Activity Report
Community Support Division, Kesennuma Regional Center

Report of the Kesennuma Regional Center
Mitsuaki Katayanagi – Manager, Psychiatric Social Worker
Community Support Division, Kesennuma Regional Center, MDMHCC

The 2016 main initiatives are noted for each project. In addition, the number of activities for eachproject have been published in Chapter I Section 2: State of activities listed by project for 2016, sohere the core project contents are noted with minimal detail.
Resident support
In 2016, as in previous years, resident support began with home visits to people who had been
identified as high-risk in the health survey that had been carried out by Miyagi Prefecture and eachmunicipal body, and this support was carried out based on referrals from each of the relevantorganizations and bodies and on direct consultation requests from people asking for advice.
Moreover, one staff member was relocated to Kesennuma and one to Minamisanriku, and we
carried out resident support as part of our cooperation in psychiatric social work for each municipal
body.
1.

(1)

Kesennuma
Home visits were carried out with citizens who were considered high-risk in the healthsurvey carried out in Kesennuma targeting inhabitants of apartment-type temporary housing(Table 1).
Moreover, as in 2015, as a result of proactive plans to cooperate with various support
groups, requests increased from these support groups for consultations regarding resident
support or home visits. In addition to this, in 2016, due to requests from elementary, juniorhigh, and high schools, there was a notable increase in support for children and parents withissues such as truancy.
Table 1: Support such as health survey visits(2)

Summary

Support period and main
support targets

Number of incidences of
support such as visits forwhich the Kesennuma
Regional Center was
responsible

Home visits based on tenant
health surveys such as the 2015
survey on apartment-type
temporary housing

June 2016 – January 2017
K6 upper grades, focusing on
cases of “drinking alcohol frommorning onwards”

31

Minamisanriku
Home visits were carried out with residents who were considered high-risk in the healthsurvey carried out with disaster victims. (Table 2) Aside from this, based on requests from themunicipality, support was carried out through home visits or over the telephone. Moreover,by participating in activities such as tea ceremonies in container-type temporary housing or
public housing, we got a sense of the state of health of residents and implemented specificsupport as necessary.

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Table 2: Support such as health survey visits

Summary

Support period and main support
targets

Home visits based on tenant
health surveys such as the 2015
survey on residents of containertype temporary housingHome visits based on tenant
health surveys such as the 2015
survey on residents who do notlive in temporary housingHome visits based on tenant
health surveys such as the 2016
survey on residents of containertype temporary housing

March – July 2016
K6 upper grades, focusing on
cases of “drinking alcohol frommorning onwards”
April – August 2016
K6 upper grades, focusing on
cases of “drinking alcohol frommorning onwards”
January – March 2017
K6 upper grades, focusing on
cases of “drinking alcohol frommorning onwards”(3)

Number of incidences of support
such as visits for which the
Kesennuma Regional Center was
responsible
31

43

21

Discussion
The home visits for the health survey in Kesennuma included many cases in which
psychological burden was linked to a wide variety of changes, such as changes to the labor
environment and family structure, in addition to changes in living environment following theearthquake disaster. Moreover, large-scale public housing complexes were being built one
after another, and people were anxious about moving, so this may have been reflected in the
results.
Furthermore, in 2016 the number of incidences of consultation from educational
institutions were remarkably high, but one of the causes behind that may have been that
educational institutions had become aware of the Miyagi Disaster Mental Health Center
Kesennuma Regional Center (hereinafter, the Center) as a familiar consultation organization.
In 2016 reconstruction continued in Minamisanriku, such as maintenance of all public
housing. However, when visiting and confirming the condition of people considered high-riskin the results of the health surveys of residents of container-type temporary housing and theirown homes, while there were people whose condition had improved, there were some who
were now feeling the mental health effects of their experiences during the earthquake, andpeople who had anxiety about issues such as their relationships with neighbors or financial
prospects in the future, so the health condition of residents was varied. For that reason, fromnow on we will be working closely with local public health nurses, supporters, and life
support advisors (hereinafter, LSAs).

