Ishinomaki Regional Center Community Support Division Activity Report[Resident support project]
1.

Consultation support project (walk-in visitors, home visits, telephone consultations, etc.)(1) Handling individual consultations
Since the disaster, we have been providing support to those with poor physical conditions and those withmental illness, and we have responded to referrals from other institutions and requests from individuals
themselves. However, the number of referral cases has decreased with the withdrawal of support
organizations, and the number of consultation cases has decreased.
(2) High-risk follow-ups following public housing occupant health surveys① Ishinomaki City public housing health survey
In March 2020, we received a request for cooperation from the Health Promotion Division of theIshinomaki City Health Department (hereinafter, “Health Promotion Division”) for the FY2019
public housing occupant health survey. We accordingly provided individual support through on-site
surveys and other means. However, after April 2020, there was a period where home visits and soforth became difficult due to the COVID-19 pandemic.
The criteria of the Health Promotion Division for individuals requiring follow-up were as follows:① K6: 13 points or more, ② K6: 10–12 + male + 18–64 years old + no counseling partner, ③ very
poor or not very good physical health + no disease or treatment interruption. Specifically, ② entails
suicide countermeasures for working-aged men. Participants requested by the Division included
70 men from 65 households in the Hebita / Kamaokaido Districts of Ishinomaki City.
The visit survey results were as follows: 30, 33, and 7 people who continued; concluded; andrefused support, etc.; respectively. The 30 people who continued support comprised 13 men and17 women, with 80% under the age of 65 years and 46.7% in single-person households. As 10 years
had passed since the earthquake, there were cases where mental health care problems werecomplicated by disease or economic problems, and many cases required time-consuming support. The
30 people who continued support were given support until they connected with new supporters suchas consultation support, lifestyle protection, community comprehensive support centers, disability
support offices, etc. Support was concluded as of March 2021.
② Higashimatsushima City public housing health survey
We conducted telephone and home visit support to follow-up on individuals requiring support
based on the FY2019 public housing occupant health survey and the FY2020 specific medical
examination mental health care questionnaire. Home visit participants were those with a K6 of at least
18 points, and those who commenced with alcohol consumption in the morning or afternoon.

Victim support exchange project – “Koko Farm”
The Koko Farm, which commenced in April 2013, had many individuals who wished to continue its
activities; however, it was concluded after seven years in December 2020. Activities in FY2020 involved
30 sessions of the Koko Farm, a total of 122 participants, and 56 volunteers.
2.

3.

Ishinomaki Danshukai meetings
In FY2021, to expand the Ishinomaki Danshukai meetings conducted since FY2015 by Ishinomaki City,
Miyagi Prefecture Danshukai (hereinafter, “Danshukai”), and the Division to voluntary activities, the Divisionchanged its form of support from sponsorship to assistance. From April 2021, the organization began planning
activities such as the Ishinomaki Daytime Meetings.
(1) Higashimatsushima City
One psychiatric social worker was stationed at the Health Promotion Division in Higashimatsushima City.
After considering periods when multiple employees were stationed, a total of 13 individuals have been
seconded over nine years since FY2012. For FY2020, staff members took care not to burden the city after theirwithdrawal.
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Continuing from the previous year, the primary work in FY2020 involved overseeing tasks related to mental
health and welfare while receiving instructions from the city. Staff member work involved individual walk-ins,telephone counseling, home visits and accompanied visits, accompanying professional consultations,participating in various care meetings, acting as a coordinating liaison with related organizations, andparticipating in case study meetings. Activities were conducted while informing related organizations of the endof the secondment system.
Other than responding to individual cases, staff members were involved in support work for planning andmanaging the city’s health and welfare projects, public awareness activities, various meetings, and workshops.
Efforts were made to consider the overwork of city officials due to major changes in the project schedule andcontents due to COVID-19.
For example, various medical examinations conducted in the beginning of the fiscal year were postponed tothe second half of the fiscal year. Moreover, the recovery, input, and commencement of follow-up of the “Mentalhealth questionnaire” (Higashimatsushima City project) distributed at the time of medical examinations waspostponed to a start date in December. Therefore, staff members tried to compile project reports within the fiscalyear.
In Higashimatsushima City, sufficient consideration was given to cooperating with city public health nurses
or psychiatric social workers for case handling, in view of the end of the secondment system since accepting
seconded employees. Therefore, we believe that the transfer and withdrawal of work could be completed without
any confusion.
(2) Onagawa Town
In Onagawa Town, one psychiatric social worker was stationed at the Health Measures Section(Health Center) of the Health and Welfare Division and conducted the work there. The seconded employee wasmainly engaged in mental health and welfare projects, and provided support to individual residents through visits,
telephone consultations, and case conferences. It was determined from the onset that the secondment system
would conclude by FY2020, so the employee made a conscious effort to share the situation of cases asappropriate, such as visiting with the town public health nurse to a feasible extent to ensure a smooth transition.
At the end of March 2021, when the secondment was concluded, the cases supported by the seconded employee
to date were organized and handed over to the town public health nurse. Individual resident support from FY2021
onward was handled by a system where the Section would receive requests from the town as needed.
Furthermore, the employee cooperated with raising public awareness of information on mental health(e.g., stress and drinking alcohol) in venues such as health classes for residents held in each district, and in town
public relations articles.
The “Mental health care lecture” that was held in each district by the Health Center since FY2018 was held
in only one district in FY2020 due to COVID-19, but the Center’s part-time psychiatrist was dispatched as theinstructor and cooperated with planning and management. A health lecture on mental health during COVID-19
was given, and there were many questions from the participating residents given the timely topic. Furthermore,consultations from residents and supporters were conducted on the day when the part-time doctor was dispatched,
and a venue for individual consultations was also set up.
The office LAN was used once a month to send information about mental health to the town staff under thetitle of “Heart Communication,” stress checks were conducted, and interviews were coordinated with industrial
physicians.
2.

