Initiatives of Each Department
Ishinomaki Regional Center Community Support Division

Regarding the activity status of the FY2014 Ishinomaki Regional Center
Ishinomaki Regional Center

Community Support Division

Psychiatric Social Worker - Hiromi Arai
1. Introduction
Four years have passed since the Great East Japan Earthquake and the path towards recovery is underway
as infrastructure development in disaster-stricken areas in the Ishinomaki area has gradually advanced.
Along with this, reconstruction aid groups have progressively begun to withdraw from the affected areas.
In the affected areas, municipalities have begun to work on rebuilding new communities, including
individuals who have rebuilt their homes independently or relocated to public housing. On the other hand,
while some individuals are still coping with pain from the earthquake, others see no prospect in rebuilding
their lives with apartment type temporary housing or container type temporary housing. New problems,such as widening disparities in reconstruction, especially those related to alcohol, are also emerging.
In the following, we report future efforts, as well as the activities carried out by employees, seconded to
Ishinomaki Regional Center, Higashi Matsushima City, Onagawa Town, the Eastern Health and Welfare
Office, and Ishinomaki City in FY2014; in such circumstances.
2. Initiatives for FY 2014
( 1 ) Support for Local Residents① FY 2014 Health Survey Follow-Up Support (Table 1)
Miyagi Prefecture and municipalities jointly conducted a health survey of residents living inapartment type temporary housing and container type temporary housing in the prefecture. As a result,the Ishinomaki Regional Center received one-on-one interview follow-up requests from 159 individuals
in 132 households (container type temporary housing) from the Ishinomaki City, regarding the two items,"K6 results with 13 points or above" and "Start drinking alcohol from the morning or noon." Of the 109
patients who responded saying they were unable to sleep in the K6 questions (all questions), 66 havebeen prescribed sleeping pills and 16 are seeing a psychiatrist. Ninety-five individuals are 60 years orabove, and in many households, these individuals are worried about the economy as well as their healthas they say their “health has deteriorated after the disaster,” and that they find it “difficult to live.” The53 people who responded saying they drink from the mornings said, "I responded in the wrong column,""I was referring to non-alcoholic drinks but entered it anyway," "I drink when I have no plans or on
holidays and do not drink in large quantities." Therefore, few individuals were suspected to have drinking
issues, and the 6 people who did were given continuous support. Twenty-three households were provided
with such continuous support.

- 15 -

Table 1 Survey Implementation Status of Container Type
Temporary Housing Residents
Container Type Temporary Housing Resident Survey Date
Health surveys by
prefectures/municipalities

For FY2014 (September-November 2014)

Time of the first visit

Mid-January-End of February 2015

Number of households to which
we provided support visits

132 households

Number of households
continuously receiving support(repeat)23 households*Follow-up support for apartment type temporary housing residents’ health surveys in FY2014
will be implemented from April 2015.
② Consultation Support
Direct consultations from the disaster victims themselves or their families have increased among
the residents affected by the earthquake; since FY2014. There was an increase in consultations
regarding mental illness, alcohol, elderly health, living environment, resident troubles, mother-child/ family relationship, etc. About mental illness, there were many consultations with individuals who
seemed untreated. Besides, the number of trauma-related consultations that seemed to be caused by
the disaster and the pain of the earthquake also increased. We partnered with a psychiatric hospitalto provide appropriate treatment since some individuals requested to talk with a doctor or seemed
to need a medical examination. Furthermore, depending on the content of the consultation,individuals were linked to specialized organizations such as the Area Comprehensive Support
Center, a mental health and welfare service establishment, or a free legal advice consultation office(Japan Legal Support Center).
③ Local Resident Activities
a. Koko Farm Business
Through visits, container type temporary housing, and apartment type temporary housing
residents have said, "I don’t know anyone and there are no places to gather with people" and "I drink
from the mornings because I don’t have anything to do." Therefore, the “Koko Farm Business” wascreated in 2013 with the cooperation of farmers in Higashi Matsushima City, to provide a place torestore mental and physical health by doing something different and interacting with others, throughthe cultivation of vegetables and flowers. In FY2014, the program was held twice a month for twohours each from April to December. Besides, since it could not be held during the winters fromJanuary to March, a “Trivia Class for Men” was held for male participants through cooking in the
Ishinomaki Regional Center for 2 hours from 10:30 to 12:30. Including this Trivia Class, the event
has held a total of 23 times in FY2014. The date for this event was decided based on the participants'
opinions. Table 2 shows the activity status.
The Koko Farm Business event participant target is aimed at including container type temporary
housing and apartment type temporary housing residents. The number of individuals who
participated in FY2014 was 26, including 13 men (7 new participants), and 13 women (4 newparticipants). A total of 18 container type temporary housing residents and 8 apartment type
temporary housing residents participated. The men and women’s ages ranged from 40 to 70 years,- 16 -