2. Support for supporters(1)
Kesennuma① Deployment of municipal professionals
Continuing on from 2015, in 2016, professionals were deployed to municipalities, andthrough disaster support and the assistance of public health nurses, initiatives were
implemented that aimed to reduce the burden for municipal public health nurses.
② Mental health support for municipal staff
Based on a request from the general affairs division, together with the Tohoku
University Graduate School of Medicine Department of Preventive Psychiatry(hereinafter, “the Department of Preventive Psychiatry”) and the Kesennuma Council ofSocial Welfare, we discussed health support for municipal workers, and the Centerestablished a health consultation service to support municipal workers (including
temporary staff) at the Kesennuma Central Government Office on the third Wednesdayof every month from 10 am until 4 pm.

– 45 –

(2)③ Mental health support for Kesennuma-shi members of the Association for PsychiatricSocial Workers
Based on the results of a 2016 health survey concerning mental health targetingmembers of the Kesennuma Council of Social Welfare, carried out by the Department ofPreventive Psychiatry, we implemented interviews with specific members of the
Kesennuma Council of Social Welfare.
Minamisanriku① Deployment of municipal professionals
Continuing on from 2015, professionals were deployed to municipalities in 2016. By
deploying them to areas close to municipal public health nurses’ workplaces, they
instantly carried out activities such as support for victims of disaster and assistance withpublic health nurses’ work, and they worked to reduce the burden of the work.
② Mental health support for municipal staff
Based on a request from the general affairs division, we held discussions with the
Department of Preventive Psychiatry, the Kesennuma Council of Social Welfare, and the
Miyagi Mental Health and Welfare Center, and implemented support for municipal
workers.
The Center established a health consultation service for municipal workers twice amonth, on the fourth Tuesday of every month from 2 pm until 7 pm, and on a Saturday or
Sunday from 11 am until 3 pm. In addition to these, we also responded to consultationsin the form best suitable for the municipal workers’ duties. Moreover, to make these
health consultations better-known, we publish a “mini-column on health” in the monthly
guide published from the general affairs division, design and distribute flyers once a year,
and devise ways to make the consultation service easier to use.
③ Mental health support for Minamisanriku members of the Association for PsychiatricSocial Workers
Continuing on from 2015, we carried out group meetings at each satellite of the
Minamisanriku Council of Social Welfare Center for Disaster Victims’ Lifestyle Support(hereinafter, “the Center for Disaster Victims’ Lifestyle Support”) (Table 3). In thesecond half of the year, we carried out changes such as reorganizing the satellites andestablishing LSAs to support residents of public housing, and we took the opportunity toshare information regarding the residents we were supporting and the conditions ofpublic housing and container-type temporary housing.
Furthermore, in September, to support the managers of each satellite and the staff ofthe Center for Disaster Victims’ Lifestyle Support main office supervising the satellites,
we carried out separate interviews with the staff.
Table 3: State of implementation of group meetings and other activities at each satellite
Date
Location
Materialth
May 26
Shizugawa SatelliteGroup meeting
June 8th
Utatsu SatelliteGroup meeting
July 20th
Tokura SatelliteGroup meeting
July 20th
Minamikata SatelliteGroup meeting
August 29th
Shizugawa SatelliteGroup meeting
September 6th and 9thMain Office
Individual staff interviews
October 4th
Utatsu SatelliteGroup meetings– 46 –

(3)

3.
(1)