Consultation project(1) Regular meetings with health centers, municipalities, and Division
We have been holding monthly meetings with two cities and one town in the jurisdiction, and healthcenters have also been present since the meeting with Onagawa Town in August 2020.
(2) Participation in case reviews and case study meetings
We participated with health centers in a case review conducted at health centers, as well as a case study
meeting held in the municipality. In the future, we will participate in reviews of inpatient cases involving
health centers, as well as cases where treatment is difficult in the municipality, where we will regularly
evaluate the situation. We also plan to discuss at case study meetings how to manage difficult cases thatinvolve individual support.

(3) Accompanying visits with other organizations
Accompanying visits were conducted at the request of health centers and the municipalities. In
the future, we plan to conduct accompanying visits for cases for which case review was conducted,
cases for measures, difficult-to-respond cases, cases of suspected violence, and cases of handlingvarious consultation services; and provide advice for case support.

- 35 -(4) Professional dispatch project① Nursery center visits (child observations and conference)
We conducted seven visits (once in Onagawa Town, six times in Ishinomaki City) in
FY2020. There were no central intellectual problems. However, there were many cases inwhich undesired behavior was seen in the field of group childcare, and supporters were having
trouble dealing with children and their parents. We requested that descriptions of progress todate in children be provided in reports from supervising public health nurses and childsupporters, and this be prepared as the central topic of the mini lecture.
In the conference, we examined the meaning and response of children’s behavior.
Moreover, the mini lecture for supporters that was given in this conference incorporated theperspectives of child development, trauma, and attachment, with each session being wellreceived by the supporters. After the nursery center visits, a supervising public health nurse
gave a subsequent progress report of the supporters and children to the Division, and feedback
was given from the Division. Thus, this was also a learning venue and is thought to be veryeffective.
② Case study meetings
In FY2020, we studied three cases. This was an opportunity to share the roles of relatedorganizations once again by creating an integrated view of difficult-to-respond cases
involving multiple occupations when considering future forms of support based on thebackground of the cases.
[Human resource development project]
1. Supporter’s mental health promotion support project
We provided training on mental health at the request of health centers and local governments in theIshinomaki area (Table 1).
Table 1 Human resource development projects (training)
Implementation Host municipality
Training name /Subject
Number ofdatecontent
participants2020/9/15
Higashimatsushima Higashimatsushima
Social workers
80
CityCity public welfarecommittee workshop:“How to engage inbetter attentive
listening for support
recipients”
2020/9/30
Ishinomaki City
Ishinomaki City
General public,55
listening training
social workers,
course (suicide
administrative
countermeasures):staff, disability“How to be a better
welfarelistener”
personnel
2020/10/21
Ishinomaki City
Ishinomaki City
Social workers,
57
listening training
healthcourse (suicide
promotion
countermeasures):workers,“How to be a better
administrativelistener”
staff- 36 -2020/11/9

Ishinomaki City2021/1/19

Ishinomaki City

Ishinomaki City
listening training
course (suicidecountermeasures):“Supporting life andhearts”
Ishinomaki City
Health Promotion
Division new-term
public health nurse
training workshop:“Case study meeting”

barbers'association

63

Administrative
officials

6

2.

