Toyoko Kids: A case series on the psychosocial backgrounds of eight runaway girls transported to emergency care in Tokyo.

AIM: Runaway behavior, defined as leaving home without parental permission and not returning, is associated with adverse educational, physical, and mental health outcomes. In Japan, since around 2018, a group of runaway adolescents known as "Toyoko Kids" has emerged in Tokyo's Kabukicho area, reportedly engaging in substance use, violence, and prostitution. This study aimed to examine the psychosocial characteristics of Toyoko Kids who were transported to emergency care due to impaired consciousness from drug overdose or alcohol intoxication.

METHODS

We conducted a retrospective chart review of eight female adolescents under 18 years old, transported from Kabukicho to Keio University Hospital between June 2022 and August 2023. Inclusion criteria included having run away for at least two nights (or one night for those under 15) and being transported by a third party. A multidisciplinary team assessed psychosocial risks using a Bio-Psycho-Social model. Data on consciousness level, pregnancy, substance use, self-harm, psychiatric history, family structure, school attendance, abuse, and child welfare involvement were analyzed and compared with national statistics.

RESULTS

All subjects were female, aged 12-16. The most common reason for transport was impaired consciousness due to overdose, primarily involving over-the-counter medications. Self-harm was confirmed in 86% and abuse in 67% of cases. Although several had prior psychiatric or welfare intervention, support was often temporary and insufficient. Most came from single-parent households, and over half had a history of school absenteeism.

CONCLUSIONS

This study identified severe psychosocial vulnerabilities among Toyoko Kids. Findings highlight gaps in mental health and child protection systems.