and 30 to 70 years respectively. The cumulative number of participants was 261, and the average
number of participants for agricultural events was 12 - double than that of FY2013. The average
number of participants per day in the "Trivia Class for Men" was 7.2.
As a feature of the participants, many men and women had medical diseases. All the men were
single and were either being treated for alcohol problems, respiratory disorders, or congestive
disorders. Some women had experienced troubles in their temporary homes, had lost their relatives
in the tsunami, and had minimal interaction with others. In this project, two volunteers withexperience in agriculture assisted with arranging the farmland to make it easier for the participants
to work, saying that helping gave them a “purpose to live” and therefore participated every time.
Participants have commented saying that “I used to do farm work with my family, and thisreminded me of those times. I enjoy doing these tasks altogether as it makes us feel like a big family”,“I can forget the bad things and feel refreshed and energized. Just watching the vegetables growmakes me happy, and made me laugh for the first time in a long time,” “Coming to the field is fun
and gives me energy. I am glad that my family is happier after seeing me be happy.”
In March, 4 women who participated in the Koko Farm Business joined the “Trivia Class forMen” as male participants expressed that “having only male participants is lonely so we would likefor women to also be able to participate.” Male participants have commented saying that “being
able to converse while cooking is fun, and since the recipes are easy, I can make them on my own
too.”Classes with female participants were popular, in which the men expressed that the“conversations are lively and fun.” We expected to continue these events throughout FY2015 while
examining the content.
Table 2 FY2014

Koko Farm Activity Status
Cumulative
Number ofParticipantsTime and Durationof Implementation

Number of
Sessions

April – December
2nd and 4th Thursday
of Every Month
9:30 – 11:30 AM

20

Cultivation of 26 types ofplants such as pumpkins,
onions, radishes, cucumbers,
eggplant,
tomatoes,andsunflowers/tulips.

239

Trivia Class for Men
January – March 2015
10:30AM – 12:30PM

3

Oyakodon, Suiton, Fish Soup
200 yen participation fee

22Content

Total: 261*Tea Parties were held 3 times in July and August and once in December.
b. Handicraft Class (Table 3)
Many participants of the “Exhibition and Meet-and-Greet” event held in FY2012 said, “I also
want to try to make something,” “I would like to have a place where I can create something whilesocializing.” A handicraft class was opened from FY2013 at the Ishinomaki Regional Center
Branch, which aimed to provide a socializing space for apartment type temporary housing
residents. The number of participants in FY2014 was 19 (of which 3 were new participants), andtheir ages ranged widely from individuals in their 20’s to those in their 80’s, with the mostprevalent age group being people in their 60’s and 70’s. The cumulative number of participants in- 17 -

FY2014 was 111 with the average number of participants per event being 8.5. The instructors were
3 volunteers who commented saying “I am happy that this also brings me energy.” A female
participant in her 80’s who lives alone has said, “I don’t have many opportunities to talk to people,
I look forward to coming here, and I now look forward to making things even after going home.
There is competition in the class between the participants to show each other our creations.”
Table 3 FY2014

Handicraft Class Activity Status

Time and Durationof Implementation

Number of
Sessions

Creations and Content

13

Handicraft Class(collage, beads)

April 2014 – March 2015
Once a Month 3rd Tuesday
9:30 – 11:30 AM

Cumulative
Number ofParticipants

111( 2 ) Support for Supporters①

Attending each case meeting, temporary area meeting

At the request of various related organizations, we attended case meetings on alcoholrelated, mental illness-related, dementia-related, and inter-resident trouble issues; anddiscussed our roles on how we could get involved. Besides, we attended a temporary area
support meeting in which organizations such as the Ishinomaki City, the Council of Social
Welfare, the Area Comprehensive Support Center, the Nursing Association, and otherprofessional organizations gathered and considered the appropriate support methods andorganizations for container type temporary housing residents.
② Individual Support Consultations
Once a week at the request of Ishinomaki City, we went to the city hall to provide individual
support such as advising public health nurses.
③ Infant Health Checkup Support
Based on a request for infant health checkups held at the Ishinomaki City General Branchand Onagawa Town, a public health nurse and clinical psychologist were dispatched to consult
with mothers and children. After the medical examination, the public health nurse met withthe mother and child to give advice about mental care and to consult those who requirecontinuous support.
④ Cooperation towards the preliminary information sessions for residents of disaster public
housing
In response to a request from Ishinomaki City, we attended preliminary information
sessions for residents of disaster public housing on holidays (Saturday and Sunday) and madesure as facilitators that the residents felt calm during the discussions. In FY 2014, we attended
the preliminary information sessions for residents of disaster public housing from September
2014 to March 2015.
- 18 -