Discussion
When we deployed relocated staff to the Kesennuma Division for Health Promotion andMinamisanriku Health and Welfare Division’s health promotion program, by implementing
fixed-term support every week for the Kesennuma-Karakuwa General Office Health andWelfare Division they, along with the fixed-term temporary staff and the Center, were able tosupport each municipal division manager in a stratified way. Kesennuma and Minamisanriku,
where reconstruction is progressing, have continued to have an abundant flow of work, andthere will probably continue to be many municipal nurses who carry a heavy burden of work.
Through the cooperation of the relocated staff and the Center, we will continue to support
these supporters, prioritizing municipal public health nurses.
In Kesennuma, we have attempted to make the health consultation service for municipal
workers a permanent fixture. By doing so, as well as being able to carry out continuous
support, it has also become easier to understand the mental and physical condition ofmunicipal staff over time.
On the other hand, although initiatives have begun concerning the reinstatement of support
since 2015, these are still not very concrete. Therefore, we will continue to cooperate withgeneral affairs division in initiatives to cultivate a better understanding of support.
The health consultation service for municipal workers in Minamisanriku has changed its
days and times of operation, and although there have been schemes to publicize it, such as thecolumn, there has not been much increase in its use. However, considering the fact thatreconstruction activities are continuing, and that there will be a reduction in the number of
temporary government staff from now on, supporting the health of municipal workers will beessential. We will continue to consider effective methods for supporting municipal workers incooperation with relevant organizations and bodies.
Raising public awareness
Kesennuma-shi① Publication of Sanriku Kokoro Tsuushin (Sanriku Mental Health News)We have been publishing a monthly column since April called “Sanriku Kokoro
Tsuushin” in the Sanriku Shimpou, a paid subscription publication focusing on
Kesennuma, in cooperation with Kesennuma Health Care Center. Through thisnewspaper media, we have provided information about mental health to the generalpublic and made our consulting services more well known (Table 4).
Table 4: Publication contents etc. of the Sanriku Shimpou "Sanriku Kokoro Tsuushin"
Issue
Date
Topic
Authorno.1
Kesennuma Health30
April 2016
A new season, a chance for growthCenterIs this the May Blues? The mind-body slump Kesennuma
31
May
that affects many at this time of year
Regional Center
A health checkup is your best chance to improve Kesennuma Health32
Juneyour own body!
Center
How to get along well with alcohol: The Kesennuma
33
July
connection between alcohol and sleep
Regional Center
How to deal with changes to living environment
1: Mental health changes when coping with the Kesennuma
34
Augustmove to permanent housing from temporary Regional Center
housing1

Issues began in 2013

– 47 –

35

September

Health improvement with quality sleep

36

October

Rest well: How busy, working people can relax
and refresh

37

November

Understanding “hikikomori” (shut-ins)

38

December

How to get along well with alcohol 2: Self-check

39

January2017

40

February

41

March

How to deal with changes to living environment
2: Getting through environmental change
Refresh mind and body with simple relaxation 1:
Breathing exercises you can do anywhere
Refresh mind and body with simple relaxation 2:
Simple stretching to unwind mind and body

Kesennuma HealthCenterKesennuma
Regional Center
Kesennuma HealthCenterKesennuma
Regional Center
Kesennuma
Regional Center
Kesennuma HealthCenterKesennuma HealthCenter

② “Koko Café” (warm heart café, or mental health café) collaboration with Kesennuma
The “Koko Café” is a project in Kesennuma mainly targeting residents in apartmenttype temporary housing that attempts to design opportunities for people to get out of thehouse and interact with fellow residents as a precaution against isolation, and aims tostudy self-cafés for stress relief. It was organized by the Center in Kesennuma in 2016,
and jointly hosted with the Kesennuma Council of Social Welfare Volunteer Center, withthe cooperation of the Medical Corporation Utsushigawatetsujinkai Mitsumine Hospital(hereinafter, “Mitsumine Hospital”); it was implemented as shown in Table 5.
Table 5: "Koko cafe" topics etc.
Iteration

