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The following presentation slides are shared with symposium participants exclusively for personal, non-commercial,educational purposes.

● このスライドの著作権は、講演の発表者本人に帰属します（図表等の引用箇所は除く）。如何なる国・地域においても、また紙媒体やインターネット・電子データなど形態に関わらず、スライドの全部または一部を無断で複製、転載、配布、送信、放送、貸与、翻訳、販売、変造、二次的著作物を作成すること等は、固く禁止します。
Copyright of these slides belongs to the presenter and/or the Radiation Medical Science Center for the Fukushima
Health Management Survey, Fukushima Medical University (except figures, tables, etc., cited from other sources).
It is strictly prohibited to reproduce, reprint, distribute, transmit, broadcast, loan, translate, sell, modify, and/or
create derivatives of any slides, in any physical or electronic medium anywhere in the world.

2024年 福島県立医科大学『県民健康調査』国際シンポジウム
公立大学法人福島県立医科大学放射線医学県民健康管理センター
国際シンポジウム事務局（広報・国際連携室）✉ kenkani@fmu.ac.jp Tel: 024-581-5454(平日9～17時)
2024 Fukushima Medical University International Symposium on the Fukushima Health Management Survey
Secretariat of International Symposium
Office of Public Communications and International Cooperation, Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University✉ kenkani@fmu.ac.jp, TEL: +81-24-581-5454 (Weekday, 9a.m. - 5 p.m. JST)

Mental Health and Lifestyle Survey

Current issues of mental health among
affected people after the Fukushima disaster:
The importance of human bonds in society
Fukushima Medical University

HORIKOSHI Naoko, MAEDA Masaharu
1Purpose of MHLS （Mental Health and Lifestyle Survey）
MHLS aims to➢Follow mental health and lifestyle-related issues among
affected people based on a long-term view
➢Provide adequate, individually tailored support involving
health and welfare service according to results of MHLS

We are conducting telephone support for affected
people at risk of physical and/or mental health problems.
2

Survey population• Approximately 210,000 residents who, at the time of the disaster,
were living in 13 municipalities that were designated by theJapanese government for evacuation.

• We divided all the participants into 5 groups according to age.
①Age 0-3②Age 4-6③Elementary school (age 7-12）④Junior high school (age 13-15)⑤Adult (16 years and older)This survey has been performed yearly since January 2012.
3

Main survey items➢ Children (under junior high school age)
Strengths and Difficulties Questionnaire (SDQ: age 4+),
subjective health, height and weight, sleep, exercise, eating habits,
presence or absence of developmental or psychological problems.

➢ Adults (16 years and older)
General mental health (K6), trauma (PCL), subjective health,height and weight, medical history, diet, sleep, smoking,alcohol consumption, exercise, radiation risk perception, etc.

※Free description(Free space to state any questions or concerns about the survey)

4

Results of the survey

5Response rate%7063.4

60Adults

Children

50%
5040403030

25.6

2013.9 15.8

1000
H27R2R3

23.8

2010H2340.7

H23H2720.0 21.3

R2R3

From the report to the 48th Prefectural Oversight Committee meeting6Strengths and Difficulties Questionnaire(SDQ)
Proportion of children with 16 points or higher%＊ The high-risk proportion in non-affected areas is 9.5%.

3025（Matsuishi et al, 2008）
24.4
22.0

20
15
1016.2
13.7
10.8

7.0 6.9

9.0 8.0

H23 H27 R2R3

H23 H27 R2R3

11.6 10.9
8.4

9.5％

504歳～6歳
Age 4-6

Age7-12
小学生

H23 H27 R2R3
Age
13-15
中学生

From the report to the 48th Prefectural Oversight Committee meeting7

Proportion of adults at high risk of generalmental health problems, based on K6%
2015＊ 13 points or higher in K6

14.6＊High-risk proportion among the general populationin Japan: approximately 3.0% (Kawakami et al. 2007)

10
7.1
5.2

6.1

53.0％

0
H23H27R2R3

From the report to the 48th Prefectural Oversight Committee meeting8Frequency of daily exercise among adults
Aimost everyday
2011

14.9

201516.2

2020

18.3

2021

16.50%

2-4 times a week

20.3

13.9

24.8

42.7

16.8

24.6

38.8

17.8
40%

Rarely

50.9

16.2

26.1

20%

Once a week

41.1
60%

80%

100%

From the report to the 48th Prefectural Oversight Committee meeting
9Changes in proportion of those disclosing evidence ofproblematic drinking(2 points or higher in CAGE), by gender
%