( 3 ) Raising Public Awareness① Lectures and Workshops
In response to requests from organizations such as Ishinomaki City and the Council of Social Welfare,training sessions were held for residents in the Ishinomaki area for "alcohol training" and "mind and bodyself-care." Alcohol-related workshops were conducted in cooperation with Medical Corporation
Tohokukai Tohokukai Hospital (hereinafter referred to as Tohokukai Hospital) and Nonprofit
Organization Miyagi Prefecture Danshukai (hereinafter referred to as Prefecture Danshukai). Participantsfrom the alcohol workshops have said, “I now understand that individuals who have suffered from alcohol
dependency play a big role in the recovery of alcoholics” and “this helped me understand the fears of
alcohol and alcoholism.” In the attentive listening lectures, some have said, “I now understand which
points to focus on when listening” and “I want to be able to use this in my community.”② Exhibition and Meet-and-GreetThe Exhibition and Meet-and-Greet event started in FY2012 and was held again in FY2014 inside
the Miyagi Prefecture Ishinomaki Joint Government Building. Table 4 shows the activity status of the
Exhibition and Meet-and-Greet event. There were 155 visitors at the exhibition of which 19 wereapartment type, temporary housing residents. Additionally, participants of the handicraft class also
exhibited their collage and beads work. Many visitors said, “looking at the wonderful work gave meenergy” and “I am excited about the next exhibition, so I hope it happens soon,” and visitors who
experienced making collages and beads work said, “I want to try this too.” At the tea space, people who
saw each other for the first time in a while discussed the earthquake and socialized positively saying,“long time no see, I was worried about you, I hope you’re doing well” and “the disaster was tough but
I’m glad we’re all okay.”
Table 4 Exhibition and Meet-and-Greet Activity Status
Date and Time

Friday, March 6th, 2014 10 AM – 3 PM

Location

Miyagi Prefecture Ishinomaki Joint Government Building
Temporary Conference Room

Exhibited
Works

Pottery, Collages, Paintings, Calligraphy, Wagami Ningyo (dolls
made from Japanese paper), Patchwork, Tsurushi Hina (dolls madeof cloth hung on strings), Cloth Dolls (such as animals), Knitting
items (wool work, beads work)
19 Exhibitors

Meet-and-Greet Spring planting (pansy) station, collage/origami station, handContent
massage, tea space
Number of
Visitors155- 19 -

( 4 ) Human Resource Development
In response to requests from various related organizations, training sessions were held forsupporters and women's associations in the neighborhood who often met disaster victims andindividuals with disabilities. The training contents included “listening techniques,” “how tointeract with people who have disabilities,” “how to interact with people who have alcohol-related
problems” and “value your own body and mind.” Besides, alcohol issues have surfaced as time
has passed since the earthquake, and in cooperation with administrative agencies and support
organizations, Tohokukai Hospital staff and Japan Social Worker Association for AlcoholRelated Problems (hereinafter referred to as ASW Association) members have been invited 9times as lecturers to provide training on alcohol-related problems to support the community in
FY2014. Workshops in which ASW Association members were invited as lecturers, were held
five times. Workshops regarding alcohol-related problems and mental illness-related problems
were held 6 times in FY2014 (Table 5).
Workshops surrounding the theme of “What can supporters do to raise children's self-esteem?”and on the subject of "Images, Lights and Shadows” and “Staying Close to Children’s Heart”
were held twice with a total of 234 participants for professionals engaged in supporting children
in the community. Participants said, “I learned that extreme media exposure can have large effects
on children’s brain growth,” “adults working with children require a sense of security inthemselves, and I realized the importance of being prepared and being there for the other person,”and “this was a great opportunity to reflect and I hope to make use of it in the future.”
Participants socialized by discussing what support should look like in the future in groups
after the lecture on the theme of “Mental health of residents and supporters during thereconstruction period, which was the third Disaster Mental Health Care Meet-and-Greet Miyagi
in Ishinomaki.