June 14, 2016

nd

2
rd
3

th

July 5th
July 12thAugust 23

4thKesennuma

Place

st

1

5

th

6

th

7

th

8
th
9
th

10

th

Karakuwa

Date

11
th
12
st
1
nd
2

Sukoyaka
Jounan Annex
Sukoyaka
Ooshima Community
Centerrd

Septemberth
27th
October 25
November 8thth

December 6thDecember 20
January 10,
2017thJanuary 24
stFebruary 21rdJune 23 2016th
October 13

Topic
Discussing dementia, andaromatherapy relaxation
Aromatherapy hand massage
Calisthenics with musical rhythms
Health and nutrition seminar

SukoyakaMusic therapy

Sukoyaka
Matsuiwa Community
CenterSukoyaka
Sukoyaka
Matsuiwa Community
CenterSukoyaka
Sukoyaka
Akira Residence
Akira Residence

Wallpaper art
Calisthenics with slow dancing
How to make delicious matcha tea
Illustrated calligraphy
Health and nutrition seminar
Calisthenics with slow dancing
Stories from a Buddhist priest
Illustrated calligraphy
Music therapy③ Cooperating on city project “health festival”
The health festival is a project implemented by Kesennuma that aims to prevent thedeterioration of people’s health due to stress and the decline of bodily functions andattempts to maintain and improve the health of city inhabitants, based on the Stage 2
Kesennuma Health Plan 21 and Stage 2 Plan for the Promotion of Nutrition Education.
On the day of the festival, we ran a “Koko Café Corner,” provided drinks, implemented apersonal experience program, showed public awareness panels, and distributed public– 48 –

awareness materials about mental health. The personal experience program was carriedout as an experience of relaxing the five senses through “Sanshin musical performance,”“Calisthenics and breathing techniques,” and “Health kamishibai (Japanese traditional
story telling).”④ Public awareness for city personnel
In December we distributed public awareness materials about mental health to city
personnel, with the goal of creating the opportunities for people to become aware of theirown health.
⑤ Other
We carried out activities about mental health for the general public.
Table 6: Other initiatives to promote public awarenessSupporttargets

TopicsResidents

We participated and collaborated in “alcohol abstinence
meetings” held in the Motoyoshi District.

People living
in containertype
temporary
housing andpublic housing

Residents

Dementia
sufferers andtheir carers,
local
residents, andstaff atrelevantorganizations

Residents

Residents
People livingin Shishiori
District

Jointly hosted a “healthy classroom” Shishiori District healthconsultation meeting in 2016 sponsored by Miyagi University.
We offered a place in the container-type temporary housing
meeting place where people could interact with people living incontainer-type temporary housing in the Shishiori District or in
public housing, established a mental health consulting service,and led part of the discussion.
Jointly hosted the “Kisennuma District mental health creation
street campaign” in 2016 with the Kisennuma Health Care
Center. Distributed public awareness materials to spread
information about “mental health checks” and “consultation
organizations” at three shopping centers in Kisennuma during
Suicide Prevention Awareness Month.
Jointly hosted a “Kokotcha” dementia teahouse sponsored by the
Miyagi Prefecture Dementia Disorders Medical Center. Once amonth, offered a place where interested parties, carers, and local
residents could interact at a restaurant in the Mitsumine Hospitaland Sukoyaka, and led part of the mini-discussion.
Implemented a “department for raising public awarenessconcerning preventive care” by the request of the Kesennuma
Welfare for the Aged Center, Long Life and Happiness Villa.
Provided a discussion about mental health through a short play,
and relaxation and exercise as a personal experience program.
The Center presented project materials in the “World
Alzheimer’s Panel Exhibition” held by the Kesennuma Region
Inclusion and Support Center (in the Kesennuma City Hall One
Ten Government Office building).
Collaborated with the Japan International Volunteer Center’s“Ikiki Social.” Implemented health lectures and relaxation using
health consultations and kamishibai shows in the Shishiori– 49 –

Number of
times
implemented
12
participants /12 times total

8

1

12

8

1

11

container-type
temporary
housing(2)

District small-scale container-type temporary housing lounge.

