Report on Child Mental Health Symposium 2017

2. Activity Report
Community Support Division, Kesennuma Regional Center
Community Support Division, Ishinomaki Regional Center
Community Support Division, Stem Center
Planning and Research Division, Stem Center- 46 -

Report of the Kesennuma Regional Center

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

Introduction
The main initiatives of 2017 are listed for each operation. Since the number of activities for each
operation is listed under 1) Activity State by Operation Item in Chapter 1 of the 2017 Report, suchdetails will be kept to a minimum here, with details provided here centered on the operation content.
1. Resident support
Resident support services conducted in 2017 included home visits for residents classified as highrisk under the health survey conducted by the Miyagi Prefecture and each municipality, as in previous
years, as well as providing ongoing support in response to requests made by each relevant institution
and people asking for consultations directly.
Furthermore, one employee has been temporarily transferred to Kesennuma and Minamisanriku,
respectively, cooperating with psychological health welfare services and conducting resident support
services as part of their work.
(1) Kesennuma City
Based on the health survey conducted on residents in private rental housing in Kesennuma City,
outreach via home visits was conducted for those who are believed to be in a high-risk state from theperspective of K6 and alcohol-related behavior (Table 1).
Following 2016, there has been an increase in direct consultation requests from the person
concerned or their families in addition to aid requests from governmental, educational, and otherrelevant institutions. The content of consultations includes poor adjustment within school forelementary, middle, and high school students and issues related to families, similar to what was seen
in 2016. Other consultations that stood out are for those of working age regarding their workplace andtasks, and consultations related to trauma. There were many issues, with some serious in nature. There
were many cases in which aid was continuously provided. For this reason, there has been an increasein consultations in which support was given in collaboration with other relevant institutions.
Table 1: Support provided including health surveys conducted through home visits
Summary

The main support period and main support targets

The number of support cases (e.g., home
visits) conducted by the Kesennuma
Regional Center

Home visits based on 2016 healthsurvey of residents of private rental
housing

May 2017–February 2018,
Focusing on cases with high K6 scores and those who
matched with items such as “drinking from themorning.”

27 cases(2) Minamisanriku
Home visits were conducted with residents who were believed to be in a high-risk state based on
the health survey conducted at Minamisanriku (Table 2).
Furthermore, aid was provided through home visits and phone calls in response to requests madeby governmental institutions and other relevant institutions, as well as those made directly by the
person in question.

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Report of the Kesennuma Regional Center
Table 2: Support provided including health survey conducted through home visits
Summary

The main support period and main support targets

The number of support cases (e.g., home
visits) conducted by the Kesennuma Regional
CenterHome visits based on the 2016 healthsurvey of residents

July–December 2017,
Focusing on cases with high K6 scores and those who
matched with the items such as “drinking from morning”
and “drinking excessively.”

48 cases(3) Discussion
Concerning home visits conducted after the health survey in Kesennuma, although there were notmany residents in a state that required continuous support, there were several residents who discussed
sleep disturbances, feeling down, and concern about their future prospects since the earthquake.
Although these were not of such a degree as would impair their lives, this indicated that experiences
during the earthquake still affect them.
As the number of residents in private rental housing in Kesennuma decreases, the number of casesthat require support based on the result of the health survey is also decreasing annually. However, thenumber of consultations from related institutions and the number of direct consultations are increasing,with the number of consultation cases in 2017 being the highest in history. During the recovery
process following the earthquake, various daily life challenges that threaten the mental health ofresidents will appear, which leads us to believe that consultations will continue to increase in the
future.
At Minamisanriku, relocations to the upland have been in progress, in addition to public housing
being built. However, when the situation of residents believed to be in a high-risk state during thehealth survey was checked during visits, it was found that there were many residents who had received
negative impact to their mental health due to financial problems after rebuilding their own home ordeterioration in their physical health after moving. When continuous support was needed, it wasprovided by collaborating with public health nurses from the municipality, supporters, and the LSA.
With residents who had difficulties talking openly during visits due to the presence of other family
members, ongoing support was provided by arranging an environment that would made it easier forthem talk openly through such measures as providing a private consultation space.
We will continue to provide support to Kesennuma and Minamisanriku in a flexible manner. This
includes handling a wide range of issues related to the mental health of the community, regardless ofwhether there are future disasters, as well as arrangements such as implementing night-time
consultation times, depending on the living circumstances of those requiring help.
2. Support for supporters(1) Kesennuma① The allocation of specialists to the municipal body
As in 2016, a specialist was also allocated to the municipality in 2017. By providing support
for public health nurses’ tasks, we conducted an initiative toward reducing the operational burdensof the municipality public health nurses.
② Support related to municipality employees’ mental health
Health consultation contact points for municipality employees (including dispatchedemployees) were opened with a designated staff member assigned between 10AM and 4PM on
every third Wednesday of the month at the One-Ten Building in the Kesennuma Municipal Office.
In the event that the service was difficult to reach during opening hours due to work obligations
and such, alternative flexible operation hours and consultation points were arranged. The numberof contact point usages increased over 2016.
We participated in a conference on employee mental health in August 2017, where we shared
the consultation state of the municipality employees and discussed future support systems (e.g.,
support for returning to work after leave, and training).
③ Mental health support for Kesennuma Social Welfare Council employees
Individual interviews with Kesennuma Social Welfare Council employees were conductedbased on the results of the Tohoku University Graduate School of Medicine’s Department ofPreventive Psychiatry (hereinafter, “the Department of Preventive Psychiatry”)’s 2018 mental
health survey of Kesennuma Social Welfare Council employees.
(2) Minamisanriku① The allocation of specialists to the municipal body- 48 -

Report of the Kesennuma Regional Center

As in 2016, a specialist was allocated to the municipality body in 2017. By providing
assistance by supporting Earthquake survivors and performing public health nurse duties, thespecialists helped reduce the workload of the municipality’s public health nurses.
② Support related to municipality employees’ mental health
Health consultation contact points for municipality employees were open, as in 2016, twice amonth, on the fourth Tuesday (14:00–19:00) and either Saturday or Sunday (11:00–15:00). In
addition, consultations were organized by making arrangements around employees’ circumstances.
Information about the health consultation contact point was distributed so as to be easily seen
by employees. Such measures included posting the information in the Hitoiki Column (“Take a
Breather Column”), a column related to mental health published in the newsletter distributed every
month by the General Affairs Office.
③ Mental health support for Disaster Survivors’ Life Support Center, Minamisanriku Social
Welfare Council employees
Individual interviews with 24 employees of the Disaster Survivors’ Life Support Center,
Minamisanriku Social Welfare Council (hereinafter, “Disaster Survivors’ Life Support Center”),
was conducted in November in order to ascertain their mental health state.
Furthermore, there were opportunities to share information about the status of residents that
we provide support to, the temporary container-type housing, and the public housing, with thesenior citizens’ advisory center located in each satellite office and public housing by visiting themirregularly.
(3) Discussion
Through the dispatch of employees transferred to Kesennuma and Minamisanriku, municipal
employees’ operations were supported, including especially public health nurses, as well as providing
further support to the two municipalities by our Center.
Initiatives assisting recovery from the disaster continue in Kensunuma. The municipality
employees have a heavy operation workload, just as before, and are believed to be experiencing
accumulated exhaustion in both body and mind.
Even in Minamisanriku, municipality employees are still dealing with excessive workloads.
Although the need for mental health support is understood, it was difficult to lead them to avail
themselves of the employee health consultation contact point.
By regularly hosting the health advice contact point for Kesennuma and Minamisanriku
employees even into the future, we will continue to provide individual psychological support as wellas support toward creating a structure for improving the mental health of said employees.
Furthermore, Disaster Survivors’ Life Support Center employees are experiencing an increased
sense of burden by having to face new issues, such as dealing with residents who cannot be contacted
or those who died inside public housing. For this reason, we provided support to reduce their
psychological burden when we exchanged info. We will continue to provide support by responding torequests.
3. Raising public awareness(1) Kesennuma① Publishing Sanriku Kokoro Tsuushin
In Sanriku Shinpō (translation: New Sanriku Report), a newspaper with subscriptions mainly in
Kensennuma, a column named Sanriku Kokoro Tsuushin (translation: Sanriku Soul
Communication) has been published monthly since April in collaboration with the Kesennuma
Public Health Center (Table 3). Through the newspaper, accurate information on mental health andthe announcement of the health consultation contact point was communicated with the generalpublic.
The topics for the articles were decided via discussion with the Kesennuma Public HealthCenter and by considering factors such as the current state of the region. Topics related to theearthquake were included for the first time in 2017.
After publishing the column, reactions included questions regarding the article and phone calls
asking for consultation.
Table 3: Content published on “Sanriku Kokoro Tsuushin” in the Sanriku Shinpō
Issue

Date publishedContent

WriterVol. 42

April 2017

Start of the new fiscal year: Let’s deal
properly with nervousness

Kesennuma Public Health CenterVol. 43

May

Spring-time malaise!?: The physical andmental disorders most likely to be

Kesennuma Regional Center- 49 -

Report of the Kesennuma Regional CenterVol. 44

June

Vol. 45

July

Vol. 46

AugustVol. 47

SeptemberVol. 48Vol. 49

OctoberNovemberVol. 50
Vol. 51

DecemberJanuary 2018

Vol. 52

FebruaryVol. 53

March

experienced this season
Looking after both your body and mind: Let’sgo for a checkup!
Dealing with changes in residential
environment
Did you know? Appropriate drinking habits:
How to deal with alcohol well
Are you able to sleep well these days?:
Promoting health with quality sleep
Is your mind exhausted?
Taking breaks efficiently—How to rest andtake breaks for those with a busy work
schedule
On drinking and mental healthBecoming socially withdrawn—it could
happen to anyone: Let’s think about it
togetherDo you know what a gatekeeper is?