25
20.5

20

17.2
15.3 14.5

1510.5

10

9.0

8.0

6.6

50
H24

H27

男性
MenR2

R3

H24

H27

R2

R3

Women
女性
From the report to the 48th Prefectural Oversight Committee meeting10Changes in risk perception ofnext-generation radiation effects
Possibilities are very low

2011

15.2

2015

Possibilities are low

Possibilities are high

24.6

25.3

29.0

2020

23.9

2021

24.9
0%

Possibilities are very high

34.9

33.3

22.0

48.9

15.6

22.4

50.8
20%

40%

20.6
60%

80%

4.8
3.7
100%

From the report to the 48th Prefectural Oversight Committee meeting11

Risk perception of next-generation radiation
effects in FY2021 Survey,
by location of residence at the time of the survey
Possibilities are very low

Possibilities are low

Fukushima Prefecture

25.0

Other Prefecture

24.80%

Possibilities are highPossibilities are very high

51.5

20.2

45.8

20%

40%

23.6

60%

80%

3.3

5.8

100%

From the report to the 48th Prefectural Oversight Committee meeting
12FY2020
Consultations(multiple responses)

Family/ relatives

27,272

Friends/ acquaintances

15,602

Primary care doctor, Clinic, Hospitals andGeneral Medical Institution

9,027

Municipal consultation service

7,055

Psychiatry related medical facility
including psychosomatic medicine,…

4,036Colleagues/ superiors

3,138

Visiting care/nursing care service
organization

2,288

Prefectural consultation service

1,576

Fukushima Center for Disaster Mental
Health1,014

Mental Health and Welfare Center

647

Relligious organization

566

Others249

Have no one to cinsult with3,672
05,000 10,000 15,000 20,000 25,000 30,000 people

From the report to the 45th Prefectural Oversight Committee meeting13

People not having someone to consult
Proportion of those in MHLS ： approx. 11%【 Profile 】
🔹40～64

It is important toask if the person
has someone toconsult with.

🔹Male🔹Poor financial state🔹Living aloneNot having

HavingK6≥1316.2％

5.6％Problem drinking
CAGE≥2

21.5％

13.5％

General mental healthHorikoshi et.al., IJERPH, 2021, 18(19):10075.

14

The impact of the presence of family members
who can be consulted, and psychological stress
Who are the people who have not been able to consult
their families?
We suggest that asking evacuees whether they not only havepeople to consult, but also whether they are able to consult
their families, could lead to early detection of high risk
individuals.
Those who did not consult family members had a 1.33 times
higher risk of K6 (≥5 points) than those who did.

Horikoshi et al, Abstracts of the 81st Annual Meeting of the Japanese Society of Public Health, 399, 2022.

15

Connecting response results
to support

16

【Connect with affected people】

Outreach telephone support➢We provide outreach telephone support for therespondents identified as in need of support
according to the results of MHLS.

➢The telephone support is conducted with active
listening and includes secondary screening,suggestions, psychoeducation, and referral to otherfacilities (clinics, local care centers, etc.) asneeded.
➢Approximately 40,000 respondents in total havereceived the support so far.
➢On-call service is also available for all the eligible
people seeking help, not limited to those at high risk.

Support team (approx.20members)
Medicaldoctors

PublichealthnursesClinical
psychologists

Supportteam
Socialworkers

NursesMentalhealthsocialworkers

17Criteria for supportChildren (≤15)

Adults (≥16）➢ Emotional andbehavioral problems（SDQ）➢ Developmental issues➢ Someone to consult
with➢ Problems in school➢ Other troubles➢ General mental health （K6）
➢ Posttraumatic responses （PCL）➢ BMI➢ Past and current medical
history （physical and mentalissues）➢ Sleep➢ Smoking➢ Problem drinking （CAGE）➢ Other troubles＊These criteria may change depending on the survey year18Confirm selection criteria for telephone
support through interviews
Eight months after the start of the study, we conductedinterviews with affected people and others sheltered in
temporary housing. The results showed that thescreening efficiency of the selection criteria for
telephone support at that time was adequate.