- 20 -

Table 5 Alcohol-Related Problem Workshop Activity Status
Instructor Date of Event

Content

Instructor

Instructor May 18th
2014

Tohoku Alcohol-Related Issues
Social Worker Workshop“Miyagi Disaster Mental Health Care
Center ~through the activities of the
Ishinomaki Regional Center~”Ishinomaki
Regional
Center Staff

Instructor November 6th
2014

Alcohol-related problems withregards to the Ishinomaki City
Nursing Association
Case Study“Regarding Motivational Interview
Methods”

Tohokukai
Hospital
Toshihiro Suzuki
Atsuko Miura7

Co-host

FY2014 Alcohol-Related Issues
Workshop“Early detection of alcohol problems,
how to deal with them, and thecommunity’s support system~learning from activities in Osaka~”

Higashifuse
Clinic (Osaka)

33

Fukushima Mental Health Care
Center Alcohol Measures Workshop
Heavy drinkers (including alcoholic
individuals)
Dealing with, supporting and casestudies for individuals at risk of
becoming alcoholics
Training to improve practical skills
for solving alcohol-related issues“Identifying alcohol issues andintervening”

Ishinomaki
Regional
Center Staff

3

ASW
Association
Sumie Okada
Sakae Fujita

30

Training to improve practical skills
for solving alcohol-related issues“Intervention for change”

ASW
Association
Sumie Okada
Sakae Fujita

25

Training to improve practical skills
for solving alcohol-related issues“Interacting with individuals who do
not change”
Alcohol-related case conference
workshop“Thinking of regional cooperation~preparing a case conference andhow to manage it – part 1”

ASW
Association
Sumie Okada
Sakae Fujita

33

ASW
Association
Naoto Okazaki
Sumie Okada
Sakae Fujita

35

Alcohol-related case conference
workshop“Thinking of regional cooperation~preparing a case conference andhow to manage it – part 2”

ASW
Association
Naoto Okazaki
Sumie Okada
Sakae Fujita

19

Instructor

Co-hostCo-hostCo-hostCo-hostCo-hostNovember 21st2014

December 12th2014

October 10th2014
December 12th2014
January 9th2015
February 13th
2015

March 13th2015

- 21 -

Number ofParticipants40

Hospital Director

Shiro
Tsujimoto3. Reflecting on the FY2014 Activities
At the Ishinomaki Regional Center, we have been conducting support activities while being mindfulof "in-person interactions and relationships" with each support organization. For this reason, we actively
participate in meetings which related organizations attend, such as container type temporary housingarea and case study meetings for residents with mental illnesses, to coordinate the meetings and share
information. In particular, regarding alcohol-related issues that have surfaced in the region, thegovernment has worked to support individuals and their families by connecting them with various
related organizations (such as administrative agencies, the regional support division of Tohokukai
Hospital, a specialized medical institution, medical corporation Yukokai Kodama Hospital, which is alocal psychiatric hospital, and Prefecture Danshukai).
Another aspect we have valued is creating a place for people to fit in and feel comfortable. We haveinteracted with individuals who (i) have not had a place to socialize, (ii) are inactive due to old age orother factors, (iii) have had issues with neighbors, and (iv) have been in difficult situations. Activities
such as the “Koko Farm Business, handicraft classes, and exhibition and meet-and-greet events were
all attempts to create a safe space for the citizens. The primary purpose was to prevent isolation indisaster victims and to create a community in which people can have a healthy life.
4. Issues and Future Initiatives
Four years have passed since the Great East Japan Earthquake, and reconstruction progress of thedisaster-stricken areas has begun to be noticeable, though gradually, with the completion of disasterpublic housing. While some of the affected people have been relocated to their own homes which they
have rebuilt or to disaster public housing, some have not yet been able to move out of their temporary
housing. The reality is that the gap in reconstruction is widening. In FY2014, the container type
temporary housing residents who received support were mostly from elderly households, and thecontent of consultations often related to problems such as dementia, family relations, and mental illness.
From the trend in FY2014, we expect the number of consultations to increase in the future forindividuals who have suffered from the disaster, have had economic and health concerns, and haveproblems not directly related to the disaster. We will humbly listen to the affected people and help thembring out the “power that they have.” We will continuously support disaster victims through holding
handicraft classes and the “Koko Farm Business” to provide them with a safe place that we hope will
help them live better lives.
Additionally, due to continuous relationships with related organizations such as administrative
agencies and the Council of Social Welfare, we have been receiving many requests to attend individual
support meetings and about lecturers for workshops. We have been actively promoting activities tocreate relationships where each support organization and residents can support each other in the region.
Regarding support to children, we will continue the training for staff members of related organizations
in FY2015 and want to continue to push forward individual support while also building good relations
with related organizations. In particular, with alcohol problems having surfaced and a high interest in
residents towards this topic, we believe it is necessary to continue activities to raise public awarenessand to have a place where people suffering from alcohol issues can interact.
Given the uncertainty of life in the future, consultations related to the disparities in reconstruction arelikely to increase. To provide support including individual consultations, it is necessary to build asystem that can more closely cooperate with administrative agencies and support organizations in the- 22 -

