Japan has officially recognized an unprecedented number of overwork-related deaths and health disorders in fiscal year 2024, according to the latest data released by the Ministry of Health, Labor, and Welfare. The ministry reported 1,304 government-recognized cases of so-called “karoshi” (death from overwork), representing a year-on-year increase of 196 cases. This surge sets a new record for work-related deaths and health issues in Japan—most of them involving strokes, heart conditions, depression, and other mental disorders, with the majority of the cases categorized as mental health disorders (nippon.com). Notably, this marks the first time Japan has reached over 1,000 officially recognized work-related mental health disorder cases in a single year—a stark warning for both policymakers and employers.
The growing epidemic of work-induced health problems in Japan is more than a local story. It resonates across Asia and holds valuable lessons for Thailand, where the culture of long work hours and high productivity expectations likewise threatens public health. For Thais, Japan’s data offers a sobering glimpse into the potential consequences of insufficient action on occupational mental health.
Japan’s ministry found that out of the 1,304 cases, 247 were directly related to strokes and heart conditions, but the vast majority—1,057—were attributed to depression and other mental health disorders. Alarmingly, 89 of these involved suicide or attempted suicide, underscoring the lethal risks of unaddressed overwork and workplace stress. Among recognized mental health-related cases, the most frequently cited aggravating factor was “abuse of power from superiors or others,” known as “power harassment,” which accounted for 224 incidents. Other leading causes included major changes in work duties or volume (119 cases), customer harassment (108), sexual harassment (105), and experiencing or witnessing traumatic workplace incidents (87).
Demographically, the data shows that both men (552 cases) and women (503) are affected almost equally by such disorders, with more than 90% of impacted individuals between the ages of 20 and 59—a segment considered the backbone of Japan’s economy. The largest single age group was individuals in their forties (283 cases), indicating that no particular age segment is immune from the pressures of modern work culture.
By industry, “healthcare and welfare” topped the chart at 270 cases, a figure mirrored by the high rates of stress and burnout seen globally in the healthcare sector since the COVID-19 pandemic. Other sectors seeing high numbers of cases include manufacturing (161), wholesale and retail (120), transportation and postal services (110), and construction (81).
Japanese experts and government officials have issued direct appeals to address the root problems contributing to these statistics. “The first-ever passage of the 1,000-case mark for mental health recognizes the severe and persisting psychological toll of workplace stress in Japan,” noted a representative from the Ministry of Health, Labor, and Welfare. The surge is widely seen as stemming from both systemic cultural issues and evolving workplace dynamics after the pandemic, which blurred many boundaries between work and personal life.
Several studies have linked karoshi to long working hours, lack of meaningful rest, job insecurity, and persistent “power harassment.” A recent government survey cited by the World Economic Forum found that roughly one in ten Japanese workers routinely put in more than 80 hours of overtime per month—well above internationally recommended limits (weforum.org). This relentless pressure has been further compounded by changing job demands, digital fatigue, and labor shortages in essential fields like healthcare.
Whistleblower accounts and labor researchers describe how deeply embedded cultural norms—such as unwavering loyalty to employers and stigma against seeking mental health support—have made it difficult for workers to resist unreasonable demands or take advantage of company wellness programmes. “Japan’s work culture has traditionally elevated sacrifice, perseverance, and group harmony above personal wellbeing. We are now seeing the real human cost,” commented a Japanese labor sociologist featured in a 2025 editorial for Forbes Asia (Forbes).
The recognition of escalating suicides and attempted suicides deeply unsettles Japanese society, which had already introduced landmark anti-karoshi laws and compensation mechanisms in the wake of prominent cases in the 1990s and 2000s. The legal reforms, however, appear insufficient in the face of structural and cultural hurdles.