【 Research in the affected areas 】
This interview survey was positioned as a survey withsupport, and the surveyors were public health nurses andothers who had received prior training. We asked oursurveyors to visit the affected areas and to bring maps ofFukushima Prefecture and blood pressure monitors withthem. We believe that the fact that the PHNs, as surveyors,
were able to directly listen to the needs of the evacuees andprovide advice on living during the evacuation at the sametime, served as a model for future surveys to be conductedin the affected areas.
19Impressions of ourtelephone support
Satisfaction with intervention（n=358）

26.8

47.8

16.5

Understanding of the participant's feelings（n=354）

31.6

48.3

Protection of privacy（n=358）

29.6

54.7

0

very satisfied

satisfied20

dissatisfied

40

60

12.1

8.9

7.9

8.1 7.580

100

very dissatisfied

From the report to the 31th Prefectural Oversight Committee meeting20【Connect with supporters】

Connect withvarious support organizations➢We believe that having regular opportunities for information sharing
with municipalities, the Fukushima Center for Disaster Mental
Health, and other support organizations, and understanding eachother's situations will enable prompt response to the problems of
the affected population and provide a wide range of support.
Municipalities

Fukushima Prefecture
The Mental Health Support Team

Clinics, hospitals

Fukushima Center for Disaster
Mental HealthNPO, other care resources21

【Connect with the community】

Connect with municipalities
in the affected area
➢Understanding and cooperation with the implementation of

the survey
Letter from the municipality enclosed with the survey form
Questionnaires incorporating opinions of the municipality➢Sharing of support information
Regular information exchanges on individual cases in all 13 municipalities
meeting➢Seamless support for affected people in need
Support through visits and ongoing support➢Effective use of accumulated data
Use in PR magazines, health education, comprehensive plans ofmunicipalities, etc.
22

【Connect with time】

Strengths of long-term support➢The importance of looking after each and every affected

person every year through the survey form.
・ Ten years after the disaster, affected people gave theiranswers for the first time
Sometimes people need time to come to terms with the disaster・ Support for affected people who have not responded tothe survey.
From the interview survey, we found that non-respondents wereemployed, socially isolated, and had psychological stress reactions. As
they were people with high psychological stress reactions, direct support
was not possible, but information on various counselling services andleaflets to enhance self-care were enclosed with the survey form.
Horikoshi et.al., Fukushima J Med Sci, 2017, 63(3), 152-9.

23

Summary➢ We found that children's and adults' mental health improved markedly

compared to the first year, but for adults, recovery has since sloweddown and is still higher than the national indices. On the other hand,
there was a gradual improvement in lifestyle habits, such as exercise
and problem drinking.
➢ We have provided telephone support with approximately 3,000 calls per

year, and in total more than 40,000 affected people have been reachedso far. The results of the interview survey showed that satisfaction withthe telephone support was generally high and showed some usefulness.
➢ In the course of our survey and support, we feel the importance ofconnections, including various people, organizations and time, such asindividuals ( affected people), supporters (various support organizations),communities ( affected municipalities, etc.), and time (long-term support).
24

● このスライドは、非営利かつ個人的な目的に限り閲覧することができます。
The following presentation slides are shared with symposium participants exclusively for personal, non-commercial,educational purposes.

● このスライドの著作権は、講演の発表者本人に帰属します（図表等の引用箇所は除く）。如何なる国・地域においても、また紙媒体やインターネット・電子データなど形態に関わらず、スライドの全部または一部を無断で複製、転載、配布、送信、放送、貸与、翻訳、販売、変造、二次的著作物を作成すること等は、固く禁止します。
Copyright of these slides belongs to the presenter and/or the Radiation Medical Science Center for the Fukushima
Health Management Survey, Fukushima Medical University (except figures, tables, etc., cited from other sources).
It is strictly prohibited to reproduce, reprint, distribute, transmit, broadcast, loan, translate, sell, modify, and/or
create derivatives of any slides, in any physical or electronic medium anywhere in the world.

2024年 福島県立医科大学『県民健康調査』国際シンポジウム
公立大学法人福島県立医科大学放射線医学県民健康管理センター
国際シンポジウム事務局（広報・国際連携室）✉ kenkani@fmu.ac.jp Tel: 024-581-5454(平日9～17時)
2024 Fukushima Medical University International Symposium on the Fukushima Health Management Survey
Secretariat of International Symposium
Office of Public Communications and International Cooperation, Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University✉ kenkani@fmu.ac.jp, TEL: +81-24-581-5454 (Weekday, 9a.m. - 5 p.m. JST)