We kindly ask you to answer according to the category that applies to you. Thank you for your cooperation!
1. How long have you felt disconnected from school, work, or social activities?
- A. Less than 6 months
- B. 6 months to 1 year
- C. 1–3 years
- D. Over 3 years
2. What do you think are the main reasons you withdrew from school or work?
- A. Academic or work pressure
- B. Bullying or negative social experiences
- C. Mental health struggles (e.g., anxiety, depression)
- D. Lack of interest or motivation
- E. Family issues or conflicts
- F. Other (please specify): _______
3. How comfortable are you with talking about your feelings and struggles with family members?
- A. Very comfortable
- B. Somewhat comfortable
- C. Neutral
- D. Somewhat uncomfortable
- E. Very uncomfortable
4. Do you feel that school or work pressures played a role in your decision to disengage?
- A. Yes, a significant role
- B. Yes, somewhat
- C. Neutral
- D. No, not really
- E. No, not at all
5. Have you experienced bullying or negative social interactions that contributed to your current situation?
- A. Yes, frequently
- B. Yes, occasionally
- C. Neutral
- D. No, rarely
- E. No, never
6. How often do you feel overwhelmed by societal expectations to succeed academically or professionally?
- A. Always
- B. Often
- C. Sometimes
- D. Rarely
- E. Never
7. What support, if any, have you received from your family regarding your current situation?
- A. Emotional support (listening, encouragement)
- B. Financial support
- C. Professional support (e.g., arranging counseling)
- D. Minimal or no support
- E. Other (please specify): _______
8. Do you think your mental and emotional well-being has been affected by being hikikomori or NEET?
- A. Yes, significantly
- B. Yes, somewhat
- C. Neutral
- D. No, not much
- E. No, not at all
9. How do you typically spend your time during the day?
- A. Sleeping or resting
- B. Watching TV, streaming, or gaming
- C. Browsing the internet or social media
- D. Reading, studying, or personal hobbies
- E. Other (please specify): _______
10. How often do you communicate with friends or family members about your situation?
- A. Daily
- B. Weekly
- C. Occasionally
- D. Rarely
- E. Never
11. Have you sought professional help (counselor, therapist, etc.) for your emotional struggles? Why or why not?
- A. Yes, and it helped
- B. Yes, but it didn’t help
- C. No, because I’m not ready
- D. No, because I don’t believe it will help
- E. No, because I don’t know where to go
12. How do you feel about the level of support available to people like yourself who are hikikomori, NEET, or dropouts?
- A. There’s plenty of support available
- B. There’s some support, but it’s not enough
- C. Neutral
- D. There’s very little support
- E. There’s no support at all
13. What role do you think social isolation plays in your current lifestyle?
- A. It’s the main reason for my struggles
- B. It’s a contributing factor
- C. Neutral
- D. It plays a minor role
- E. It doesn’t play a role
14. How important do you think it is to eventually re-enter society, through work or education?
- A. Extremely important
- B. Important
- C. Neutral
- D. Not very important
- E. Not important at all
15. What steps have you taken to try to re-engage with school, work, or social activities?
- A. Attending counseling or therapy
- B. Joining community or support groups
- C. Looking for part-time or flexible jobs
- D. Studying or learning new skills at home
- E. None
16. How has your relationship with your parents or guardians changed since becoming hikikomori or NEET?
- A. It has improved
- B. It has stayed the same
- C. It has become strained
- D. It has worsened significantly
17. How do you cope with feelings of loneliness or hopelessness?
- A. Talking to friends or family
- B. Focusing on hobbies or distractions
- C. Seeking professional help
- D. Avoiding or ignoring the feelings
- E. Other (please specify): _______
18. What would make it easier for you to seek help or support for your situation?
- A. More affordable mental health services
- B. Greater understanding and empathy from others
- C. Easier access to information about support options
- D. A more welcoming and non-judgmental environment
- E. Other (please specify): _______
19. Do you believe there is a stigma around being hikikomori, NEET, or a dropout in Japan?
- A. Yes, and it affects me greatly
- B. Yes, but I try not to let it bother me
- C. Neutral
- D. No, not much stigma
- E. No, no stigma at all
20. How can society better support individuals like yourself who struggle with social withdrawal or disengagement?
- A. Offering more counseling and mental health services
- B. Providing flexible work and education options
- C. Increasing public awareness to reduce stigma
- D. Supporting families to better help individuals like you
- E. Other (please specify): _______