On natural disasters and their impact on the
body and mind
* The “issue published in” refers to the cumulative issue number since 2013.

Kesennuma Public Health Center
Kesennuma Regional Center
Kesennuma Public Health Center
Kesennuma Regional Center
Kesennuma Public Health Center
Kesennuma Regional Center

Kesennuma Regional Center
Kesennuma Public Health Center

Kesennuma Public Health Center
Kesennuma Regional Center② Hosting the Koko Café (Warm-Hearted Café), a mental health interaction project for residents
The Kokoro Café is a project that the City of Kesennuma has been running since 2012, withdisaster survivors who reside in private rental housing as the main target subjects. The objective of
the project is to provide opportunities for residents to interact with one another and to go outside inorder to prevent them from becoming isolated, as well as to help them learn stress relief methods aspart of self-care methods.
In 2016, the project was held jointly with the City of Kesennuma, with our Center hosting it in2017. The Kesennuma Citizens’ Health Management Center Sukoyaka (hereinafter, “Sukoyaka”)
was used as the main venue in collaboration with the Medical Corporation, Testushisa Igawa
Association Mitsumine Hospital (hereinafter, Mitsumine Hospital), and it was held by the City of
Kesennuma and the Social Welfare Volunteer Center of the Kesennuma City Council (hereinafter,“Volunteer Center”) (Table 4).
Table 4: Kokoro Café Implementation Content

1st Session

Date conducted
June 13, 2017 (Tues)

Sukoyaka

Location

2nd session
3rd Session
4th Session
5th Session
6th Session
7th Session
8th Session

June 27 (Tues)
July 18 (Tues)
August 29 (Tues)
September 19 (Tues)
October 17 (Tues)
November 7 (Tues)
December 12 (Tues)

Jonan Branch
Sukoyaka
Matsuiwa Civic Hall
Sukoyaka
Ojima Community Center
Sukoyaka
Sukoyaka

9th Session
10th Session

January 23 2018 (Tues)
February 13 (Tues)

Matsuiwa Civic Hall
Sukoyaka

Content
Talks on stress & aromatic hand massage
experience session
Picture-letter workshop
Decorative magnet workshop & exercises
Rhythm exercises
Workshop on how to make coffeeWorkshop on how to make coffee
Story time & Music
Story on life habits that increase immune
system strength
Workshop on how to make green tea
Story from a chaplain③ Cooperation with the city Health Festival project
Based on Kesennuma Health Plan 21 and the Healthy Eating Promotion Plan, the HealthFestival is a project conducted by the City of Kesennuma for the purpose of preventing thedeterioration of health and physical functions caused by lifestyle habits and stress to maintain andpromote the health of citizens.
During the festival day, a Kokoro Café (Koko Café) Corner was run under the topic of “finding
stress relief methods suitable for you,” with drinks provided, self-experience programs conducted,
and awareness-raising panels displayed. The experience program involved a Sanshin (Okinawan
traditional instrument) performance, breathing methods, and a story time on health, all held as partof a relaxing experience that stimulates the five senses.
Note 1*: “Story-time” in this paper refers to Kamishibai, a form of Japanese street theater andstorytelling that involves the usage of large illustrated cards as a visual aid.

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Report of the Kesennuma Regional Center④ Distribution of awareness-raising materials for city employees
Awareness-raising materials related to mental health were distributed to city employees in
December 2017 to provide them the opportunity to be mindful of their own health.
⑤ Others
The following mental-health support activities were conducted as part of awareness raising forresidents (Table 5).
Table 5: Other public awareness-raising initiatives
Support targets

Support content

Residents

We participated in and cooperated with regular alcohol abstinence
meetings managed by the Miyagi Prefecture-based nonprofit organization
Danshukai held in the Honyoshi District.

Shishiori
District
temporary container-type
housing/public housing
residents

We co-sponsored the 2017 Shishiori District Genkikyoushitsu (translation:
Energetic Class) hosted by Miyagi University. We were in charge of
opening a mental health advisory contact point and delivering part of thelectures, as well as providing a place in which residents of temporary
container-type housing and public housing can interact at a Yasugrai,
Kesennuma Citizens’ Welfare Center Center.
We co-sponsored the Kesennuma District Health-Promotion On-Street
Campaign in 2017 hosted by the Kesennuma Public Health Center. We
distributed awareness-promoting goods that have a mental healthchecklist and advisory institutions information printed on them at three
supermarkets within Kesennuma City during Suicide Prevention Month.
We co-sponsored Koko-cha, a dementia café hosted by the Miyagi
Prefecture Dementia Patient Medical Center. We provided a place inwhich persons with dementia, caregivers, and local residents can interact
once a month at either one of the locations of restaurants within
Mitsumine hospital, the One-Ten Building in Kesennuma Civic Hall, andYsauragi, Kesennuma Citizens’ Welfare Center.
We cooperated with a Public Awareness-Raising Course on Preventative
Care organized by Fukuju-Sou, a Kesennuma Elderly Welfare Center. Talks
about mental health through skits and experience-based programs, suchas relaxation techniques and exercises, were provided.
Activities for men were held and sponsored by our Center and cosponsored by the City of Kesennuma. A place for giving lectures about
health, self-experience, and interaction for men who are prone toisolation were provided for the purpose of improving and promoting
psychological health.
We participated in the Families of Dementia Patient Exchange Meeting in
response to a request made by the Kesennuma Northern regional general
support center. Relaxation and exercise sessions were provided at the
San-san Building of the Kesennuma Karakuwa Health and Welfare Center.
We participated in a Dementia Round-Table Conference in response to arequest made by the Kesennuma Southern regional general support
center. Talks and relaxation exercises were conducted at Ikoi, aMotoyoshi Health and Welfare Center.

Residents

Persons with dementia
and their caregivers, local
residents,
and
staff
members of relevant
institutions
Residents

Residents

Caregivers & families

Caregivers & families

Residents

Residents

Residents

Residents

Residents

Talks on mental health through a skit and experiment-based program,
such as relaxation techniques and exercises, were provided in response toa request made by the Kazuno Residents’ Association.
Story-time on mental health was conducted at Iki-Iki (translation: lively)
Health Classroom in Nagaisohama, Nagaisohara District, in response to arequest by the Kesennuma Health Promotion Division.
Story-time on mental health and experience-based programs, such as
relaxation techniques and exercises, were provided at a resident’s
association in the Kamizawa District in response to a request made by the
Volunteer Center.
Talks on mental health and experience-based programs, such as
relaxation techniques and exercises, were provided at the Iki-Iki(translation: lively) Health Salon, at temporary container-type housing at
Kisennume Park in response to a request by the Volunteer Center.
A regular program on mental health was produced and broadcast incollaboration with Radio Kesennuma, as per their request. The program
aired information on mental health and advisory institutions.

