Creating a 'Kind System' for Childcare Centers

――Learning from real-world experiences and failures to build a 'kind system'
Reflections after attending Dr. Kishimoto's seminar: How to protect 'peace of mind in childcare'

Hello, I'm Tou.

I started writing this note as a 'personal memorandum,' but
I now want it to be read by 'nursery directors, head teachers, and staff who face children every day in the field.'

1. Introduction: To protect the 'best interests of the child'

The childcare field operates daily under the mission ofthe best interests of the child—but to truly support that 'best' interest, it is essential that the adults working in the field have
a system where they can work safely and healthilyin the first place.

How can we root 'occupational health systems' and 'external consultation services (EAP)' in childcare centers?
The goal is not just to 'install' a system, but to create one that is 'truly useful in the field.'
A seminar I recently attended by Dr. Yu Kishimoto (Occupational Physician/Psychiatrist) made me realize the essence of this and prompted me to think deeply about what we can do on the ground.

2. What is happening in childcare settings now

'I came to work this morning while unable to stop crying'
'A fellow teacher suddenly took time off'
'They returned to work, but then resigned again'...

I have started hearing these voices very often in childcare settings.
According to a **Tokyo Metropolitan Government survey (2022)**, the leave rate for childcare workers due to mental health issues is higher than the all-industry average, and it is not rare for centers to exceed 5%.

'Our center is small, so we're fine'—
The reality that this could happen at any time is right there, even for those who think that way.

3. Noticing the gap between 'policy' and 'field implementation'

'Occupational physicians are only for big companies, right?'
'We have fewer than 50 employees, so it doesn't apply to us'

—These are voices I often hear in the field.

It is true that under theIndustrial Safety and Health Act, the obligation to appoint an occupational physician only applies to workplaces with '50 or more employees.'
However, theduty of safety considerationimposes a 'legal responsibility on directors and management to protect the health and safety of staff,' regardless of the size of the center.

A 2021 Supreme Court rulinghas even recognized cases where 'management is held liable for damages if they neglect necessary health management or the use of external experts, even in small-scale centers.'

'Thinking about it only when something happens' is too late.
A serious system that bridges the 'gap' between policy and the field is required.

4. Field episodes of 'unsuccessful returns to work'

What the field really wants to know is not 'success stories,' but the 'honest truth about failures'—why things didn't work out.

● Case 1: Re-taking leave after being 'left to the individual'
Ms. B (a childcare worker in her 30s) went on leave for about 3 months due to depression caused by stress during the busy season and interpersonal relationship issues.
She and her doctor decided on their own that she was 'fine now' and requested to return to work, and the director approved it without deep verification, thinking 'if she says she can do it.'
However, she couldn't keep up with the previous pace from the first day, and those around her treated her like she was made of glass.
She pushed herself, saying 'I don't want to cause any more trouble,' and went on leave again after two weeks.
Her colleagues reportedly regretted it, saying, 'Leaving it to the individual was a mistake after all' and 'If only someone had stopped her...'

● Case 2: A field where 'encouragement' had the opposite effect
At Center C, everyone welcomed a returning teacher with applause.
The head teacher said, 'We've all been waiting for you! Let's do our best!'
However, that encouragement and expectation became pressure, and the person pushed themselves, thinking 'I have to do my best,' blamed themselves for small mistakes, and their health deteriorated again.

● Case 3: The failure of "leaving it only to the director and head teacher"
Often, managers and head teachers try so hard to "somehow provide support" that they end up taking on too much worry and stress themselves.
The mindset of "I must protect the atmosphere of the center" or "I must keep the staff together" can, conversely, spread "isolation" and "awkwardness" among the entire staff.

5. Learning from failure—to "avoid repeating the same stumbles"

There is always a "pattern" to these kinds of failures.