local community. At the same time, we will humbly support the disaster victims and supporters bylistening attentively and hope to improve the mental health and welfare of the community.
Regarding the situation of the Ishinomaki area, once a month, Higashi Matsushima City Health andWelfare Department Welfare Division Disability Welfare Section, Onagawa Town Health and Welfare
Division, Eastern Health and Welfare Office Maternal and Child Disability Section, and staff members
seconded to the Ishinomaki City Health Promotion Division; held meetings and workshops attended
by all employees, including seconded members, and discussed the current support activity status. We
hope to continue this support work and improve it even more in the future.
5. Seconded Employee Initiatives( 1 ) Higashi Matsushima City Initiatives① FY2014 Activities
a. Resident support
Individuals subject to follow-ups were mainly high-risk persons based on health surveys. On theother hand, the Higashi Matsushima City also conducted their screenings combined with specificmedical examinations referred to as the “Mental Health Survey Screening,” to select high-risk
individuals on their standards, followed by follow-ups (Tables 6 and 7). For residents of disasterpublic housing, screening was conducted for all residents after moving in, and a second follow-up
was conducted based on their results. This was not limited to high-risk persons related to theearthquake, but also for mental illness, recluse, and dementia-related cases. We often connected
people with other organizations, attended medical examinations, and participated in case study
meetings and care meetings.
b. Support for supporters (Cooperation with projects)
We held regular meetings with city public health nurses and cooperated in examining various
projects. Besides, we helped with clerical work such as data entry and record keeping. Higashi
Matsushima Alcohol Open Seminar (4 times a year) was held with the Tohokukai Hospital and thePrefecture Danshukai as an alcohol-related project. We also cooperated with the Tohokukai Hospitalon alcohol-related case study meetings. To strengthen the coordination of preventive interventions,
we had meetings with the Health Promotion Division and accompanied visits. Higashi Matsushima
City is characterized by its focus on suicide prevention-related projects. We collected information
on suicide cases and reviewed the cases regularly with psychiatrists and individually followed up
with bereaved families.
② Activity Considerations

In FY2014, two psychiatric social workers were dispatched from the Miyagi Disaster Mental
Health Care Center to the Higashi Matsushima City Health and the Welfare Department Welfare
Division Disability Welfare Section (hereinafter referred to as Disability Welfare Section). Threepeople, including one from the Miyagi Reconstruction Bureau's reconstruction support staff(psychiatric social worker), were responsible for the post-earthquake mental health care. Regarding
the local situation, some residents have successfully moved into disaster public housing and part ofthe mass relocation site construction has been completed, and container type temporary housing
consolidation has begun. Most of the activities were in response to cases requested by the Disability
Welfare Section rather than health survey follow-ups and worked as psychiatric social workers in
the administration, such as coordinating with other departments and organizations. The city's- 23 -

projects focus on suicide prevention, and engages in post-earthquake mental health care, alcoholrelated issues, and care for suicide survivors’ families. Until now, we have mainly worked withindividual victims, but as rebuilders are being incorporated into the region, we have set a policy tofocus more on the region in FY2015.

Table 6 Health Survey Follow-Up Status

28 cases

8 cases

1 caseWeigh 10kg lessthan 1 year ago

1,202
235
households households(19.6%)Start drinking
alcohol frommornings or noon

Treatment
discontinued due tomental illness
Insomnia + No
Hospital Visits + No
person to consult with

Follow-Up
Targets

Collection(collection rate)

Distribution

Container Type
Temporary
Housing *1(FY2014)0 cases 15 cases 4 cases

Apartment Type
841
288
households households 28 cases 11 cases 0 cases 0 cases 12 cases 5 cases
Temporary2(34.3%)
Housing *(FY2013)*1
Container type temporary housing resident secondary health survey follow-up(Miyagi Prefecture “Questionnaire on health and life”)
2*
Apartment type temporary housing resident secondary health survey follow-up(Miyagi Prefecture “Questionnaire on health and life”)
3*
Index to measure anxiety and depression
Table 7 Specific Medical Examination Mental Health Survey Screening
Follow-Up Status (some overlaps)

Special
MedicalExamination*4(FY2014)*4(2)

Distribution

Collection(Collection
Rate)

FollowUp
Targets

K6

10,9373,328(30.4%)