Number of
implementations
Participated 11
times/Hosted 12 times

6 timesOnce

12 times

3 times

3 times

Once

Once

Once

Once

Once

Once

13 times(2) Minamisanriku① Holding health-themed story-time jointly with the Survivors’ Life Support Center- 51 -

Report of the Kesennuma Regional Center

A health-themed story-time on mental health was conducted by the Survivors’ Life Support
Center during tea-time, and held at temporary container-type housing and public housing. The
public awareness-raising campaign was conducted eight times during the year, reaching a total of
83 local residents.
② The implementation of health story-time in conjunction with Minamisanriku regional general
support center
In response to a request made by the Minamisanriku regional general support center, storytime relating to mental health and exercise was conducted during tea parties held by localorganizations. Public awareness-raising campaigns were conducted twice a year to a total of 28
local residents.
③ Alcohol and Health Class for Residents
From 2017, health classes for residents concerning alcohol consumption using health storytime were conducted via “Free-talk health advice meetings,” which were held by the
Minamisanriku and Miyagi Nursing Association as part of Minamisanriku’s alcohol-related issue
countermeasure project. Public awareness-raising campaigns were conducted seven times a year
for a total of 45 local residents (Table 6).
Table 6: Implementation Status of Alcohol and Health Class for Residents
Sessionnumber1

Date

Location

Number of participants

October 20, 2017 (Friday)

Yodorogi/Niranohama Housing Estate Assembly Hall

14 (14 women)

2

November 14 (Tuesday)

Viva Minamisenriku

03

November 21 (Tuesday)

Kanaham Housing Estate Assembly Hall

6 (6 women)

4

December 8 (Friday)

6 (2 men, 4 women)

5
6January 16, 2018 (Tuesday)
February 9 (Friday)

Shizugawa-West (West) Restored Housing AssemblyHall
Togura Restored Housing Assembly Hall
Shizugawa-East (East) Restored Housing Assembly Hall

7

March 13 (Tuesday)

Natari Restored Housing Assembly Hall

4 (1 man, 3 women)

11 (1 man, 10 women)
4 (4 women)④ Distribution of awareness-promoting material to municipality employees
Before the long-term holidays at the end of the year, leaflets about promoting mental healthwere created and distributed to all employees (approximately 450).
⑤ Participating in Minamisanriku Welfare/Health Festival
As in 2016, we opened a booth at the Minamisanriku Welfare and Health Festival, where we
presented a panel describing our Center’s activities and mental health, as well as presenting stressrelief goods designed to involve all five senses. Furthermore, an eco-bag with the Center’s logo
printed on it was distributed to 500 festival attendees and stress releasers to 384 booth visitors in an
attempt to raise public awareness about mental health.
⑥ Cooperation with Café Azumare (Translation: Come Together) Opening Ceremony
Due to the closing immediately after the earthquake of the salon where the recreation activities
that the Survivors’ Life Support Center had been conducted, relaxation experiences using music
were provided to participating residents in the closing ceremony.
(3) Discussion
Kesennuma saw an increase in public awareness-raising campaign requests in 2017 from relevant
institutions and resident associations. This increase can be attributed to further collaborations between
the Center and relevant institutions, along with the usage of methods that were easier to understand,including story-time and exercise. In particular, resident reactions toward such mediums for awarenessand promotion were very favorable. Furthermore, given that these activities were frequently conductedin small groups involving face-to-face interaction, participants were provided with the opportunity toperceive mental health as something close to and directly impacting them.
There have been instances where holding public awareness and promotion activity has led toconsultation. Such activities not only serve to disseminate information about mental health, but also
about the places at which consultations could be carried out.
Activities to help raise public mental health awareness in Minamisanriku centered on health storytime about alcohol. These were conducted in public housing and in districts relocated to upland andother pre-existing regions, rather than simply at container-type temporary housing.

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Report of the Kesennuma Regional Center

Furthermore, public awareness-raising activities were conducted for a wide range of ages by
operating a booth at the Welfare and Health Festival in which many residents participated in.
By participating in the festival two years in a row, we were able to further learn about the changes inawareness on mental health, as well as the daily lives of the residents who were in attendance.
In the future, we will continue to engage in providing support for residents using the methods thathave been accumulated to date.
4. Human resource development and training(1) Kesennuma City
① Listening seminar for those working in the district (e.g., welfare commissioners)
We cooperated in holding a listening seminar conducted by Takeshi Yamazaki, Vice
President of our organization. Titled “Learn to listen well and provide mental support to thosearound you,” the seminar was hosted by the Omose District Social Welfare Council and
Kesennuma City, with the welfare commissioners and volunteer association members of the
district as seminar attendees.
② Training for managers of facilities for the elderly
We conducted training for workplace mental health for managers in response to requests
made by the Keichoen, a special nursing home for the aged.
③ Social Skills Training (SST) at the Employment Support Liaison Committee
We conducted a talk on SST at the Employment Support Liaison Committee in response torequests made by Kanae, an employment/living support center for persons with disabilities.
④ Mental health training for nursing students
We conducted a talk on mental health self-care of nursing professions in response to requests
made by the Kesennuma Shiritsu Byoinfuzoku School of Nursing.
⑤ Training for municipality employees
We conducted a talk on mental health self-care as part of the mental health training formunicipality employees in response to requests made by Kesennuma City’s Human Resource
Division.
(2) Minamisanriku① Training for aid workers and LSA at Survivors’ Life Support Center
Workshops on the topic of relaxation and looking back at past activities were conducted twicea year in response to requests made by the Survivors’ Life Support Center.
② Training for municipality employees
A training session on the topic of Workplace Mental Health was conducted for 14 employeesof the departments that requested it via the General Affairs Division.
③ Training at the Miniamisanriku Family Caregiving/Regional Living Support Workshop
Talks and relaxation experience sessions were provided under the title of “Talking is
Important, Don’t Hold It In” to 19 people during workshops for volunteers in response to requests
made by the regional general support center.
(3) Discussion
Similar to 2016, we conducted training sessions based on demands from relevant institutions. In
Kesennuma in particular, there were many requests made by institutions on topics surrounding themental health of workplace and aid workers.
In Minamisanriku, we met the needs of Survivors’ Living Support Center employees by providing
training in accordance with the current state of this Center, which was closed in 2017.
In 2017, we took part in the Family Caregiving/Regional Living Support Workshop held for the
first time in Minamisanriku. We provided training to residents, who will be the future bearers of aid
work in the region, on the importance of self-care. This training led to conducting awareness-raising
activities via story-time in existing regions, expanding our endeavors.
Securing and fostering specialists and other human resources has become a major issue in
Kesennuma and Minamisanriku. We therefore aim to contribute to resolving regional issues by taking
charge of all possible roles at the Center.
5. Support for various activities(1) Kesennuma
In 2017, we continued to provide support for numerous activities as we strengthened our bonds
with various groups and organizations operating in the region via such venues as the NPO/NGO- 53 -

Report of the Kesennuma Regional Center

liaison conference.
We also continued to cooperate with Wakachiai no Kai (Association of Sharing) in 2017. This wassponsored by the nonprofit organization Sendai Grief Care Research Association as part of theirsupport to families of the deceased. In the middle of the year, we reflected on our activities, examined
how the association should handle itself in light of the regional situation, and channeled these ideas
back into the activities held in the latter half the year, in which we saw an increase in participants.
Furthermore, we cooperated with a presentation of the experience of the loss felt by the parties
concerned and their supporters and related group work at the East Asian Grief Meeting held by theEast Asian Grief Meeting Implementation Committee, as well as providing café space to conduct these
activities.
(2) Discussion
There has been an increase in new participants this year concerning Wakachiai no Kai, as well as
increases in continuing participants. Although there was a prolonged state until the previous year inwhich the number of participants was small, we came to recognize once again the significance ofcontinuously holding these meetings and the importance of sharing this with relevant organizations.
Through our participation, the East Asian Grief Meeting became an opportunity to deepen ourcoordination with these institutions with regard to providing support to the families of the deceased.
6. Children’s Mental Health Care Regional Base Project(1) Main activities① Conducting mental health-promotion activities for high school students
As an institution that makes up Working, a Mental Health Medical and Welfare Liaison
Conference within the Kensennuma jurisdiction, as implemented mainly by the Kensennuma
Public Health Center, we conducted mental health promotion activities targeting 11 th gradestudents and teachers at Miyagi Prefecture Shizukgawa High School. We provided healtheducation via skits and shared information on the advisory organs within the Kesennuma
jurisdiction. We also managed the Working Office in collaboration with the Kensennuma Public
Health Center.
② Holding training at daycare centers
We provided information to daycare center employees about how to interact with children
using games. In order to help integrate this information with their daily operations, we created Tshirts using stamps made from erasers for Kesennuma Municipal Sekko Daycare Center.
③ Holding training at Resident Association children’s group meetings
We conducted public awareness-raising activities relating to mental health in response to arequest by the Resident Association children’s group meeting. This involved providing abdominal
breathing exercises using a blowing pipe, a Christmas-card-making workshop, and speaking panels
designed to raise awareness surrounding mental health.
④ Holding training at middle schools
A training session under the topic of communication was conducted for 8th grade students at
Kessenuma City Omose Middle School.
(2) Discussion
The number of consultations by teachers concerning school children increased in 2017. It isbelieved that there are a number of children who require support concerning their mental health due tothe impact of the disaster and about issues related to their household and school life.
We will continue to provide individual support and raise public awareness by attempting tocontinue cooperating with schools and educational institutions.