Minamisanriku① Provision of programs in the day service “Caregiver classroom and regional social”
On the request of the Minamisanriku Council of Social Welfare, as we had in 2015,
we provided discussions at the Iriya and Togura Day Service Centers on mental healththrough materials that evoked the feeling of intimacy of a kamishibai show. Moreover,
we carried out tapping touch and musical calisthenics. In 2016, we held these publicawareness-raising activities about nine times, for an aggregate total of 87 local residents(Table 7, Table 8).
Table 7: Day Service Iriya
Date
May 22, 2016
June 19th
July 17th

November 20th
February 19th

TopicsHealth Kamishibai “About nutrition”
Relaxed musical calisthenics
Health Kamishibai “How to have a positive mind”
Tapping touch
HealthKamishibai“Gentle-hearted
communication”
Aromatherapy hand massage
Health Kamishibai “Stress and hypertension”
Recreation calisthenics
Health Kamishibai “About sleep”
Relaxed musical calisthenics
Total of 5 times

Attendees
6
6
7

12
13
Aggregate total
44

Table 8: Day Service Togura
Date
May 29thJune 12th
July 10th
November 27th

TopicsHealth Kamishibai “Environmental change andstress”
Relaxed musical calisthenics
Health Kamishibai “How to have a positive mind”
Tapping touch
Health Kamishibai “Gentle-hearted communication”
Aromatherapy hand massage
Health Kamishibai “Stress and hypertension”
Recreation calisthenics
Total of 4 times– 50 –

Attendees
11

12
12
8
Aggregate total
43

② Implementation of Health Kamishibai jointly with Center for Disaster Victims’ LifestyleSupport
Jointly implemented Health Kamishibai about mental health, such as at the tea
ceremonies carried out at container-type temporary housing or public housing by theCenter for Disaster Victims’ Lifestyle Support. Carried out 24 regular public awarenessraising activities in a year, for an aggregate total of 199 local residents.
Using kamishibai as a tool allowed many participants to get a sense that “it is easier tounderstand because there are pictures” and “it feels relatable because it reminds me of
my childhood.” Moreover, there was the major result of some of the participants being
able to incorporate this into their daily lives, as by later adopting breathing techniquesthat were introduced in the play in the calisthenics they do regularly.
③ Alcohol training for residents
We discussed topics with someone previously involved in health promotion, createdkamishibai aiming to make these topics easy to understand and relate to, and put theminto use.
④ Distributing flyers for municipal staff
We made flyers about mental and physical conditions that are common during timesof distress and about the consulting service for municipal staff and distributed them to all
staff (450 people).
⑤ Participation in Minamisanriku Social Welfare Festival
We participated in the annual Minamisanriku Social Welfare Festival for the first timeand exhibited in a booth. We carried out panel displays and quizzes relating to mental
health, and distributed stress care goods to respondents. 175 people participated in thequiz, and we also distributed eco-packs with the Center’s logo to another 300 people
attending and raised public awareness about mental health.
(3)

4.
(1)
(2)

Discussion
In addition to the high-risk approach toward residents with a low level of mental health,
we have lots of practice at emphasizing a population approach in order to increase the level ofmental health of the whole population. In 2016, in both Kesennuma and Minamisanriku-shi,there was an increase in requests for lectures about mental health and our activities expanded.
We aimed to respond to the original needs of the request, to make mental health easier forresidents to understand, and to help them to understand it more intimately. We have employedvarious approaches, incorporating as concrete materials music, kamishibai, calisthenics, andshort plays. We hope to expand our activities similarly in 2017. Moreover, we are once again
investigating the creation of teaching materials so that these methods can continue to be put togood use by local governments after this Center’s activities come to an end.
Moreover, we participated in the first welfare festival in Minamisanriku, taking theopportunity to teach lots of people about the existence of this Center and convey the value ofmental health.
We are planning a method of approach to make it easier to access participants and regions.

