How to Get Japan’s Mental Health and Welfare Disability Handbook
The seishin shougaisha hoken fukushi techou (精神障害者保健福祉手帳) is a disability handbook (also called a disability certificate) for people with a mental health condition or a developmental disability that causes long-term difficulty in daily or social life. It is one of Japan’s three disability handbooks, alongside the shintai shougaisha techou (身体障害者手帳) for physical disabilities and the ryouiku techou (療育手帳) for intellectual disabilities.
This handbook was created in 1995 when Article 45 was added to the Mental Health and Welfare Act (seishin hoken oyobi seishin shougaisha fukushi ni kansuru houritsu / 精神保健及び精神障害者福祉に関する法律). It is the newest of the three disability handbooks and has gone through several updates since then.
For families of children with developmental disabilities such as autism (jiheishou / 自閉症), ADHD (chuui ketsujo tadousei shougai / 注意欠陥多動性障害), or learning disabilities (gakushuu shougai / 学習障害) who do not have an accompanying intellectual disability, this is the disability handbook that applies. If your child has both a developmental disability and an intellectual disability, they may be eligible for both this handbook and the ryouiku techou.
Who Is Eligible?
The certificate is available to anyone who has a mental health condition that causes long-term limitations in daily or social life. The condition must have been present for at least 6 months from the initial visit (shoshinbi / 初診日) to a medical institution for that condition. This 6-month rule is a key requirement.
The eligible conditions include:
| Condition (English) | Japanese |
| Schizophrenia | 統合失調症 (tougou shicchoushou) |
| Depression, bipolar disorder, and other mood disorders | 気分障害 / うつ病 / そううつ病 (kibun shougai / utsubyou / souutsubyou) |
| Schizoaffective disorder (atypical psychosis) | 非定型精神病 (hiteikeiseishinbyou) |
| Epilepsy | てんかん (tenkan) |
| Substance-related disorders (alcohol, drugs, solvents) | 中毒精神病 (chuudoku seishinbyou) |
| Organic mental disorders (including higher brain dysfunction) | 器質性精神障害 (kishitsusei seishin shougai) |
| Developmental disabilities (autism, ADHD, learning disabilities) | 発達障害 (hattatsu shougai) |
| Other mental disorders | その他の精神疾患 (sonota no seishin shikkan) |
Important distinctions:
- Intellectual disability alone (without a co-occurring mental health condition) is not covered by this certificate. People with intellectual disability only should apply for the ryouiku techou (Intellectual Disability Handbook / 療育手帳).
- If a person has both a developmental disability and an intellectual disability, they may be eligible for both the seishin shougaisha hoken fukushi techou (Mental Disability Certificate / 精神障害者保健福祉手帳) and the ryouiku techou (Intellectual Disability Handbook / 療育手帳).
- Developmental disabilities such as autism, ADHD, and learning disabilities are explicitly included as eligible conditions for this disability handbook.
The Grade System (Grades 1 through 3)
The seishin shougaisha hoken fukushi techou (精神障害者保健福祉手帳) has three grades, based on the severity of the mental health condition and the extent of limitations in daily and social life. The grade is determined by evaluating both the psychiatric condition (mental function impairment) and the person’s ability to perform daily activities (activity limitations).
| Grade | Description |
| 1 | The person has a mental disorder that makes it impossible to carry out daily activities without the assistance of others. This is the most severe grade. |
| 2 | The person has a mental disorder that significantly limits daily life, or that requires significant accommodations in daily life. Assistance from others is not always needed, but the person cannot handle unfamiliar situations or stressful events alone. |
| 3 | The person has a mental disorder that places some limitation on daily or social life, or that requires some accommodations. The person can generally manage daily life but has difficulty in social situations or under stress. |
For tax purposes, Grade 1 holders are classified as tokubetsu shougaisha (特別障害者, special disabled person), which provides a larger income tax deduction. Grades 2 and 3 are classified as general disability for tax purposes.
The 6-Month Rule
You cannot apply for the seishin shougaisha hoken fukushi techou until at least 6 months have passed since the initial visit (shoshinbi / 初診日) to a medical institution for the relevant mental health condition. The diagnostic form must be written on or after that 6-month point.
This rule ensures that the condition is persistent and not a temporary episode. The initial visit date is the first time you or your child saw any doctor (not necessarily a psychiatrist) for the condition that led to the diagnosis.
How to Apply: Step by Step
Step 1: Visit your city or ward office welfare desk.
Go to the disability welfare desk (shougai fukushi tantou madoguchi / 障害福祉担当窓口) at your local city hall or ward office. Tell them you would like to apply for a seishin shougaisha hoken fukushi techou. They will give you the application form and the blank diagnostic form.
Step 2: Get the diagnostic form completed by your doctor.
