomenon of Hikikomori. Hikikomori are individuals, typically young and predominantly male, who isolate themselves from society to the extent of confining themselves to their homes and avoiding contact with the outside world.

The need to seek solutions within the adult education sector arises because, once these individuals leave the school system, it becomes increasingly challenging to monitor their mental state and level of isolation. An inclusive adult education system must, therefore, extend its reach to this complex target group. This involves not only recognizing the unique needs of Hikikomori but also developing targeted interventions that can effectively engage them.

Our project aims to create a supportive framework within the adult education sector to identify, reach out to, and assist Hikikomori. This includes training educators and community workers to recognize signs of extreme social withdrawal, providing resources for mental health support, and fostering environments that encourage gradual social reintegration. By doing so, we hope to bridge the gap that often leaves these individuals without support once they transition out of the youth sector, ensuring they receive the continuous care and attention they need to overcome their isolation.

Project OUTSIDE Activities

To gain a deeper understanding of the phenomenon, we began with a literature survey. This foundational step allowed us to gather insights from existing research and theoretical frameworks. As the essence of Erasmus+ projects emphasizes an action-oriented approach, we also collected relevant good practices and current assessment tools utilized in the field. Recognizing that the concept of Hikikomori—characterized by extreme social withdrawal—is not widely known despite its prevalence, we extended our research to cover related topics.

These include:

• Social Withdrawal and Social Isolation
• Addiction
• Disengagement and Procrastination
• NEET (Not in Education, Employment, or Training)
• Avoidance Behavior
• Undiagnosed Neurodiversity

Among these, the partners focused on four types of challenges:

• disengagement,
• addiction (with a focus on screen addiction)
• avoidance behavior and procrastination,
• undiagnosed neurodiversity

We developed two distinct training modules for each challenge:

• one theoretical module designed to raise awareness and provide an in-depth understanding of the issues discussed
• one practical module aimed at equipping participants with actionable strategies and tools for preventing and addressing the challenge.

In total, we have developed eight modules for the toolkit proposed as one of the key outcomes of the project. This toolkit represents a collaborative effort among all project partners, who have researched and curated effective strategies for Hikikomori prevention. At its core, the toolkit serves as an invaluable resource for educators and professionals seeking to address the complexities of Hikikomori within their communities.

The OUTSIDE Toolkit equips trainers with the necessary tools and insights to navigate the challenges posed by Hikikomori effectively. By providing a wealth of resources, guidance, and intervention strategies, the toolkit empowers educators to create supportive environments conducive to holistic growth and recovery.

More than just a collection of materials, this toolkit embodies a collective commitment to fostering understanding, empathy, and actionable solutions. It serves as a bridge between theory and practice, offering tangible pathways for educators to engage with and support individuals affected by Hikikomori.

Creating a comprehensive and effective prevention strategy requires gathering detailed insights from educators, trainers, and teachers. Their frontline experience and understanding of relevant behaviors, challenges, and needs are invaluable. Therefore, we reached out to educators, trainers, and teachers to listen to their perspectives, insights, experiences, and needs. 

Project OUTSIDE Findings

To further enrich our understanding and ensure the relevance and applicability of our toolkit and protocol, we conducted a series of focus groups with educators and trainers. These focus groups were instrumental in gathering firsthand insights and experiences regarding the challenges and needs associated with addressing Hikikomori and related phenomena. Through these discussions, we aimed to delve deeper into the practical aspects of intervention and support, drawing on the invaluable knowledge of those who are on the frontline of education and mental health.

Participants were asked to reflect on the differences they have observed in social relations in the classroom, at home, and within the family over the past decade, and how these changes have impacted their thoughts and feelings. We explored the point at which potential problems with socialization become noticeable in children and young people and discussed perceptions of the differences between online and physical socializing. Reflecting on their own childhoods and youth, participants shared how their relationships with technological tools and the online world have evolved.

Additionally, we examined the personal and societal measures necessary to prevent the development of social isolation and similar situations. Participants also provided examples of good practices and relevant protocols that could be applied to prevent social isolation. The discussions revealed a wealth of insights and strategies, which are detailed in the findings from various organizations in Italy, Spain, and Türkiye.

Comparing the findings from Italy, Spain, and Türkiye reveals both common trends and distinct cultural perspectives on the evolving challenges of youth social relations and the impact of technology. In Italy, there is a significant shift towards digital communication among young people, leading to decreased face-to-face interactions both in classrooms and at home. This trend raises concerns about the emotional and social development of youth, highlighting the need for improved communication within families and educational settings to bridge the growing gap between digital and personal interactions.