293
cases

18
cases

CAGE
Alcohol
Questionnairewith morethan 2 criteria
107 cases

Wish toconsult

SuicidalThoughts

144
cases

24 casesSpecific medical examinations mental health survey screening and second follow-up(From the Higashi Matsushima City “Questionnaire About Mental Health)Onagawa Town Initiative
In Onagawa Town, disaster public housing was completed for 200 households in FY2013, but after
this, full-scale transitions occurred in FY2016-2017, excluding rebuilt houses. For this reason, about
1,000 households were forced to live in temporary housing even past FY2015. Inferring from thissituation, it is expected that alcohol problems, poverty, and isolation will become more apparent due toa great deal of stress from long-term living in temporary housing.
- 24 -

① FY2014 Activities
a. Resident support
In FY2014, one-on-one visit support was provided to heavy alcohol drinkers and apartment type
temporary housing residents, mainly focusing on cases with mental health problems. Furthermore, a
psychiatrist was dispatched from the Miyagi Disaster Mental Health Care Center once a month (fullday), so a team approach could be taken including doctors.
b. support for supporters
Continuing from FY2014, as part of the mental health care for the Onagawa Town staff, we attended
occupational physician interviews and conducted activities to understand the actual situation and maderecommendations to the town office. Besides, a café (Heart Salon) for town officials continued to beheld twice a month. In addition to conducting alcohol seminars and community development lecturesin each district, we were able to act as close supporters for the townspeople by actively participating in
local projects. Besides, we individually provided supervision and advice to the Social Welfare Council,
the Comprehensive Support Center staff, and the Health and Welfare Division staff regarding support
to townspeople and the way that projects should be conducted.
c. Support regarding the community-based welfare plan development
Regarding the Onagawa Town Community Welfare Plan, which was formulated in FY2014, weparticipated in a joint working group with meetings, district round-table conferences, and the Councilof Social Welfare, and worked to provide mental health care to future community building and support
mechanisms in Onagawa Town.
Working Towards FY2015
Since many townspeople will continue living in temporary housing in FY2015, new individuals inneed of follow-ups are expected to emerge in addition to existing individuals requiring support. In
addition to the reduction of temporary support staff, the Miyagi Disaster Mental Health Care Center
will also only dispatch one individual, so closer collaboration and sharing of information among
affiliated parties is required. Regarding support for regional development and community mental healthfor new regional restructuring, as the Miyagi Disaster Mental Health Care Center, we will be required
to continuously be actively involved and put the high-risk approach into practice, as well as the
population approach and a community work perspective to support high-risk individuals in thecommunity.

②(3)

Initiatives at the Eastern Health and Welfare Office① FY2014 Activities
a. Resident support
At the Eastern Health and Welfare Office, requests were not limited to support activities specializing
in problems caused by the earthquake and included requests for consultation services and home visitsthat were carried out by conventional health centers. In addition to the individuals involved, we
provided various support, such as support for their families and the coordination of supporters of relatedorganizations with individuals.
b. Support for supporters
We actively participated in alcohol-related projects that the office was working on and provided
case support for specialized consultation desks and planned and operated family classrooms andtraining. We also provided supervisors to help newly appointed public health nurses deal with mental
illness cases.
- 25 -

② Working Towards FY2015
To live in the region, multi-professional supporters must cooperate and support each otheraccordingly, and we were keenly aware of the difficulties of continuing these duties as coordinators.
The Ishinomaki area, especially in the coastal areas, has long been a tolerant and open-minded city
towards drinking alcohol, so many individuals and their families have been living without realizing theissues regarding alcohol. After the disaster, drinking problems surfaced due to changes in the living
environment and supporter interventions, and the region is currently facing an issue of how to provide
support. To support local living even with the presence of these issues, we believe that it is essential tobuild a system that can flexibly cope with the local community and to create relationships in which thecommunity, medical care, and the government cooperate and can meet face-to-face.
(4)

Status of Initiatives at Ishinomaki City Hall
Before the supply of reconstruction public housing in Ishinomaki, 149 apartment type public houses
were prepared in FY2013, and the transition from container type temporary housing for disaster victims
to reconstruction public housing has begun. From July 2014, we have been involved in a community
formation project utilizing preliminary information sessions for residents of reconstruction public
housing that incorporate “Measures against Isolated Death” after moving into reconstruction public
housing, which had been considered by the Reconstruction Housing Division since FY2013.