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Report of the Ishinomaki Regional Center

Report of the Ishinomaki Regional Center Activity
Shigeru Okazaki – Manager, Psychiatric Social Worker
Hiromi Arai – Assistant Manager, Psychiatric Social Worker
Community Support Division, Ishinomaki Regional Center, MDMHCC

Introduction
The region managed by the Ishinomaki Regional Center, Miyagi Disaster Mental Health Care
Center (hereinafter, “Center”), as of the end of March 2018 included the two cities and a town of
Ishinomaki (population: 145,386, number of households: 61,236, area: 554.5km2), Higashimatsushima(population: 40,138, number of households: 15,732, area: 101.9km2), and Onagawa (population: 6,575,
number of households: 3,124, area: 65.8km2), with a total population of 192,099, number ofhouseholds: 80,092, and area: 722.km2. Compared to 2017, the population decreased by 1,728 while
the number of households increased by 187, indicating an advancement in the shift toward nuclear
families.
As of the beginning of 2017, this Center was comprised of a part-time psychologist as president,
four full-time psychiatric social workers, one admin, three part-time public health nurses, two full-time
psychiatric social workers transferred to Higashimatsushima and Omegawa, respectively, and a fulltime occupational therapist currently transferred to Ishinomaki. Our Center is divided into four
separate workplaces. At the end of March 2017, the member posted at Omegawa left the job, with one
psychiatric social worker being transferred from the Regional Center in October 2017. In the latter halfof the year, our Center consisted of eleven members.
In this paper, a summation of the activities of the Center will be presented and reported on.
The characteristics of our Center’s activities
The resident support provided by our Center in 2017 (excluding by those who were transferredexternally) accounted for 57.6% (549.9 hours) of all our activities (954.8 hours) in terms of time,making it the core of our undertakings.
As a general rule, visits and health surveys were conducted by several members. In order toprovide the same service to those who we were unable to meet during the week due to work
obligations, a public health nurse and psychiatric social worker conducted home visits during holidays.
By conducting visits by people of various occupations, we believe that we are capable of carrying out
an assessment from multiple angles.
Furthermore, most of our Center’s employees have worked within municipalities in the prefecture,with the average age being 60 years old. We believe that having a young staff member visit pairedwith an older, more experienced member will serve as a positive experience for the younger staff.
Other activities characteristic to our Center are salon activities (e.g., Koko Farm), mental healthcare workshops, human resource development training for supporters (e.g., suicide prevention
workshops), and alcohol-abstinence experience meetings supported by the concerned parties. These
activities have been conducted smoothly thanks to the Center’s employees, who actively take on
whatever duties are possible.
1. Resident support(1) Visiting survey
The City of Ishinomaki, our Center’s main area of activities, conducts independent health surveys
of residents such as those living in public housing. The aim of this project is to ascertain the state ofhealth and daily living needs of public housing residents, as well as to channel results back to specifichealth support projects for those who require latent assistance. The results of the research will be used
to create the future support structure necessary for public housing residents. This project was
conducted based on the 2015 health survey results made during residency application, with specialists
visiting individual residents during the period from one to two months after residents move in until all- 55 -

Report of the Ishinomaki Regional Centerhouseholds had done so. For 2017, subjects were those who had moved into public housing between
February 2017 and the end of January 2018.
Employees transferred to the Health Promotion Division, Department of Health, City ofIshinomaki (hereinafter, “Ishinomaki Health Promotion Division”), mainly engaged in providing
support for supporters. They organized the public health nurses who had been transferred to thecommunity based on the Local Autonomy Act, conducted health surveys by visiting residents’ homes
with the nurses dispatched as per autonomous law, and coordinated requests and contacts withoutsourced organizations.
Separate from the health survey form given to each citizen when applying for residency intemporary housing, interview surveys were conducted for those aged 40 and above on items such as:1) “I feel like I am forgetful” and 2) “compared to one year ago, I feel like I’m forgetting more.”
Among those who were suspected to suffer from peripheral symptoms of forgetfulness and dementia(e.g., delusion and depression) and those who consented to be surveyed by the person in question or
their cohabiting family members, there were several cases that led to a connection to the Ishinomaki
Dementia Initial Concentrated Support Propulsion Project conducted by Ishinomaki Health
Department Nursing Insurance Division (hereinafter, “Ishinomaki Nursing Insurance Division”).
As per the requests for conducting public housing residents’ health survey by the Ishinomaki
Health Promotion Division, the number of households that the employees from this Center surveyed
were 95 out of 110 (implementation rate: 86.4%). The mean age of subjects regarding whom we
received requests in 2017 was 48.0 ± 21.0 years old, meaning that there were many relatively young
households, with 31 out of 42 households being made up of single men. Furthermore, 21 out of 42
households claimed that they suffered from a mental illness or complained of having mental issues(K6 score of 13 or higher) or psychological disorders (e.g., sleep disorder). Likewise, we often
encounter households during our visits whose members reside with parents who have a mental illness
or require nursing care among households with other family members. Thus, there are quite a few
people in such households who say that they do not feel that well, consult us because they have
nobody else to consult despite having concerns about their family or nursing care issues, or consult us
because they have stopped working in order to look after their parents. Among these households, we
determined that the following required continuation of support: five members of five households who
terminated their treatment due to their symptoms worsening because of their illness, six members ofseven households that continued their post-earthquake mental health care, two members of two
households that received support after applying for welfare services for the disabled, three membersout of three households who required help with financial problems, and two members out of two
households that required assistance with family issues. We also continued lending support to elderly
households and households that resided with elderly parents by sharing information with the regional
general support center. Concerning the handling of financial problems, there were cases that werereferred to the Japanese Association of Social Workers in Health Services, which had beencommissioned by the City of Ishinomaki. There were also households that were found not to requireassistance urgently at the time of the survey, but which were believed would require future support.
These included single households and people with mental illnesses who were suspected to be solitaryor isolated in nature, as well as households with family issues such as social withdrawal. Information
on 22 people in 21 households was relayed to the Ishinomaki Health Promotion Division, and on 5
people in 4 households to the Ishinomaki Nursing Insurance Division.
Members involved in disaster survivor health support conducted meetings in 2017 held by the Cityof Ishinomaki, with the first of these held on September 6, 2017, and the second on December 1, 2017,
where they discussed the support structures for social withdrawal and alcohol dependency, which are
believed to be the main psychological issues of survivors anticipated to be of future concern. Issues
were shared such as the understanding of the implementation of support structures, which included
how the consultation contact point was advertised and methods of treatment. Other topics discussed
were the worsening of illnesses due to the aging population within public housing and the increase insingle households, dealing with those who terminated their treatment due to financial difficulties, anddealing and supporting those who were not yet in a state to receive unofficial services.
(2) Local resident salon activities (group activities)① Koko Farm Project
The Koko Farm Project was started with the objective of having the survivors of theearthquake recover their mental and physical health by using farm work to provide a place of- 56 -

Report of the Ishinomaki Regional Center

recreation and interaction. Five years have passed since it started in 2013. This project is
conducted twice a month from March to December on the second and fourth Wednesdays, and asneeded during the summer vegetable harvest season, excluding during winter, for about two hours(including a break) from 9AM, cultivating vegetables such as eggplants, potatoes, onions, Chinese
cabbage, and leafy vegetables.
The participants were 7 men and 11 women aged between 52 and 88 years. The mean maleand female participant ages were 74.3 and 68.6 years, respectively, with the mean age being 70.8
years old.
In 2017, this project was conducted 19 times, with total participants totaling 221 (including
the December harvest festival). The breakdown of the participants was 95 men and 126 women,with the average number of participants approximately 12 per session. Those newly participatingwere one man and one woman, both of whom had lost their families in the earthquake.
Although the Center employees had been driving those who were unable to participate on theirown until 2016, employees began to question what would happen should an accident occur. For
this reason, we discussed correct procedures during an accident with the Stem Center.
In the discussion conducted before starting the project for the 2017 fiscal year, many opinionsfrom the participants were collected, including: “let’s collect membership fees,” “I feel a lot
healthier both in mind and body after participating in farming when I was feeling mentally weak,”“opportunities for me to go out have become few after moving into public housing. The farm
activities that take place twice a month are much more enjoyable than anything else,” and “please
continue this initiative because I’ll pay the membership fee to reduce the burden on the
MDMHCC."We proposed that participants use taxis as a means of transportation to and from the farm.
Although some participants said that they would like to partially pay for the taxi fare, we came toan agreement after the discussion with the participants that they would use the taxi and not have to
pay for it.
A participant suggested donating potatoes, onions, and Chinese cabbage to the children’s foodhall (an initiative that provides free meals to children from low-income households), which
received the approval of all the participants. We started donating vegetables to the three children’s
food halls from 2017, including the Ishinomaki Social Welfare Council and NPO organizations
that provide support to children. After the donation, we received a thank you letter from thechildren. Participants were delighted to see this, with one quoted as saying, “I’m happy that thechildren enjoyed the vegetables, which make us feel more encouraged thanks to them.”
Five years after conducting the Koko Farm Project, many people have been going outside of
their homes in their daily lives, including those who have continuously participated in the project.
Many people stated how pleased they were with the project, making us feel that they have been
recovering both physically and mentally.
Furthermore, we are able to operate the Koko Farm Project smoothly thanks in large part tothe cooperation of farm owners and volunteers with many years of farm experience, all of whom
have expressed agreement with the Project’s objectives. In particular, the volunteers provide
advice while talking with participants about how to plant vegetables to make the farming taskseasier. Enabling the participants to all work together is believed to be a large factor that leads totheir mental health recovery.
We often encounter people with a high K6 level and those with drinking problems. We would
like to continue running the Koko Farm Project in conjunction with our home visits so that those
who experienced and were impacted by the natural disaster firsthand can interact with one anothercasually while also coming in contact with nature, in the hopes that they can recover their spirits.
The state of implementation in 2017 is displayed in Chart 1.
Table 1: Koko Farm Implementation
Implementation
period and time