• The individual's tendency to overexert themselves or be overly considerate exceeds their limits

• The workplace expects the individual to "handle it themselves" or "return to normal all at once"

• Good intentions easily create pressure and a sense of isolation

• There was no place for consultation or a safe space to speak one's true feelings

That is precisely why, to avoid repeating the "same failure," I strongly feel that
preparing "systems" and "procedures" in the workplace is essential.

6. Thinking about the "essence of return-to-work support"—from Dr. Kishimoto's seminar

At a seminar hosted by the EAP Mental Health Counseling Association's West Japan Branch,
Dr. Kishimoto emphasized that "returning to work" does not mean "returning to how things were."
**"A sustainable, phased return-to-work plan"** is necessary.

It is important to create an atmosphere where both the returning employee and the workplace "do not overexert themselves."
When a third party (such as an occupational physician, EAP, or psychologist) is involved, "true feelings" and "real issues" come to the surface.

Those providing support should also "not carry the burden alone" and feel free to borrow external expertise—
Dr. Kishimoto's talk reaffirmed that the goal of systems and policies is not just "implementing them," but that the perspective of "how to operate them and how to provide accompaniment" is what is truly needed in the workplace.

7. [Column] A small initiative called a "Health Meeting"

Something I personally feel is important in the workplace is a small initiative called a "monthly health meeting."
Centers with fewer than 50 employees are not legally required to establish a safety and health committee.
Even so, I have realized that just by "casually discussing work styles and physical condition together once a month,"
the sense of security and psychological safety in the workplace changes significantly.

Rather than formalities or obligations, "small efforts that can be made in the workplace" are the primary foundation for mental health and teamwork.
These practices are also the core of my business project, "Sotosapo."

8. "5 Steps for Return-to-Work Support" that can be done at childcare centers

To prevent failure, I will summarize the "5 Steps for Return-to-Work" thatcan be used in the workplace "starting tomorrow."

Step 1. Preparation—Establish a shared understanding of "supporting everyone together"

• Once there is an intention to return to work, share information among the individual, attending physician, occupational physician, clinical psychologist, EAP, director, and head teacher

• Conduct thorough interviews to ask what kind of work style is possible and what areas are causing anxiety

• Establish an agreement that it is always okay to consult when in trouble

Step 2. Reinstatement Plan Agreement — "Gradual" Return Design

• Returning to full-time work or full duties immediately is not recommended

• Create a plan with all stakeholders to start with "shortened hours" or "lighter duties"

• Clearly define considerations and support personnel

Step 3. Initial Response — Be Careful During the "First Few Days"

• The first day of returning to work should basically be "short hours and few tasks"

• Appoint a support person and establish a system where they can talk immediately when in trouble

• If necessary, have an EAP or psychologist present to ensure a smooth start

Step 4. Progress Follow-up — Review Through "Regular Interviews"

• Hold regular interviews at 1 week, 1 month, 3 months, etc., after returning to work

• Create an atmosphere where it is okay to speak honestly without hesitation

• Reconfirm the agreement that "taking time off again is okay" if trouble arises

Step 5. Return to Normal Duties — "Reasonable" Gradual Independence

• Proceed gradually until the individual feels confident that they are "okay"

• Continue support even after a full return, such as "monthly EAP/psychologist interviews"

• Support each other across the entire center to ensure "no one carries the burden alone"

9. Adding Depth with "Voices from the Field" and "Honest Comments"

These kinds of voices often reach us from the field.

• "Everyone works so hard that they don't even notice their own SOS signals."

• “Just having a clinical psychologist on my side made a world of difference in my sense of security.”

• “Management also learned that it’s okay to say ‘you can talk to me when things get tough,’ so I no longer feel isolated.”

Conversely, when things didn't go well—

• “I took the person’s word that they would ‘do their best,’ and in the end, they collapsed again.”

• “I realized later that ‘encouragement’ from the workplace can sometimes become pressure.”

• “I was trying to push myself and carry everything on my own... I regret that.”

