This month marks the time of year when suicides typically spike across the country. It’s appropriate, then, that March is Suicide Prevention Month in Japan.

To help raise awareness of the issue for this post, I spoke with two experts on the subject: Andrew Grimes, the director of Tokyo Counseling Services, a clinical psychotherapist with over 30 years experience working in Japan, and Samuel Annesley, the executive director of Tokyo English Life Line (TELL), a hotline aimed at helping foreigners in distress in Japan.

I began by asking Annesley why March historically sees such a high number of suicides in Japan. “In Japan, March comes right before the start of the new fiscal and academic year. Anxiety and fear peaks as people worry about starting a new job or going back to school after spring vacation. This can be overwhelming for people and cause them to think about suicide.”

He added that foreigners in Japan are especially at risk given the “lack of immediate family support, fewer social networks and little in terms of support services available in their native language.”

Both Grimes and Annesley share the view that access to such services for foreigners in Japan — especially in more rural areas — is extremely limited.

However, Grimes struck a positive note on the weighty subject when I asked him about the number of patients he has helped through the years. “Suicide numbers shot up in 1998, coinciding with the bursting of Japan’s ‘bubble economy’ the previous year. Since then, we’ve seen an increased number of people seeking counseling and support. There is still a long way to go but certainly there is less stigma around seeking professional help in Japan than there was 20 years ago.”

So, with the parameters and the problem firmly established, what exactly can we do about it? I asked both experts what I should do if I suspect a friend is at risk.