Number of times
implemented

Total number ofusers

Total number ofvolunteers

Total number ofstaff

Total number ofparticipants

April to December
Twice a month
9:00–12:00

25

211

39

103

353

- 57 -

Report of the Ishinomaki Regional Center

The number of times implemented include sessions with only volunteers (four times) and with only
volunteers and staff (twice).
② Handcraft class
From 2013, we have been conducting a handicraft (collage) class taught by three volunteers
with the objective of providing a place for private rental housing residents to interact. In 2017, a
total of nine classes were held, with class held once a month from April to December. The total
number of participants was 60, with the mean number of participants per class being 7. Althoughclasses were scheduled to be held from 9:30 AM to 12 PM, some participants arrived at the venue
prior to 9AM, as they enjoyed talking with other participants and staff members.
One participant stated, “I look forward to coming here and seeing everyone,” while theinstructors have said that the participants have been helping one another to improve. After theclass, tea and snacks were provided while participants and staff members showed their work to one
another, talking freely about the class and their daily lives in a friendly atmosphere. Work createdat the class has the opportunity to be presented in the work presentation and exchange meeting
held at our Center.
Given that the Center will be relocated to a new government building in March 2018, it was
anticipated that finding a place to hold the class would be difficult. After deliberating over the
future of the collage class and discussing it with the instructors, we decided to end classes in
December 2017.
We have had participants say, “I didn’t have anything to do after moving into the public
housing and so I started making collages on my own. By chance, I happened to participate in acollage trial session at the jointly-used government building, and it made me want to participate in
the class, too. Although it was only for a short time, I had a lot of fun,” and “I was happy that I
could come even if it was just once a month.” The instructor also commented, “I feel sad, but if
there is anything you don’t understand about collages, please let me know.” After they finishedtheir tea and the class was disbanded, we saw participants talking to one another, forging a bondover collages, saying to one another, “I live here so please feel free to drop by.”At first, the classes started as a place in which private rental housing residents who did nothave a gathering place could interact with one another. However, as time passed, there were those
who started anew, moving into public housing or self-housing restoration. The classes then started
transforming into a place in which residents affected by the earthquake were able to get together.
Implementation for the year 2017 is displayed in Table 2.
Table 2: Handcrafts class (collage class) implementation status
Implementation period and time

9:30–12:00
April–December
Once a month

Numberof
implemented(farm work)
9 timestimes

Type of work and content

Total
numberparticipants

Collage-making

60of③ Life skills class
The activity was held on the fourth Tuesday of each month at the Ishinomaki Health
Consultation Center, with a maximum of five participants per class. The classes were conductedby a total of three people, including two employees from our Center and an occupational therapist
who had been transferred to Ishinomaki. The content of the class consisted of two parts: Things
that the participants had engaged in or wanted to engage in as hobbies, and handcrafts and cooking.
Each part was conducted for one hour. In the handcrafts classes in 2017 we attempted leathercrafts,
as per the request of a participant, and created a train fare card holder. For cooking, we tried foodthat can be easily made at home using seasonal ingredients. Although the classes were small in
number, the activities were held in a warm atmosphere in which the participants created artworkand cooked food together, then enjoyed sharing it with one another.
In 2017, one of the participants left due to finding employment, while another participant was
unable to continue due to reasons pertaining to their home. For this reason, these participants
stopped attending from August onward. When we visited those who had participated, meeting- 58 -

Report of the Ishinomaki Regional Center

them at their homes, they said that their physical condition had stabilized after attending the life
skill class, with one participant happily stating, “although I had been hospitalized once a year,
even my physician said that my condition has improved.” Furthermore, a participant stated thatthey had opportunities to cook and serve the food they had made in class at home to the delight of
their family members. Their role within the household also increased, indicating that they areliving their lives more fully. They said that although it was difficult to continue participating in theclass at that time, they would like to participate once again should they have the chance.
In terms of the future of the life skill class, we would like to inquire about this further with theRegional Center, as we confirm the needs of the local community as we visit the homes of its
residents.
2. Changes in support services
The employees who had been transferred to Ishinomaki have been allocated to the Adult Health
Section of the Ishinomaki Heath Promotion Division, with occupational therapists in charge of theSurvivors’ Health Support Project. This involves admin work related to home-visit health surveys atresidences such as public housing, acting as a contact point by coordinating with support organizations,
reporting, and passing on information to other divisions and institutions after visiting homes. Other
work includes forming a survivor support team with the city public health nurses and dispatchingsupporting public health nurses. As occupational therapists, they provide support to the Disuse
Syndrome Prevention Project (also known as the Yuikko Project), the Association for Families with
Executive Dysfunction, and the early-onset dementia projects.
The staff member transferred to Higashimatsujima is assigned to the Health Promotion Division,
Mental Health Welfare Division, Higashimatsujima City (hereinafter, “Higashimatsujima Health
Promotion Division”). They are in charge of providing auxiliary support services to the district publichealth care nurses, individual support for psychiatric cases, consultations regarding children’s mental
health care, coordinating support for the families of suicide victims, cooperation and coordination with
relevant institutions, planning for projects run by a mental health group, assisting with operations,participating in meetings with relevant parties, supervising supporters, and organizing various resource
materials.
The employee posted in Onagawa is posted in the Health Welfare Division, Health Care Center,
Onagawa town. Their activity in the latter half of 2017 is as follows, as per their reporting:
We started supporting Onagawa employees’ mental health projects from 2012, as we did in 2017.
One such activity was issuing the Haato Tsuushin (translation: “Heart Correspondence”) twice amonth to all employees as a mental health awareness-raising effort using the office network.
Information that could be casually read between work hours was distributed, including stress reduction
methods, tips on looking after oneself, and trivia related to health, to benefit employees’ mental health.
Although we had been running Heart Salon twice a month, which is a contact point where
employees could consult for advice at any time until September 2017, we determined that theestablishment of an individual advisory structure had become well-known due to our previous
activities. For this reason, from October 2017 we started providing individual consultations whenever
there was a request. In addition, we conducted a stress evaluation service in Onagawa, using a stresscheck sheet along with a medical questionnaire sheet during employee health examinations. An
industrial physician conducted an individual consultation based on the medical examination and stressevaluation results. Our Center’s employee who was posted in Onagawa aggregated the stressevaluation results, coordinated and assisted with the industrial physician’s consultation, and provided
other necessary assistance. Although seven years had passed since the earthquake, there were still
many live issues, such as the drastic change in the employment environment and the continuing
instability of the living environment. We started making adjustments from 2017 so that as many
employees as possible could receive a consultation with the industrial physician.
We continued dispatching our Center’s part-time psychiatrist since 2012, with a dispatchment
structure being rearranged to one day (full day) every other month from 2017, holding a consultation
meeting in the style of MDMHCC Consultation Meetings. We have allowed consultations not only forcity residents and their families but also for supporters who provide aid to the lives of the city residents,
the comprehensive support center employees, and for public health care nurses. In addition to thedissemination of information via Onagawa press releases, we also disseminated information via
conferences in which relevant organizations could gather, making the service available to a wider
audience. The content of consultations included relevant psychiatric symptoms (e.g., depression and- 59 -

