TOKYO (Reuters) - All the phones at a Japanese suicide hot line started ringing at 8:00 p.m. on a Friday night, exactly when it opened, filling a narrow room off a Tokyo back street with the voices of those trying to help.
"Is it trouble at work, or something at home?" asked Machiko Nakayama, a hot line volunteer in her 60s, speaking softly into her headset. "You feel like you want to die?"
In Japan, a place known for personal reserve, experts and volunteers say allowing people to express their innermost feelings has helped reduce suicides by nearly 40 percent from their 2003 peak.
"The fact that I couldn't talk about my feelings at all became oppressive," said author and suicide activist Akita Suei, whose mother killed herself in 1955, when he was a child. "So once I finally was able to talk ... all of a sudden my mood became much lighter."
Operating every day, almost always from 8 p.m. to 5:30 a.m., the phones at Befrienders Worldwide Tokyo are rarely silent, staffed by about 40 volunteers working four at a time in three-hour shifts.
"If the phones stop ringing for a few minutes, we worry they're broken," said Nakayama, who volunteered for 20 years and now is the director.
Befrienders is one of scores of organisations operating hot lines around Japan. They advertise with messages like "Are you down? There are people to help lift you up" in Tokyo's vast network of subways, the site of many suicide attempts.
"There are still very closed-off aspects to society here; it's really hard to talk about personal things - especially for men, who since the old days have scorned 'letting things out,'" said Yoshie Otsuhata, subdirector of the helpline.
Most callers are in their 30s and 40s, with 56 percent of them women and 43 percent men in 2018.
About 450 kilometres north of Tokyo, largely rural Akita prefecture, which for decades had the highest suicide rate in Japan, also emphasizes outreach. Alongside hot lines, there is a network of trained "listeners," who connect with the area's lonely and isolated elderly.
Sumiko, a formerly active 73-year-old woman who is largely bedridden after a fall, thought there was no meaning to life until Ume Ito, a "listener," started visiting two years ago.
"Everyone left for the day. People would call, but they'd just say 'keep fighting' and hang up really soon," recalled Sumiko, wearing a pink bathrobe as she sat in a hospital bed in a windowless inner room of her son's home, two mobile phones propped on a nearby dresser.
Ito said most of the people she visits insist at first that they want to die. But over weeks and months, their mood brightens.
"Our work is to give them enough space in their hearts to think," she said.
Sumiko, whose health is gradually improving, says Ito's visits have given her a new goal.
"I want to get stronger as fast as possible and become a listener," she said. "If I could help even just one or two people, that'd be great."
(Additional reporting by Mayuko Ono; Editing by Gerry Doyle)