The diagnostic form (shindansho / 診断書) must be completed by a psychiatrist or a doctor specializing in mental health. Unlike the shintai shougaisha techou, which requires a specially designated doctor (shitei i / 指定医), the seishin shougaisha hoken fukushi techou diagnostic form can be completed by any psychiatrist or doctor who treats mental health conditions. However, the form must be written at least 6 months after the initial visit and must have been created within 3 months of the application date.
The doctor will charge a fee for completing the diagnostic form. This is not a standardized fee and varies by hospital.
Alternative: applying with a disability pension certificate. If you are already receiving a disability pension (shougai nenkin / 障害年金) based on a mental health condition, you can apply using a copy of the pension certificate (nenkin shousho / 年金証書) instead of the diagnostic form. This can save time and the cost of the diagnostic form.
Step 3: Submit your application.
Bring the following to the welfare desk:
- The completed application form
- The diagnostic form (or disability pension certificate copy)
- A passport-style photo (4 cm x 3 cm, upper body, no hat, taken within the past year)
- Your My Number card or notification card
- ID for identity verification
Note: the photo is required by default, but in special circumstances (for example, if taking a photo causes significant distress), some prefectures allow you to apply without a photo. A disability handbook without a photo may not be accepted as ID in some situations.
Step 4: Wait for the decision.
The application is reviewed by the prefecture (or designated city). Processing time varies but typically takes 1 to 3 months.
Step 5: Receive your handbook.
When the decision is made, you will be notified. Go to the welfare desk to pick up your certificate.
Validity Period and Renewal (Every 2 Years)
This is one of the most important things to know about this handbook: the seishin shougaisha hoken fukushi techou (Mental Disability Certificate / 精神障害者保健福祉手帳) expires every 2 years. This is different from the shintai shougaisha techou (Physical Disability Handbook / 身体障害者手帳), which generally does not expire, and the ryouiku techou (Intellectual Disability Handbook / 療育手帳), which has reassessment dates but does not technically expire.
The validity period runs from the date the application was received at the welfare desk to the end of the month 2 years later.
To continue using the certificate, you must apply for renewal (koushin / 更新). You can start the renewal process 3 months before the expiration date. The renewal requires a new diagnostic form (or updated pension certificate copy) and the same documents as the original application.
Do not let the certificate expire. If it expires, you will lose access to all the services and discounts that depend on it. Mark the expiration date in your calendar and start the renewal process early, because processing can take 1 to 3 months.
If your condition has changed, you can also apply for a grade change (toukyuu henkou / 等級変更) at any time during the valid period, without waiting for renewal.
Benefits and Services You Can Access
Disability Welfare Services
The certificate qualifies the holder for services under the shougaisha sougou shien hou (障害者総合支援法). These include day services, home helpers, short stays, group homes, and employment support services.
Tax Benefits
There are a variety of tax benefits, see Tax Benefits and Subsidies for People with Disabilities in Japan for more information.
Train and Bus Fare Discounts
Historically, train fare discounts were only available to shintai shougaisha techou and ryouiku techou holders. However, as of April 2025, JR companies have introduced fare discounts for seishin shougaisha hoken fukushi techou holders as well. The specific discount terms may differ from those for the other two certificates, so check with JR or your local railway company for the latest details.
Many private railways, bus companies, and some airlines also offer discounts, but availability varies by company and region. Check with your local transport companies. Read the article on travel discounts here.
NHK Fee Reduction
Households with a disability handbook holder may qualify for a reduction or exemption from NHK broadcasting fees.
For details: NHK Fee Exemption Information
Mobile Phone Discounts
Major carriers (NTT Docomo, au/KDDI, SoftBank) offer disability discount plans for people with disability handbooks.
Employment Support
The certificate qualifies the holder for disability employment (shougaisha koyou / 障害者雇用). Employers count disability handbook holders toward their legally required employment quota.
Self-Support Medical Care (Jiritsu Shien Iryou / 自立支援医療)
While not strictly a benefit of the handbook itself, many people who apply for the seishin shougaisha hoken fukushi techou also apply for the independence support medical care recipient certificate (jiritsu shien iryou jukyuusha shou / 自立支援医療受給者証) at the same time. This program reduces the medical cost burden for outpatient psychiatric treatment. The two applications can often be submitted together at the welfare desk. Ask about this when you apply. See our article on the jiritsu shien iryou jukyuusha shou for full details.
Other Local Benefits
Depending on your municipality, additional benefits may include: medical expense subsidies, taxi vouchers, reduced admission to public facilities, and more. The specific benefits available for seishin shougaisha hoken fukushi techou holders may differ from those for the other two certificates, so ask your welfare desk for the complete local list.
