Last updated 10:19, May 18 2018
ISSEI KATO
Martha Savage, the mother of a New Zealander Kelly Savage (portrait), who died in Japanese psychiatric hospital in May 2017.
Martha Savage, the mother of a New Zealander Kelly Savage (portrait), who died in Japanese psychiatric hospital in May 2017.
A Kiwi teacher died in a Japanese psychiatric hospital. His family wants answers - and change. Bess Manson reports.
In the grip of a psychotic episode, Kelly Savage thought the treatment he was undergoing at a Japanese hospital would lead to his death.
He was distressed and he was paranoid. But he was also right.
The New Zealander died on May 17, 2017, after being held in restraints nearly continuously for 10 days at Yamato Psychiatric Hospital in the southern prefecture of Kanagawa.
On the 10th day he suffered a heart attack. He was later revived, but never regained consciousness.
His family have been campaigning to stop the 'terrifying' practice of long-term restraints on psychiatric patients in Japanese hospitals to spare other families going through the same agony of losing a loved one.
Last week - a year to the day their son died - they were in Japan to deliver a petition to the Japanese Minister of Health, Labour and Welfare with more than 6000 signatures calling for the Government to stop the use of body restraints for long periods of time (24 hours or longer) in psychiatric hospitals.
Kelly Savage had a long held fascination for the Japanese culture.
A life-long love of Japan
Kelly Savage was 27 when he died in Japan - a country he had long held a fascination for.
Born in Reno, Nevada, he had moved with his family to Wellington in 1995 when he was five. After Onslow College, he went on to Victoria University where he had graduated with a double major in Japanese and psychology in 2015.
He and his older brother Patrick had both been on student exchanges in Japan and Patrick had later moved to Yokohama where he had married a Japanese woman.
In 2015, Kelly, too, moved to Japan to take up a teaching job in Shibushi, a city in the prefecture of Kagoshima where he taught English to primary and middle school children under the Japanese Government's JET programme.
Kelly Savage was a charismatic English teacher under Japan's JET programme for almost two years.
The kids loved him, says his mother Martha Savage, a professor of geophysics at Victoria University.
After his death she would receive books full of poems and letters from many children he had taught saying how much they appreciated him as their teacher, how much they missed him.
Kelly had been there almost two years when he had a manic episode.
He had suffered depression for about five years and had had one previous psychotic episode in Wellington after which he spent a month in a psychiatric hospital. He was put on medication usually prescribed for those with bipolar, though he had not been formally diagnosed with that condition.
In early 2017 he began taking his psychiatric medicine irregularly and in April his psychotic symptoms began appearing. He went to be with his brother and his father Mike, who was visiting at the time, in Yokohama City, but his symptoms worsened.
He was compulsorily admitted to a psychiatric hospital on April 30.
Kelly Savage with his parents, Martha and Michael, during his graduation from Wellington's Victoria University.
Restraining like torture
Kelly had not harmed himself or anybody else, says Savage, and had calmed down before arriving at the hospital. But on admission he was tied to his bed with restraints on his wrists, ankles, and waist.
"When Patrick took him to the hospital he was asked to pay for diapers because Kelly would be restrained for a long time," Savage says.
"They tied him up in what they called body restraints from his ankles to his torso and arms. He wasn't able to move. We had thought we were doing the right thing, that he would be safe in the hospital, but he wasn't.
"The treatment - restraining and keeping patients in isolation - it's torture. It's like something out of the Middle Ages."
The family was not allowed to visit Kelly for the first seven days because it was the 'Golden Week' holiday and there were not enough personnel to allow for family visits, she says.
Kelly Savage died after spending 10 days strapped to a psychiatric hospital bed in Japan.
"After that, Mike and Patrick were only allowed to see Kelly for 20 minutes a day. They were afraid to make too much of a fuss in case they were stopped from seeing him at all.
"[They] had brought him to the hospital for help and [doctors] were supposed to help him. If we had known then what we know now we would have complained more.
While she was en route to be with her son, Kelly had a heart attack.
She arrived to be met with the news that he had been moved to another hospital where he was on life support.
A later brain scan showed there was no function.
A week later he was dead.
"After he died we talked to the psychiatrist about what had caused this death and one said they thought it was because of deep vein thrombosis - economy class syndrome - caused by the restraints."
Savage asked Yamato Hospital to provide his medical records and for them to investigate whether they should stop using restraints for such a long time on psychiatric patients so that other people would not suffer a similar fate. The hospital refused to acknowledge any wrong-doing and there was no coronial process, she says.
"Kelly's autopsy was inconclusive. There was no underlying heart or lung condition and there was no blood clot, which would have been the smoking gun.
"But it doesn't matter - the main point was that he was physically healthy when he went in and whatever they did to him he had this heart attack on their watch and they didn't do enough about it.
"Even if being tied up didn't have anything to do with him dying it's a terrible for a psychiatric patient's well-being."
Martha Savage attended a news conference in Tokyo, Japan in July 2017 to speak about the death of her son Kelly in a psychiatric hospital.
Campaign for change
Toshio Hasegawa - a professor of health sciences at Kyorin University in Tokyo - has been campaigning against restraints for some time and approached the Savages to assist with their efforts to stop the practice of restraining patients in Japanese psychiatric hospitals.
Most of the petition's 6010 signatures are from the general public, but also from health professionals all over the world, says Savage.
United Nations rules state that restraint should not be "prolonged beyond the period which is strictly necessary for this purpose".
Professor Hasegawa says that for those placed under restraint, the average duration in Japan was 96 days, and it was common for hands, legs, and waist to be secured to the bed frame.
The latest data available, from 2014, suggested roughly 10,000 psychiatric ward patients were under restraint in Japanese hospitals.
Reaction in Japan to Kelly's death opened up the discussion around restraining practices, says Savage.
"In Japan people are reluctant to talk about any psychological problems they or their family may have. They want to hide problems to keep up appearances of everything being perfect. That's one reason why no-one was complaining about it before.
"I think we're the first people to say, at least publicly, 'look, this is not OK',.
An emotional journey
The gathering of signatures and her fight to change the laws in Japan has been an emotional and sometimes cathartic journey.
"I don't have Kelly to take care of any more so I want to take care of other people, to put my efforts into his memory by trying to keep other people from suffering the way he did. It's part of my connection to him, to keep up the fight, and I'm not going to let go. I'm going to be a thorn in their side until they make a change."
Savage was able to see her youngest son once while he was in hospital, Skyping him from New Zealand.
But she's still haunted by Kelly's last conversation with his brother the day before he died.
"Kelly had asked his brother Patrick not to leave him, that they were going to kill him, that he would never see him again. And he was right."