Report of the Ishinomaki Regional Center

insomnia) and dealing with family issues. Having the same doctor handle the cases continuously also
led to a sense of security for the residents and supporters who were providing consulting, with there
being some members who continued to make use of the meetings. The dispatch structure iscoordinated in accordance with the city’s requests for each year. In 2018, we are planning to provide
lectures with local volunteers by going to the meeting halls of such places as public housing areas, aswell as a tea-party organized as a response to requests made by the municipal government where a
psychiatrist provides talks on mental health within a new residential community.
Even with regard to residential support, we would like to continue providing support via homevisits by coordinating and consulting with public health care nurses and related organizations, andwould like to continue needed support by being mindful of conducting respectful interactions.
In Onagawa, the development of assembly-type public housing was completed in 2017, with mostresidents planned to relocate to their new living foundations during 2018. Presently, we have heard
many people state that although they came to reside in the public housing, interaction between
residents has decreased. This indicated that in-depth support would be required for a longer time. We
would like to be mindful of providing support that meets the residents’ needs in the future byexamining what we, as dispatched employees, can do on a daily basis.
At the Center we provide help to supporters by accompanying municipal public health care nurses
during home visits, participating in case conferences and area meetings, and providing support for
infant health checkups. The stance of the Center is to meet the needs of municipalities as much as
possible.
(1) Attendance to case conferences and area meetings
We attend case conferences on issues related to alcohol and mental illnesses after receiving arequest from the Miyagi Prefectural Nursing Association of the Ishinomaki City Social Welfare
Council in Ishinomaki City (hereinafter: Nursing Association), and the regional comprehensive
center within Ishinomaki. We then confirmed the approach toward support provisions of each aid
institution, as well as examining cases including the division of roles. Furthermore, we attended
area support meetings of the Hebita and Sumiyoshi Districts, with such organizations participating
as Ishinomaki City, the Social Welfare Council, the Hebita regional general support center, theNursing Association, and occupational skills organizations.
We then attempted to share information and examine the needs and situation of the residents in
temporary housing. The area meetings were changed to also share information on the residents inpublic housing, and not just those in temporary housing.
(2) Support for infants’ health examination
We conducted a mother-child consultation service by dispatching a public health nurse to theinfant health checkup examinations conducted in the Ishinomaki Kahoku block (Kahoku, Kitakami,
and Ogatsu) following a request by Ishinomaki City. We provided support a total of ten times in
the Kahoku block, with advice on mother and child mental health care provided during theconference held after the examination. We were also in charge of individual care for those who
required continuous support.
3. Raising public awareness(1) Hosting an alcohol abstinence meeting experience session in front of Ishinomaki Station
In order to create a structure in which an alcohol abstinence meeting experience session, which
we have been conducting from June 2015 at Ishinomaki Kahoku General Branch Office, could be
conducted continuously by Danshukai, Alcoholic Anonymous, within Ishinomaki, we conferredwith the Non-Profit Organization Miyagi Prefecture Danshukai and the Ishinomaki Municipality.
We did this with the approach of 1) moving the meeting to the periphery of a train station or to thecity center area, and 2) holding it within the appointed day.
Date and time held: 1:30PM–3PM on the second Thursday of each month
Venue: 1F Conference Room, Ishinomaki City Health Consultation Center
Sponsor: Our Center
Co-sponsor: Ishinomaki Municipality
Cooperating organization: Non-Profit Organization Miyagi Prefecture Danshukai (hereinafter:“Danshukai”)
The targets for this initiative were people and their families who aimed to abstain from alcohol- 60 -

Report of the Ishinomaki Regional Centerand supporters who were interested in abstinence. Leaflets were distributed at the contact point ofconsultation institutions. The meetings were held from April after asking for the cooperation of
medical institutions within the Ishinomaki area.
Those who had been participating since the time the meetings were held in the Kahoku General
Branch Office continued participating using the JR train service and were also joined by newparticipants. Furthermore, two members who aimed to stop drinking alcohol became regularmembers, enrolling in Danshukai. In 2017 the total number of participants was 117: This included
35 members wishing to quit alcohol, 35 members of Danshukai, 6 family members, and 41
supporters.
The sessions are currently officially hosted by us with the support of Danshukai. In reality,
however, the meetings are conducted autonomously by Danshukai from start to finish. For thisreason, we would like to cooperate with the Ishinomaki Municipality to provide support so that
Danshukai will become the official host of the meetings as soon as possible.
(2) Work exhibition and social gathering
This project has been held since 2012 as a work exhibit and social gathering for private rental
housing residents. This initiative was held as a place of interaction for people who were forced torelocate to new private rental housing or to temporary container-type housing after the Great
Tohoku Earthquake away from regions they were familiar with, since many of these people had
fewer opportunities to participate in regional activities.
With seven years having passed since the disaster, there have been more and more people whohave commenced new lives by rebuilding their houses by themselves or by relocating to therestored public housing. This Center also had its office relocated to the Hebita District inassociation with the relocation of the integrated governmental office in March 2018. As a token ofgratitude to the survivors who have cooperated with the work exhibition and exchange meetings,
we held a meeting to deliver our gratitude (Kansha no Tsudoi) on November 14 (Tuesday) at theold Ishinomaki Integrated Governmental Office, in which 99 people participated.
This meeting was co-hosted by the Ishinomaki Public Health Center, received a sponsorshipfrom the Ishinomaki Social Welfare Council, and was held with the objective of serving as an aid
for the promotion of mental and physical health of the survivors.
On the day of the event, we received cooperation from the Japanese Association of Social
Workers in Health Services, installing a traffic safety section with the cooperation of the Traffic
Division of the Ishinomaki Police Department.
The content of the activities were: 1) social exchange section (e.g., café space and handmassage), 2) crafts corner (origami and collage), 3) work presentation (exhibiting work by theparticipants of the collage class and living skill class held by the Ishinomaki Regional Center). 4) ,and health advice (in cooperation with the Miyagi Prefecture Nursing Association), life skill
consultation (cooperated by the Japanese Association of Social Workers in Health Services), andan alcohol patch test (conducted by our Center) were held as part of the services provided at theconsultation segment, and 5) a traffic safety segment involving the Miyagi Prefectural Police
Traffic Safety Education Car (“safety support car”) to provide traffic safety education for theparticipants.
(3) Other projects
We received a request to dispatch instructors from governmental and various other institutions.
For this reason, we dispatched an employee to the Ishinomaki City Eating Habits Improvement
Promotion Member Liaison Conference Workshop and Nanba District Health Promotion Member
Workshop.
4. Human resource development/training(1) Training on alcohol-related issues
With the passage of time after the disaster, alcohol-related issues have begun to surface. We
provided a workshop on alcohol-related issues by coordinating with governmental institutions andvarious aid institutions in addition to inviting a Tohoku Hospital employee as a lecturer.
① Ishinomaki Public Health Center
In 2017, we co-hosted a workshop conducted by psychiatrists from the National Hospital- 61 -

Report of the Ishinomaki Regional Center

Organization Kurihama Medical and Addiction Center. The workshops provided were “Things
You’d Want to Know about Issues with Alcoholism” (63 participants) in August 2017 and “About
Brief Interventions” in October 2017 (37 participants).
② Workshop in Ishinomaki
We conducted workshops on CRAFT Program, skills how we should support people who can’t
stop drinking alcohol, after receiving a request from the Ishinomaki municipality to learn aboutalcohol-related issues starting from their fundamental aspects. The workshops were conductedwith the cooperation of Tohokukai Hospital and were aimed at Ishinomaki municipality employees,
including those working at the General Branch Office.
③ Workshops at Higashimatsushima and public awareness-raising activities via residential visits.
In Higashimatsushima we actively conduct workshops, health consultation meetings, and postspecific medical examination activities in order to promote healthy living and health promotion for
the residents, with the municipal public health care nurses playing a central role.
With regard to alcohol awareness projects, we held workshops on how to best interact withalcohol for the members of the Dietary Habits Improvement Promotion Committee. We also
engaged in awareness-raising activities during the consultation meetings held by the districtautonomous association by having a public health care nurse work in collaboration with the
Tohokukai Hospital to provide a mini-talk on alcohol, and by holding an alcohol issue caseexamination meeting with the regional general support center employee within Higashimatsushima.
Since 2016, Higashimatsushima Municipal public health care nurses, psychiatric social
workers, and our Center’s public health care nurses have paired up and visited homes of those
aged under 65 whose γ-GPT was 100 or over (40 cases) during the specific medical examination.
Specific medical examination results conducted in 2017 showed that there were nine members
whose test values had improved from that of the 2016 exam. There were many family members of
the tested residents who were also worried about test results. For this reason, explanations of thehealth exam data during the home visits were well received by these residents, with the reactions
being positive.
In 2017, our Center cooperated with follow-up home-visits conducted after specificexamination for approximately a month, starting in late October. There were many people who
showed a high value, not just in liver function but also in cholesterol, triglyceride, and BMI values.
Given that some citizens needed to improve their dietary habits, we conducted home-visits (39cases) in pairs formed from public health nurses, nutritionists, psychiatric social workers, andemployees from our Center.
Those we visited suffered from some kind of illness, with some living their lives in anxiety.
The home visits were received favorably by the residents’ family members as well, partially due toan accompanying nutritionist during the visit. There was feedback stating that “there were manythings I learned about my diet habit (including alcoholic consumption) and it was useful.” Thevisits led these residents to review their dietary habits, continue with their treatments, become
motivated to drink moderately, and reduce the concerns of their family members. The specificmedical examination follow-up visit served as an opportunity for subjects to once again understandthe importance of living healthily.
Although the targets for this initiative were those aged under 65, those in their senior years face
many issues, including excessive alcohol consumption. For this reason, examining how to expand
the support framework within a region, including through collaborations with aid institutions, is asignificant issue we need to address.
Our Center is extremely grateful for being allowed to participate in such a pioneering initiative,
and we wish to actively participate in this during the following year as well.
④ Workshops at Onagawa
The workshops in Onagawa were held in cooperation with the Tobu Public Health and Welfare
Office and the City of Onagawa from 2015. In 2017, the Onagawa Regional Medical Center madea request to the municipality, with a robust discussion being conducted with 45 participants in
October 2017 under the topic of “learning how cooperation between the local community and a
specialist institution should be made through case examples in Onagawa,” in which case examples
were provided by Regional Liaison Office nurses from the Regional Medical Center. In January
2018 we received a debriefing from Tohokukai Hospital staff members on Treatment Programs for
Alcohol Dependency, in which there were 38 participants. In addition, two supporters from the- 62 -