①

FY2014 Activities
From November 2014, the supply of reconstruction public housing in the central government officeareas of Watanoha, the Kama / Okaido, the Hebita, and the general branch office areas of Kahoku andKanan have been in full swing. Weekly information sessions on moving in are being held. We believethat the community formation support project at the preliminary information sessions for residents ofreconstruction public housing is important as a new method of support for the Mental Health Care
Center, and will report on the support system and activities. The Koganehama Model had a community
formation system from applying to moving in, unique to Ishinomaki City, consisting of a total of four
sessions required for residents, including three information sessions and one follow-up meeting. Here
we report the support process with some considerations.
a. Preliminary information session (1st Session Main Theme: Get to Know Your Neighbors)
The preliminary information sessions were generally held about six months before the start of theindividual’s residency, with the Regional Cooperation Division in charge of the overall coordination
until residents moved in. The Reconstruction Housing Division was responsible for explaining theroom lottery process and moving-in procedure on the day of the information sessions, and the Health
Promotion Division in charge of dividing tables by residential building or floor at the community
meeting. At the first preliminary information session, which was held for the first time in collaboration
with multiple divisions, some challenges were presented with the attendance of many elderly
households, including singles, such as assisting with application procedures, creating a place forresidents to socialize, and responding to complaints of poor physical condition. For the Health
Promotion Division to strengthen the system for managing the physical conditions of prospective
residents attending information sessions as well as supporting their application procedures,cooperating organizations such as the Miyagi Nursing Association, CANNUS Tohoku, and theJapanese Association of Social Workers in Health Services facilitated situations that requested thecooperation of the Disaster Mental Health Care Network Miyagi (Karakoro Station) and the Miyagi- 26 -

Disaster Mental Health Care Center as facilitators of creating spaces for residents to meet one anotherfor the first time. This system was partially changed and will be followed accordingly in FY2015.
b. Local visits and community meetings (2nd Session Main Theme: Get to Know Your Floor andBuilding)
The second information session, which is held about two months before the tenants move in, consistsof two parts: an on-site tour for prospective residents and a community meeting. The on-site tour is set upby the Reconstruction Housing Division, and the Health Promotion Division oversees setting up a
community meeting and coordinating with the facilitators. Since persons using wheelchairs and canes wereattending the second information session, the Regional Cooperation Division, Reconstruction Housing
Division, and Health Promotion Division considered sharing information about high-risk individuals andhow to communicate with them in advance. On the day of the information session, the second employee
cooperated with the Reconstruction Housing Division as an exclusive correspondent. Later, a wheelchairparticipant of the on-site tour said over the phone that “the staff was generous, and the interior of the house
was nice.” Additionally, a participant of the community meeting held by the Miyagi Disaster Mental
Health Care Center said, “I feel safe having such as opportunity before moving into the reconstruction
public housing,” and we were able to see prospective residents who met each other at the first information
session conversing with one another.
c. Information session just before moving in (3rd Session Main Theme: Get to Know the Whole
Complex)
At the information session held approximately two weeks before the move-in date, the Housing
Management Division was responsible for providing information regarding moving into
reconstruction public housing and handing over keys, organizing housing meetings, and selecting
officers. The Regional Cooperation Division was responsible for calling for participation in theneighborhood association’s chairperson and bridging the public housing residents with the residents.
The seconded individual was responsible for discussing how to communicate with high-risk
individuals attending information sessions with the Housing Management Division, proposing
communication methods to the staff in charge and the cooperating organizations. They also had tocommunicate and coordinate with the Miyagi Nursing Association which is involved with physicalcondition management of attendees and assistance in handing out explanatory documents, CANNUS
Tohoku, and the Japanese Association of Social Workers in Health Services which is involved inhelping individuals who have difficulties filling out documents.
d. Follow-up after moving in (4th Session Main Theme: Get to Know the Community)
The Koganehama Model has a support system from applying to moving in, unique to Ishinomaki
City, consisting of a total of four sessions required for residents, including three information sessions
and one follow-up meeting (Figure 1). The model advocates the creation of a local community forthe integration of public housing residents and residents one month after they move in. The Health
Promotion Division explores the needs of individuals and groups while conducting reconstruction
public housing resident visit health survey projects from FY2015, and plan to resolve problems facedby residents and address them according to their needs in cooperation with multiple organizations.