A Note for Parents of Children with Developmental Disabilities
If your child has a developmental disability (hattatsu shougai / 発達障害) such as autism, ADHD, or a learning disability, and does not have an accompanying intellectual disability, the seishin shougaisha hoken fukushi techou is likely the appropriate certificate. This can feel counterintuitive because the name of the certificate refers to “mental health,” and developmental disabilities are not mental illnesses. However, under Japanese law, developmental disabilities are classified within the scope of mental health for the purpose of this certificate.
The 6-month rule still applies: you must have had an initial visit to a medical institution for the developmental disability at least 6 months before applying. The diagnostic form can be completed by the psychiatrist or developmental specialist who diagnosed your child.
If your child has both a developmental disability and an intellectual disability, you may want to apply for both the ryouiku techou and this certificate, as each may provide access to different services and benefits.
Can You Hold More Than One Certificate?
Yes. A person can hold the seishin shougaisha hoken fukushi techou (Mental Disability Certificate / 精神障害者保健福祉手帳) alongside a ryouiku techou (Intellectual Disability Handbook / 療育手帳) or a shintai shougaisha techou (Physical Disability Handbook / 身体障害者手帳) (or both). Each handbook is independent.
The Card Format Option
Since 2019, some prefectures offer the seishin shougaisha hoken fukushi techou as a plastic card instead of a paper booklet. Both formats are equally valid. Tokyo began offering the card format in October 2020. Check with your prefecture to see if the card format is available.
The Mirairo ID Digital App
The Mirairo ID (ミライロID) smartphone app lets you store a digital copy of your disability certificate. Many businesses and transport companies accept it as proof of disability.
Practical Tips
- Track the 6-month date. You cannot apply until 6 months after the initial visit for the condition. Mark this date so you know when you can start the process.
- The 2-year renewal is critical. Unlike the other handbooks, this one expires. Put the expiration date in your calendar and start renewal 3 months early.
- Ask about the jiritsu shien iryou recipient certificate at the same time. The application can often be done together with the handbook application. It can significantly reduce your out-of-pocket costs for psychiatric outpatient treatment. See our article on the jiritsu shien iryou jukyuusha shou.
- If you receive a disability pension, use the pension certificate. Applying with the pension certificate copy instead of the diagnostic form saves you the diagnostic form fee and can simplify the process.
- The diagnostic form fee is out of pocket. Ask your hospital about the cost before your appointment.
- Check JR discount eligibility. As of April 2025, JR companies have begun offering discounts for this handbook. Ask at your local station for current terms.
- The handbook is not mandatory. You are not required to apply. Some people prefer not to for personal reasons, and that is perfectly fine.
- You do not have to disclose. Holding the handbook does not appear on any public records. You choose when and whether to show it.
Key Terms
| English | Japanese |
| Mental health and welfare handbook (also called a disability certificate) | seishin shougaisha hoken fukushi techou / 精神障害者保健福祉手帳 |
| Mental Health and Welfare Act | seishin hoken oyobi seishin shougaisha fukushi ni kansuru houritsu / 精神保健及び精神障害者福祉に関する法律 |
| Initial visit date | shoshinbi / 初診日 |
| Diagnostic form | shindansho / 診断書 |
| Renewal (required every 2 years) | koushin / 更新 |
| Grade change application | toukyuu henkou / 等級変更 |
| Developmental disability | hattatsu shougai / 発達障害 |
| Autism | jiheishou / 自閉症 |
| ADHD | chuui ketsujo tadousei shougai / 注意欠陥多動性障害 |
| Learning disability | gakushuu shougai / 学習障害 |
| Epilepsy | tenkan / てんかん |
| Schizophrenia | tougou shicchoushou / 統合失調症 |
| Mood disorder | kibun shougai / 気分障害 |
| Independence support medical care (reduces outpatient costs) | jiritsu shien iryou / 自立支援医療 |
| Disability pension | shougai nenkin / 障害年金 |
| Special (severe) disability status (Grade 1, higher tax deductions) | tokubetsu shougaisha / 特別障害者 |
| Disability welfare desk | shougai fukushi tantou madoguchi / 障害福祉担当窓口 |
Useful Links
- MHLW: Disability Certificates Overview
https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/hukushi_kaigo/shougaishahukushi/techou.html
- MHLW: Seishin Shougaisha Hoken Fukushi Techou Implementation Guidelines
https://www.mhlw.go.jp/web/t_doc?dataId=00ta4614&dataType=1&pageNo=1
- MHLW: Grade Assessment Criteria for the Seishin Shougaisha Hoken Fukushi Techou
https://www.mhlw.go.jp/web/t_doc?dataId=00ta4615&dataType=1&pageNo=1
- Saitama Prefecture: Seishin Shougaisha Hoken Fukushi Techou
https://www.pref.saitama.lg.jp/b0606/p-techou.html
- NTA: Disability and Tax
https://www.nta.go.jp/taxes/shiraberu/taxanswer/shotoku/1160.htm
- Mirairo ID (Digital Disability Handbook App)