Mental health care workshop (wide-area training)
We co-sponsored workshops with Miyagi Prefecture and the Miyagi Prefectural Board of Education for
public health nurses, nursery teachers, and educators who have been engaged in supporting children inmunicipalities within the prefecture since 2013; however, this was suspended for 2020 due to COVID-19.

3.

Children’s mental health care Ishinomaki area training
We co-sponsored training with Ishinomaki City / Ishinomaki City Board of Education,
Higashimatsushima City / Higashimatsushima City Board of Education, and Onagawa Town / Onagawa
Town Board of Education for supporters involved in health, childcare, and education in disaster support inthe Ishinomaki area. However, this was suspended for 2020 due to COVID-19.

4.

Various workshops
To date, we have hosted workshops in collaboration with health centers on alcohol-related problems andsuicide countermeasures for cooperation between internal medicine and psychiatry. The collaborative projectwith health centers was a major asset when considering new projects for the activities of the Division after
FY2021, but this was suspended in FY2020 due to COVID-19.

[Raising public awareness]
Support for Ishinomaki City Koyo municipal housing complex health counseling meetings
We have provided continuous support since FY2019 at the request of the Ishinomaki City Hebita
Community Comprehensive Support Center. We planned to host these meetings monthly for FY2020;
however, due to COVID-19, we were only able to host them four times from July to October. The total
number of participants was 41 residents of the housing complex.
[Research aggregation project]
We reflected on the progress of support toward the independence of the Danshukai meetings, which
was conducted by the “Danshukai” and the Division in collaboration with the Health Promotion
Division. It was thus considered that suggestions could be made for future community mental healthand welfare activities by studying aspects to be aware of when supporters support self-help groups, aswell as the role of each member (including support toward “independence” and the ideal way tocooperate). Therefore, a publication presentation was made at the 11th Miyagi Convention of theTohoku Mental Health and Welfare Society as follows: “Implementation of joint projects with selfhelp groups (Danshukai) and support toward autonomy: Reflecting on activities at the Ishinomaki
Regional Center of the Miyagi Disaster Mental Health Care Center.”[Future prospects and issues]
Nine years after opening in April 2012, we have cultivated relationships of trust while conducting
various projects with health centers and municipalities in the area. We could not predict how thewithdrawal of seconded employees at the end of March 2021 would affect municipalities. Moreover,- 37 -there was a need to determine how the health centers, municipalities, and the Division would cooperate,
collaborate, and look ahead in the future. To respond to requests from health centers, municipalities,
and other organizations as much as possible after careful examination as was done before, the requests
were confirmed directly with health centers and municipalities from November 2020. We also
formulated how health centers and municipalities should implement the projects going forward as the“Miyagi Disaster Mental Health Care Center Ishinomaki Regional Center activity plan for FY2021onwards.” This was based on the second operation plan of the Miyagi Disaster Mental Health Care
Center for FY2021 onwards, where we also summarized these under the three projects of ① resident
support, ② support for supporters, and ③ raising public awareness, and shared them.
The Division is an organization that will disappear from the Ishinomaki area in five years; and wewish for our organization to be used by people, including the administration of the area, while still
active. We would like to respond to requests from health centers and municipalities as much aspossible, such as conducting consultations and visits together, and we would like to cooperate tocontinue activities that help victims of loneliness and suicide as much as possible.
Furthermore, for cases where direct requests for support are received, we wish to collaborate withmunicipalities as a rule and continue to provide support in the form of home visits and walk-in visitors
primarily as a background presence. Moreover, we wish to further strengthen collaboration with
Karakoro Station, disability support offices, and community comprehensive support centers.

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