Report of the Ishinomaki Regional Center

Onagawa municipality attended practitioner training at Tohokukai Hospital in February 2018.
(2) Various workshops
In the past, we have hosted Mental Health Care workshops for those who provide support tochildren in the municipalities, including public health care nurses, childcare workers, other parties
involved with school (e.g., teachers and school nurses), clinical psychologists, and general citizens in
the prefecture. In 2017, however, we provided the following workshops:① Workshop on cooperating in mental health aid activities for children in disaster-affected areas
・ Objective: Through the activities of Kohnodai Hospital immediately following theearthquake up to now, to hear about the future of regional cooperation, as well as
the hospital’s aid activities and children’s mental health, which present an
opportunity to examine support for the children and review cooperation within
the region.
・ Sponsor: Natural Disaster Mental Health Care, Inc./Network Miyagi Karakoro Station(hereinafter, “Karakoro Station”), and the Ishinomaki Regional Center, MDMHCC
・ Co-sponsor: Ishinomaki City, Ishinomaki City Board of Education
・ Lecture: Children’s mental health in Ishinomaki: What I learned/witnessed from five yearsof aid activities since the Earthquake
・Lecturer: Naoko Satake (Hospital psychiatrist, National Center of Neurology and Psychiatry)・Time and date: August 31, 2017 (Thursday), 2PM–4PM
・ Venue: Big Bang Tsudoi no Heya (translation: “Big Bang Meeting Room”), Ishinomaki
Kawakita General Center・Participants: Those involved in survivor support, including health, nurturing, and educationin the Ishinomaki District
・Number of Participants: 62② Mental health care workshop
・Objective: Six years have passed since the earthquake and although tangible outcomes ofrestoration are being seen, the environment that the children are in remains muchthe same drastically changed state as immediately following the earthquake.
Children, who are the most vulnerable, are prone to experience strain from such achange. Furthermore, because they cannot speak up by themselves, supporters
and guardians often only respond once children’s problematic behaviors havemanifested.
This lecture will serve as an opportunity to examine how supporters shouldinteract with children that show signs of concern or impatience that may indicate
a developmental disorder, as well as how supporters should interact with children.
Furthermore, we will examine what we can do to elicit children's strength while
being mindful of their mental health.
・Sponsor: Miyagi Disaster Mental Health Care Center (MDMHCC)
・Co-sponsor: Miyagi Prefectural Education Committee
・Lecture: Parent’s affection and children’s psychological development
・Lecturer: Makiko Okuyama, Director, Department of Medical Care, National Center forChild Health and Development
・Date and time: September 22, 2017 (Friday), 2PM–4PM
・Venue: Aeon Cinema Ishinomaki, Theater 8・ Participants: Those who are involved in health, nurturing, education, and childcare.
Approximately 200 people: Public health nurses, childcare workers,
kindergarten/primary school teachers, child welfare commissioners, and foster
parents
・Number of participants: 243③ Suicide prevention workshop- 63 -

Report of the Ishinomaki Regional Center・Objective: In the restored public housing health survey conducted in Ishinomaki, there has
been an increase in people whose physical condition has improved since
relocating to public housing from temporary housing. On the other hand, there
are also many single households, solitary elderly households (those aged 65 andabove living by themselves), and unemployed persons, resulting in an increase in
the percentage of people with illnesses.
Regarding those who have committed suicide, the national census conducted by
the Ministry of Health, Labour and Welfare in 2016 showed that suicide occurs
most commonly among those between their 60s and 70s, who are unemployed,or who have health and financial/life issues. For this reason, the disaster-afflicted
area is prone to greater risk factors.
We invited Dr. Shinichi Tanba from the Aizu Medical Care Center Departmentof Psychiatry in the Fukushima Prefectural School of Medicine, who has studied
suicide related to natural disasters. Dr. Tanba gave a lecture titled “Suicide
Related to Natural Disaster: In Search of Clues to Support Suicide Survivors,”
providing us with the opportunity to examine the issue of suicide in the
Ishinomaki region and how to support suicide survivors.
・Host: Tobu Public Health and Welfare Office, Miyagi Disaster Mental Health Care Center(MDMHCC) Ishinomaki Regional Center・ Lecture: Suicide Related to Natural Disaster: In Search of Clues to Support Suicide
Survivors
・Lecturer: Shinichi Tanba (Doctor, Fukushima Prefectural School of Medicine Aizu Medical
Care Center Department of Psychiatry)・Date and time: November 7, 2017 (Tues), 3PM–5PM
・Venue: Kahoku Hall, Sanriku Kahoku Newspaper
・Participants: Approximately 100 members who are involved in health, medical, welfare,education, fire, and police services in the Ishinomaki region.
・Number of Participants: 63(3) The 17th Earthquake Survivor Mental Care Exchange Meeting in Ishinomaki
This exchange meeting held for supporters adopted an executive committee format from 2015.
In 2017, an Executive Committee was created for the meeting, comprising members from thirteen
governmental and private organizations, including the Tobu Public Health and Welfare Office,Ishinomaki Health Promotion Division, Higashimatsushima Health Promotion Division, Onagawa
Health Promotion Division, Ishimatsu Social Welfare Council, Miyagi Nursing Association,
Japanese Association of Social Workers in Health Services, Onagawa Stem Consultation Support
Center Kurumi, Youth Support College Ishinomaki NOTE, the non-profit organization TEDIC,
Shinwakai Disabled Person’s Consultation Support Office Tomo, Inc., Karakoro Station, and ourCenter.
There were those within the Executive Committee who were feeling mentally and physicallyexhausted as their work following the earthquake increased due to supporters having to handle
issues that were becoming increasingly complex and diverse, and because the residents affectedby the earthquake had been scattered. For this reason, we conducted a meeting, as in 2016, withthe title Healing Ability II,” with its content focused on stress care and directed solely to the
supporters.
A commemorative lecture was given with the title “The Mental Health of Supporters: From
the Perspective of Emotional Labor,” for which Seiji Maeda (Chairperson, Faculty of Disaster
Mental Health Medical Science, Department of Medical Sciences, Fukushima Medical University)
was asked to give a speech.
The survey given during this exchange meeting collected the following opinions on thecommemorative speech:• Although there have been talks and training on the mental health care of survivors, it wasgood that the speech focused on the mental health care of the supporters.
• Although I have been empathizing with people as if it’s something that comes naturally, I
realized that it leads to emotional labor, allowing me to realize once again the importanceof looking after one’s own mental health.

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Report of the Ishinomaki Regional Center

•
•
•
•

I had not been that aware of the mental and self-care of supporters, so it was useful.
I was able to learn the importance of the mental health care of supporters from a
specialist’s perspective.
I felt once again that looking after the supporters themselves is important in order to allow
the support to go on for a long time.
It was good to hear about the idea that the feeling of guilt and blaming oneself was related
to PTSD and stress.