Human resource development and training
Kesennuma
At the request of facilitators in workshops, we cooperated in everyday management.
Minamisanriku① Training for Victim Support Center supporters and LSAs
In 2016 we also implemented this at the request of the Victim Support Center. We did
this twice during the year on the theme of “teamwork.”– 51 –

② Training for nursing officesa. Minamisanriku Residential Care Center
Based on a request from the offices, we carried out training for four staff memberson the theme of “communication.”b. Medical Corporation Itokukai Utatsu Tsutsujien Nursing Rehabilitation
Facility for the Elderly
At the request of Kyoukai Kenpo, we carried out training for 25 staff members on
the theme of “mental health for working people.”③ Earthquake Mental Health Care Social Miyagi in Minamisanriku
Meeting at the Minamisanriku Tokura Community Center Assembly, we aimed tocarry out network building between supporters active in Minamisanriku and Kesennuma.
We gave lectures about activities at the time of the earthquake in Chuetsu, Niigata; wepresented the group activities conducted in the municipalities; and we carried out panel
displays on relevant organizations and bodies.
(3)

5.
(1)

(2)

Discussion
Similarly to 2015, upon request from relevant organizations and bodies from Kesennuma
and Minamisanriku, all kinds of training were carried out. In 2016, what stood out was thatrequests have increased not just from earthquake-related support organizations, but also fromexisting organizations, and also the themes have not just been about mental health, but also
about relevant communication and teamwork.
As the reduction and withdrawal of earthquake-related support organizations moves
forward, we hope to take on roles with existing organizations. We will carry out humanresource development and research in 2017 in a form that is based on the requests suited tothe conditions during reconstruction.
Support for various activities
Kesennuma
Throughout the year, we carried out initiatives to build links with each group ororganization that is active in the wider region, prioritizing NPOs and NGOs. Moreover, we
collaborated on grief care seminars with an NPO in Sendai, holding “Wakachiai meetings” tosupport bereaved families. Also, we participated in an organizers’ meeting in order tocollaborate on “the East Asian Grief Assembly in Kesennuma,” which was held with thesponsorship of the East Asian Grief Assembly Secretariat in 2017.
Discussion
By continuing initiatives to cooperate with various groups that are carrying out support
activities in the region, we deepened our cooperation with organizations with which we hadalready built relationships, and also made links with new groups. Through these activities, ourunderstanding of the region deepened, and we were able to put our support duties to good use.

6. Children’s mental health care regional projects(1)
Main activities① Implementation of “Activities to build up mental health in senior high school students”
Kesennuma Health Care Center, an organization for mental health medical carewelfare liaison conferences working in the jurisdiction of Kesennuma, implemented
activities to build up mental health in second-year students and their teachers at
Kesennuma Kouyou High School, Miyagi-ken. We presented consultation organizationsin the Kesennuma region and health education through a short play. Moreover, we took

– 52 –

(2)responsibility for the Working Secretariat jointly with the Kesennuma Health Care
Center.
② Deployment of lecturers to nursery schools
We deployed lecturers to the parent-and-child “candle holder making” activity
implemented at the Kesennuma Tateishiko Nursery School as an activity to build up themental health of parents and children.
③ Carrying out training for junior high school teachers
We carried out training in health committees and workshops of Kesennuma Municipal
Nakai Junior High School on the theme of “building mental health in order to protect
work-life balance” for teachers.
Discussion
Many children have continued to experience psychological changes today, many years
after the earthquake disaster, due to changes in living environment, economic conditions, andfamily functions. In 2016, we carried out initiatives to direct attention to mental health duringchildhood, and activities to improve the mental health of the parents and supporters aroundchildren. Through these activities, we were able to comprehend the beginning of the future
turn toward advancing mental health and welfare in all areas struck by the disaster.

– 53 –