- 27 -

Knowing neighbors

1 Preliminary Information Session- 28 -

Figure 1

Creative Methods

Creative Methods

Contractor

Neighborhood chairman / Administrative director
Children’ s Welfare Commissioner
Social Welfare Council
Miyagi Disaster Mental Health Care Center
Japanese Association of Social Workers in HealthServices
Area Comprehensive Support Center
Community Improvement Coordination Groups
Ishinomaki Senshu Un iversity

Contributors (to be adjusted in the future)- Setting to make it easier to talk with grouped seating byfloors-Establishment of tea-drinking area

- Promotion of discussions by cooperating associations as
facilitators (creating a soft atmosphere)

Housing Management Divisions- Formation of housing estate
association- Management of common
expenses- Explanations of basic rules forapartment-house- Key delivery

Contractor

Neighborhood chairman / Administrative
director
Children’ s Welfare Commissioner
Social Welfare Council
Health Coordinator (Nurse
Association/Cannus)
Area Comprehensive Support Center
Community Improvement Coordination
Association

Contributors (to be adjusted in the
future)- Setting to make it easier to talk withgrouped seating by floors-Establishment of tea-drinking area

Implementation System

Implementation System( 1 ) Move-in explanations (mutual
understanding)- Key delivery- Understanding of apartment-houserules- Understanding management method ofcommon expenses

Main Theme

Knowing the entire housing complex

3 Move-in Information

Mid-January 2015

Health Promotion Divisions- Talk with residents (mainly to resolve healthconcerns)
Start with introductions
Regional Collaboration Divisions- Municipality chairman introductions
Welfare General Affairs Divisions- District welfare officer introductions
Reconstruction Housing Divisions- Tour of rooms and buildings (preliminary inspection)( 2 ) House inspection- Visiting rooms and meeting places( 1 ) Communication- Knowing each other and the local community

Main Theme

Knowing residents on the same floor and building

2 Local visits + round-table discussions

November

Late January

Start ofMove-In
Follow Up

After February

Contractor

Neighborhood chairman / Administrative
director
Children’ s Welfare Commissioner
Social Welfare Council
Area Comprehensive Support Center
Community Improvement Coordination
Association

Contributors (to be adjusted in the
future)- Setting that facilitates peaceful
dialogue by setting up groups by floor-Establishment of tea-drinking area

Creative Methods- To resolve issues that occurred
after moving in

Related Divisions

Implementation System- Nursing care prevention classes /health classes, etc.

- Interacting with the region
Regional integration

Main Theme

Knowing the region

Post-Move In

Community Support System at Ishinomaki Reconstruction Public Housing Movement Information Session (Koganehama Model)(Contractor : separate contract

Social Welfare Council
Health Coordinator (Nurse
Association/Cannus)
Japanese Association of Social Workers in
Health Services
Karakoro Station
Community Improvement Coordination Groups

Contributors (to be adjusted in the
future)- Assuming participants will attend from various areas,
the venue will be at the city hall (including temporary
conference rooms)- Setting to make it easier to talk with grouped seatingby floors- Establishment of a tea-drinking area

Creative Methods

Regional Collaboration Divisions- Pre-consultation with the community- Securing venues- Event MC
Reconstruction Housing Divisions- Room lottery- Move-in procedure explanations
Health Promotion Division- Resident follow-ups, etc.

Implementation System( 2 ) Communication- First meeting between residents (introductions)

Main Theme( 1 ) Move-in procedure explanations- Room lottery- Explanation of move-in procedures and required
documents- Future schedule information- Sharing the necessity of a housing estate association

July 2014.

② Working Towards FY2015
In FY2014, before the residents moved into Ishinomaki City’s reconstruction of public housing, we
helped create a grand local community to integrate public housing residents and residents. The
Koganehama Model, devised by the Reconstruction Housing Division, the Regional Cooperation
Division, and the Health Promotion Division, has held three information sessions since July and is being
promoted by the four divisions: the Housing Management Division, the Welfare General Affairs Division,
the Nursing Care Insurance Division, and the Life Reconstruction Support Division, as well as related
departments such as the Area Comprehensive Support Center, the Council of Social Welfare. In recent
years, the collapse and regeneration of local communities have been reported in the mass media, withthe stricken areas after the Great East Japan Earthquake being no exception and the collapse ofcommunities in areas where geographical ties have been diluted becoming a serious issue. In the future,building a support system for the community will be challenging based on the difficulties of living ofresidents in reconstructed public housing, regional issues such as self-help, mutual aid, and cooperation,
including disaster prevention and crime prevention in the area.
The manuscripts of the (1) Ishinomaki Regional Center were written by Assistant Manager Hiromi
Arai, (2) Higashi Matsushima City by a psychiatric social worker Shizuka Oguchi, (3) Onagawa Town
by psychiatric social workers Koichiro Tsuru and Tomoko Arashi, (4) the Eastern Health and Welfare
Office by nurse Tomoko Uchida, and (5) Ishinomaki City by occupational therapist Miyoko Kubota.
Finally, Okazaki (Ishinomaki Regional Center Community Support Division Manager from April 2015)
put this together into a single manuscript.

- 29 -