Spain similarly observes a rise in social isolation among youth, exacerbated by excessive screen time and challenges in setting boundaries at home. Educators emphasize the importance of in-person activities like sports to foster holistic social skills while advocating for balanced technology usage to maintain mental well-being and genuine relationships. Recommendations include enhanced parental involvement and standardized guidelines to effectively combat social isolation.

In Türkiye, findings underscore a broader spectrum of social challenges, including increased materialism, negative social behaviors, and a decline in social skills worsened by the pandemic. Participants express a mix of concern, sadness, and determination to support youth amidst conflicting societal messages about technology. They advocate for holistic approaches that integrate emotional learning into education, promote community involvement, and enhance awareness of technology's impacts on social interactions.

In conclusion, while all three countries face common issues such as digital dependency and declining face-to-face interactions among youth, their responses reflect unique cultural contexts and priorities. Italy emphasizes improving familial and educational support systems, Spain prioritizes balanced technology usage and community engagement, and Türkiye focuses on holistic approaches and societal awareness to mitigate the impacts of social isolation effectively. By integrating these insights into policy and educational frameworks, each country can work towards fostering healthier social environments and supporting the well-being of their youth.

Project OUTSIDE Protocol

The final product of the OUTSIDE project is the OUTSIDE Hikikomori Prevention Protocol. The protocol covers several key areas to ensure a comprehensive approach to the prevention of hikikomori. It addresses the validity and sustainability issues, as well as control and monitoring mechanisms and strategies for communication and dissemination. Both intervention and prevention strategies are included in the protocol. For intervention, it covers the identification of warning signs, methods for identification, and support mechanisms. For prevention, it will detail various risk factors at personal, family, societal, and cultural levels, as well as considerations for different age groups. The roles of schools and families in prevention will be emphasized.

Additionally, the protocol provides specific guidelines for different groups involved in the prevention of hikikomori, including detailed guidelines for teachers and trainers, parents, and peers to equip them with the knowledge and tools necessary to support at-risk individuals effectively. By integrating these comprehensive strategies and guidelines, we aim to empower our community to effectively prevent and address hikikomori, fostering a supportive environment for all individuals.

Conclusion

In conclusion, the OUTSIDE project highlights the critical need for comprehensive approaches to address the complex issue of hikikomori and its global implications. By emphasizing the importance of understanding cultural, social, and economic factors, the project underscores that hikikomori is not an isolated phenomenon but one deeply rooted in broader societal contexts. Through extensive research, focus groups, and the development of practical toolkits and protocols, the project has laid a strong foundation for educators, community workers, and policymakers to collaboratively address and mitigate the impacts of social withdrawal. The shared insights from Italy, Spain, and Türkiye offer valuable perspectives, reinforcing that while digital dependency and social isolation are universal challenges, tailored interventions reflecting unique cultural contexts are essential. Moving forward, the integration of these findings into educational and policy frameworks is vital for fostering healthier social environments and supporting the well-being of youth globally.

References

Guo, Z. (2022). A Review of Social and Cultural Causes of Hikikomori: Collectivism in Japan. Proceedings of the 2021 International Conference on Public Art and Human Development ( ICPAHD 2021), 638(Icpahd 2021), 727–731. https://doi.org/10.2991/assehr.k.220110.139 

Naveed, A. (2019). Hikikomori: Applying culture-bound theory to acute social withdrawal. IAFOR Think. https://think.iafor.org/hikikomori-applying-culture-bound-theory-acute-social-withdrawal/ 

Nonaka, S., & Sakai, M. (2021). A correlational study of socioeconomic factors and the prevalence of hikikomori in Japan from 2010 to 2019. Comprehensive Psychiatry, 108, 152251. https://doi.org/10.1016/j.comppsych.2021.152251 

Maglia, M. (2020). Hikikomori: a systemic-relational analysis. Health psychology research, 8(2).

Suwa, M., & Hara, K. (2007). “Hikikomori” among Young Adults in Japan. 

Teo, A. R., & Gaw, A. C. (2010). Hikikomori, a Japanese culture-bound syndrome of social withdrawal?: A proposal for DSM-5. Journal of Nervous and Mental Disease, 198(6), 444–449. https://doi.org/10.1097/NMD.0b013e3181e086b1

Watts, J. (2002). Public health experts concerned about “hikikomori”. Lancet, 359(9312), 1131. https://doi.org/10.1016/S0140-6736(02)08186-2