Japan expands mandatory stress checks to all workplaces from 2028

Japan is set to significantly broaden the reach of its workplace mental health regime by extending mandatory stress check requirements to all workplaces, regardless of workforce size. From 1 April 2028, workplaces with fewer than 50 employees will become subject to the same annual stress check requirements that have applied to larger workplaces since 2015.

Background

Japan introduced its stress check system in 2015 under the Industrial Safety and Health Act as part of a broader initiative to address workplace mental health risks and encourage preventive measures before employees develop more serious psychological health concerns. Since its introduction, employers operating workplaces with 50 or more employees have been required to conduct annual stress assessments and facilitate access to occupational health support for employees identified as experiencing high stress levels. Workplaces with fewer than 50 employees have been subject only to a best-efforts obligation to conduct stress checks, meaning employers were encouraged, but not legally required, to implement the program.

The Act Partially Amending the Industrial Safety and Health Act and the Working Environment Measurement Act was promulgated on 14 May 2025 and removes the long-standing exemption for workplaces with fewer than 50 employees. Cabinet Order No. 195 of 2026 was issued on 10 June 2026 and confirmed that the changes will take effect on 1 April 2028, providing smaller employers with a transition period to establish the necessary compliance framework and occupational health arrangements.

Key details

From 1 April 2028, all workplaces in Japan, regardless of workforce size, will be required to conduct annual stress checks for eligible employees. Key features of the regime include:

• Annual stress assessments: Employers must arrange for stress check assessments to be conducted at least once each year. Employers may create their own questionnaires, provided they meet specific statutory and scientific requirements including psychological stressors (e.g., job demands and workload), psychological and physiological stress reactions (e.g., symptoms of anxiety or depression), and social support in the workplace (i.e., support from supervisors and coworkers). They may also use the official stress check questionnaires created by the Ministry of Health, Labour and Welfare (MHLW) here (opens a new window). While employers are required to implement the program, employees are not obligated to undergo a stress check and must not be treated unfavorably for declining to participate.

• Qualified administrators: Stress checks must be overseen by appropriately qualified occupational health professionals, such as physicians or public health nurses.

• Strict confidentiality requirements: Individual results must be disclosed directly to employees and may not be shared with employers without the employee's explicit consent.

• Medical follow-up for high-stress employees: Employees identified as experiencing high stress may request an interview with a physician, and employers must facilitate this process and consider any resulting recommendations.

Employer action: ACT

The reform is expected to have the greatest impact on small and medium-sized employers that have previously been subject only to a best-efforts obligation. These organizations will now need to establish formal procedures to comply with the law. Implementation guidance and resources from the MHLW are available here (opens a new window) and here (opens a new window). Employers should also continue to monitor future guidance from the MHLW.

Employers that currently operate workplaces with fewer than 50 employees should begin preparing in advance of the 1 April 2028 implementation date. This preparation may include engaging a qualified occupational health professional, developing annual stress check procedures, communicating the upcoming requirements to employees and managers, and reviewing existing mental health and wellbeing policies. Organizations that take proactive steps now may be better positioned to support employee wellbeing, mitigate mental health risks, and demonstrate compliance with Japan's evolving occupational health requirements.

Further Information

Stress Check System & Mental Health Measures | Ministry of Health, Labour and Welfare (opens a new window)

Laws and Regulations Related to the Stress Check System | Ministry of Health, Labour and Welfare (opens a new window)