10. The peace of mind brought by EAPs (external consultation services) and clinical psychologists

You can safely talk to external experts (EAPs/clinical psychologists) about things that are hard to say within the center. Whether you are a director, head teacher, childcare worker, or part-time staff,
anyone can consult them.

Beyond just leave and return-to-work support,you can catch small, daily feelings of unease early on. Just stating clearly that ‘we have an EAP’ significantly increases the sense of security in the workplace.

Whether it’s a failure or a success, the outcome changes depending on whether there was a ‘place where you could speak your true feelings’—this is something I have realized from observing workplaces.
This is something I have realized from observing workplaces.

11. An actual episode from the field where a crisis was averted

For example, at one center,a clinical psychologist was in charge of return-to-work support.

• When someone wanted to return to work, the clinical psychologist first held a thorough interview. They carefully listened to things like, ‘What are you most anxious about?’ and ‘What kind of work style seems manageable?’

• The director and head teacher were also involved to design a realistic support system.

• Even after the return, the psychologist conducted regular follow-up interviews, staying close to the staff at a pace that didn't cause strain.

• Staff could also consult the psychologist individually about interpersonal relationships and communication worries.

The result—
‘Six months after returning, they are working stably without strain. It became the catalyst for all staff to create an atmosphere of “consult first,”’ said the director. Management and head teachers also began to feel that they ‘don’t have to carry everything alone,’ and
an atmosphere of the whole team supporting each otherwas born.

12. A checklist and examples of what to say that you can use in the workplace right now

Is your center okay? 10 signs that are easy to overlook

• Are you failing to see the ‘strain’ in someone who says ‘I’ll do my best’?

• Are they working full-time immediately after returning to work?

• Is there no designated support person for those who are struggling?

• Does everyone know about the existence of EAPs and psychologists?

• Are managers and head teachers able to say, "It's okay for me to seek advice too"?

• Is there an atmosphere where no one notices until the person says, "I can't take it anymore"?

• Are you demanding results and speed too soon?

• Is there a habit of sharing work and information within the team?

• Is there an atmosphere where it is "easy to report" failures and mistakes?

• Is there a culture of saying "Thank you" and "Good work today" to each other?

Examples of phrases you can use right away

• "Thank you for coming back. Don't push yourself; it's okay to go at your own pace."

• "If you feel overwhelmed again, please don't hesitate to tell me."

• "When you're in trouble, let's all help each other out."

• "Let's check in together from time to time to see if you're pushing yourself too hard."

13. Organizing systems and legal grounds in a friendly way

• Industrial Safety and Health Act Article 13: Centers with 50 or more staff must have an industrial physician.

• Labor Contract Act Article 5: Legal responsibility for health and safety regardless of size.

• 2021 Supreme Court Precedent: Even small centers are required to provide necessary health management and utilize external experts.

• Ministry of Health, Labour and Welfare: "Recommends utilizing external resources such as external industrial physicians and EAPs."

14. Tou's field experience

I myself have experienced the self-blame of thinking, "I've let them go on leave again..." while working in the field.

"I thought I was fine," "Everyone else is working hard, so I can't be a burden"—
I still wish I had listened to those voices sooner.

I truly believe that learning from mistakes together is the first step toward a kind workplace culture.

15. What is the "kind system" needed for future childcare centers?

Shortages of childcare workers, exhaustion in the field, and staff turnover—
these are serious problems everywhere.

However,

• Making external counseling (EAP) and industrial health not "special" things

• Managers and directors also "relying on others" and "taking care of themselves"

• Learning from mistakes together

Such a workplace culture will surely change the center, one step at a time.

"When you're in trouble, talk to someone first."
"Don't carry it all alone."
I feel that is the foundation of a "kind system."

Conclusion—A system that is "gently by your side"

To all the teachers working hard in the field, thank you for your efforts.

Please be kind to yourself, even when you are working too hard for the sake of others.
Instead of panicking after someone collapses, let's aim for a center where everyone can work in good health.