For Thais, Japan’s data mirrors familiar risks even as local reporting is less formalized. Research published in 2024 found that Thailand’s own workforce, particularly healthcare professionals, has experienced a surge of stress-related disorders since the COVID-19 pandemic. A cross-sectional study from Khon Kaen University in northeast Thailand revealed that 15.47% of healthcare personnel screened positive for severe or very severe stress, while nearly half reported moderate levels (PMC11755378). The study identified a range of risk factors: excessive workload, unsatisfactory compensation, insufficient personal protective equipment, and the dual burdens of professional and family responsibilities. Physicians and nurses were 36% more likely to experience very severe stress compared to their peers.
Furthermore, the Ministry of Public Health’s data shows that at the peak of the pandemic, up to 41.97% of healthcare workers experienced significant work-related stress (PLoS One). These figures may even understate the true scope of the problem, as stigma and fear of career repercussions often prevent workers in both Thailand and Japan from disclosing mental health issues.
Like Japan, Thailand’s most affected industries are those in the health, welfare, retail, and manufacturing sectors, mirroring the breakdowns seen in the Tokyo report. Similar themes of overwork, workplace bullying, and harassment emerge in local studies, with additional factors including job insecurity, lack of access to professional support services, and deep-seated beliefs about endurance as a virtue (Nature).
Thai mental health experts warn that, like Japan, failure to act on early warning signs can escalate into wider public health problems. According to a senior official at the Department of Mental Health, Ministry of Public Health, “There is still a widespread reluctance to treat occupational stress as a real health risk. Many Thai workers—especially in essential sectors—continue to see high stress and burnout as normal or unavoidable.”
Workplace culture and legal enforcement remain inconsistent. Although the Labour Protection Act and guidelines issued by the Ministry of Labour address workplace harassment and excessive working hours, there is little evidence of comprehensive implementation or a robust compensation and reporting structure akin to Japan’s karoshi recognition system. This gap puts many Thai workers at heightened risk, especially with the economic and social shocks that have emerged in the post-pandemic era.
Culturally, both Japan and Thailand share a reverence for hard work, discipline, and loyalty. However, Thai Buddhist traditions also value collective harmony and non-confrontation, making it challenging to address “power harassment” or raise grievances. Local labor advocacy groups highlight this as an additional obstacle to open conversations about workplace mental health.
Internationally, the World Health Organization (WHO) now recognizes burnout as an “occupational phenomenon” and urges governments to address the psychosocial risks of modern work environments. The International Labour Organization likewise emphasizes the need for legal recognition, employer responsibility, and the creation of independent compensation boards, citing Japan as both a cautionary tale and a leader in the development of legal remedies (ILO).
Looking ahead, there are multiple potential outcomes. Without timely intervention, experts warn, Thailand could experience a spike in work-related stress, depression, and suicide similar to what Japan has recently recorded. Thai businesses and policymakers have an opportunity to learn from Japan’s experience by strengthening workplace wellness standards, limiting overtime, launching anti-harassment campaigns, and fostering psychological safety in the workplace. Further, strengthening the reporting and compensation system for occupational mental health disorders will be a key step in building employer accountability.
Practical recommendations for Thai readers include self-monitoring for signs of workplace stress, advocating for fair and humane work hours, and seeking support when facing harassment or bullying. Both employers and employees should be proactive in using newly available digital mental health resources, engaging in open dialogue about stress and work-life balance, and pushing for systematic change at both organizational and policy levels.
For health sector leaders, investing in robust support structures for frontline workers, ensuring safe shift scheduling, and offering regular wellness checks are not merely ethical imperatives but strategic necessities for national workforce sustainability and patient safety (Clinical Practice and Epidemiology in Mental Health). Ultimately, avoiding “the next karoshi crisis” will require coordinated efforts from businesses, government regulators, healthcare providers, and civil society.
As Japan struggles to reverse its karoshi epidemic, Thailand stands at a critical crossroads. By taking action now—recognizing the warning signs, learning from neighboring experiences, and reimagining workplace culture—Thailand can protect its most valuable resource: the health and dignity of its working people.