For group discussions, we conducted four sessions: 1) Discussion with Dr. Maeda, 2) Hand
massage workshop, 3) Yoga workshop, and 4) Exhaustion level checkup & easy stretching.
Regarding each group discussion, we received the following feedback. 1) Discussion with Dr.
Maeda: “I was able to understand more about the topic” and “it was good to learn about the
supporters from each region”; 2) Hand massage workshop: “I felt that massage is important whenit comes to taking care of yourself” and “I felt very rejuvenated”; 3) Yoga workshop: “I was able
to concentrate on my body and was able to relax a lot” and “although there were parts that I felt
were a little difficult because it was my first time, I was able to escape from reality a little”; and 4)
Exhaustion level checkup & easy stretching: “It was good that these stretches could beincorporated into one’s daily life in the future.” Judging from the survey, we feel that the goal of
Healing Strength II has been more or less met.
We received the following statements concerning the execution committee:• It was good that the voices of the supporting organizations that practice mental health careon site are well reflected. Although it’s good to check up on the status of things by
establishing a committee, I feel that one can also check using surveys where the situation
permits.
• I think it’s good that there’s an opportunity for us to express our opinions and thoughts.
• It was good that I was able to learn about the current state of things within the Ishinomaki
area and to hear about concerns and resolution methods from each person’s perspective.
• It was good we discussed this because I believe that there are ideas and methods that canbe gained from discussing it with the Executive Committee.
• We were able to talk frankly in a fun environment.
• It was good that I was able to interact with people from various occupations during the
preparation stage.
• I think it’s great to create an exchange meeting with various organizations. I hope it willcontinue in the future.
• As we provide mental health support to the survivors, it is indispensable that trainings
focus on treating targets to be supported. It was very worthwhile because I don't think
there are many training programs that deeply discuss the self-care of human service
providers.
The 2017 exchanging meeting was held after receiving feedback from organizations that
operate within the Ishinomaki area and discussing it with them. We would like to keep holding
mental care exchange sessions for those affected by the earthquake as a cooperative operation inwhich supporters participate.
For the meeting to be held in March 2018, we would like to examine the time this meeting
will be held so that more people can participate, given that it will be held at the end of the
fiscal year.
(4) Children’s Mental Care Regional Base Operations
We have been holding lectures on understanding the issues that occur among children indisaster-afflicted areas and support methods for supporting and dealing with parents whose lives
have changed drastically. From 2013, we have been holding a Mental Care Workshop for publichealth nurses, childcare workers, kindergarten and elementary school teachers, school-nurses,
child welfare commissioners, and foster parents. This 2016 lecture was positioned using thechildren’s mental health care regional base operation plan as its basis.
In 2017, the children's workshops we held were “on cooperating with children’s mental healthaid activities in afflicted regions,” “the mental health care workshop,” and “on parents’ affection
and children’s mental development.”- 65 -

Report of the Ishinomaki Regional Center

Requests for consultation from Ishinomaki related to the children’s regional base project isincreasing. In Ishinomaki, we handled a total of eleven cases—seven from nursery centers and one
each from the governmental institution, elementary school, childcare support center and others—
as well as a request to provide assistance to professions such as public health nurses, childcare
workers, kindergarten teachers, and teaching staff members. The Mother-Child Health Section of
the Ishinomaki Health Promotion Division served as the contact point, receiving consultations
from such locations as the nursery center. By coordinating with the public health nurses of thecontact point of our Center, we visited and set up conferences with the consulting member.
At Higashimatsushima and Onagawa, vice president of our organisation, who is also a clinicalpsychologist, and public health care nurses mainly handled individual case consultations after ourCenter discussed it with the two municipalities.
We would like to continue holding workshops for employees of relevant institutions andcontinue coordinating with relevant institutions in regard to providing support for individuals.
Summary
With seven years having passed since the Great Tohoku Earthquake, we are starting to tangibly see
recovery in the disaster-afflicted areas, albeit gradually, as indicated by steps such as the completion of
public housing. Among people who have been affected by the earthquake, although there are those
who have rebuilt their homes on their own or have relocated to public housing, there are also a few
people who have yet to regain any prospect in terms of their regaining their livelihood, such as bymoving out from temporary container-type housing. As can be seen, a discrepancy in the speed atwhich people can recover from a disaster is starting to surface. Furthermore, as if to coincide this trend,
restoration support organizations are gradually starting to leave the afflicted areas.
With regard to cooperation with other institutions, we conduct regular information exchanges once
every two months with Ishinomaki and once each month with Higashimatsushima and Onagawa.
Although not regularly, we also engage in information exchanges with public health centers andmental health welfare centers.
By holding the disaster-afflicted mental health care exchange meeting in Ishinomaki in an executive
committee format, we were able to discuss the topic with relevant organizations in a frank and upfront
manner. We feel that our mutual understandings have deepened, in which each organization is now
asking on a regular basis for input from other organizations in the areas they excel in.
The 2017 public housing health survey independently conducted by the City of Ishinomaki duringhome-visits conducted one to two months after the residents had moved in became an opportunity to
discover a wide variety of cases and people requiring support. By coordinating with each relevant
institution, we were able to connect these people with the support they require. Given this conclusion,
we would like to continue fully cooperating with the Ishinomaki City public housing resident homevisit health survey in 2018.
By visiting those who were aged under 65 and had a score of over γ-GPT100 during the specificmedical examination conducted in Higashimatsushima in 2017, we were able to motivate those people
to review their dietary habits and treat their medical diseases, as well as provide preventative support
including advice on appropriate alcohol consumption. We believe that this pioneering initiative served
as a starting point to resolve alcohol issues. Higashimatsushima also oversees many other pioneering
initiatives, including all-household social withdrawal research and support for the families of suicide
victims. Part of this initiative is handled by our employee who had been temporary transferred there
from our Center, and we are planning to also cooperate actively in 2018.
In 2017, we held a workshop on alcohol-related issues as per the wishes of Onagawa. We would
like to continue holding workshops that meet the needs of the city next year as we continue
discussions.
Coordination with the three cities within the Ishinomaki area is now smoothly operating and more
frequent. This is the result of the daily activities of our employees who had been transferred there. Oneof the major topics to discuss is how the regional centers should cooperate with temporarily transferred
employees and support them.
In conjunction, the organizational/support structures of governmental institutions are also being
modified. Six years have also passed by since our Center was established, and thus our activities so far
have needed to develop in accordance with the current regional state of restoration. The MDMHCC isan institution whose term of operation runs up to March 2021, and we have to prove what we can passon and what we have achieved in the region during the ten years of our activities. The collage class- 66 -

Report of the Ishinomaki Regional Center

project that was terminated in 2017 fostered an approach that led its participants to engage in regional
community activities conducted by the Ishinomaki Social Welfare Council and other similarorganizations.
We believe 2018 will be a year in which we will continue to be engaged in our operations as ourentire staff will consider and search for methods and approaches in which we can further deepen thecooperation we have established with the institutions/organizations that will continue operating in theregion from March 2021 onward.
Our Center believes that our supporters are those who think about the earthquake survivors andcultivate their autonomy by aiding the survivors exhibit the power that each one of them has. We willcontinue to humbly listen to what those who were affected by the earthquake have to say in 2018 as
well, engage in support services so that we can foster the strength of each survivor, and provide
continuous support to prevent the isolation of affected residents and allow them to live as fully as
possible.
Lastly, I would like to extend my gratitude to everyone who has cooperated in making this paper.

- 67 -

Report of the Community Support Division, Stem Center

Report of the Community Support Division, StemCenterYuichi Watanabe – Director, Psychiatric Social Worker
Iku Amakasu – Assistant Manager, Public Health Nurse
Yukie Oba – Assistant Manager, Public Health Nurse
Community Support Division, Stem Center, MDMHCC

1. Introduction
The Miyagi Prefecture’s restoration plan has divided the 10-year span following the earthquake
into the three stages of recovery, regeneration, and development. As of 2018, we have entered thedevelopment stage, the last part of the plan.
Even at the Miyagi Disaster Mental Health Care Center (MDMHCC), an operation plan has been
prepared based on this restoration plan, engaging in support activities aiming for the improvement ofregional mental health welfare based on the following five principles:(1) The support for the afflicted-sites is conducted as a mental health care activity based onoutreach via each municipality;(2) Assistance for supporters is conducted multilaterally through consultation and mentalhealthcare programs;(3) Providing seamless support from children to adults based on the prefecture’s restoration plan;(4) Developing support activities for regional mental health welfare in accordance to the state of
the afflicted-municipality; and(5) Summarizing activity outcomes and research that contribute to the countermeasures for future
large-scale natural disasters.
Using the remaining time to operate the Stem Center of the Community Support Division(hereinafter, “the Division”) to the fullest, we will engage in initiatives for resolving the plan. As aprecursor for such initiatives, we need to accurately capture the actual regional status, as it is subject tochange on yearly basis, and share the information obtained with the responsible members of themunicipality.
This paper will review activity content and its outcome for this Division for 2017, followed by adiscussion.
2. Our activities
Of the Miyagi Prefecture coastal area, the jurisdiction of this Division covers the southern coastal
area that extends from Matsushima to Yamamoto but excludes the Kesennuma and Ishinomaki areas,
along with the municipalities in the inland area. The employees that handle the operation consist of 12
people, with managing employees allotted to the department in charge of the disaster survivors of eachmunicipality, providing support that matches the needs of each location.
(1) Resident support
The residential support provided by our Division has seen a gradual increase in the number ofcases handled since we began our activities. The number of cases reached its peak in 2015, but its
number has been decreasing since then (Graph 1).
■Coordinating conferences ■Support for various activities ■Support for supporters ■Human
resource development training ■Resident support ■Raising public awarenessCommunity Support Division, Stem Center Activity Report

Figure 1: The trend of Community Support Division activity time

In terms of the instigating factors behind consultations (Figure 2), health surveys and requests
from a governmental institution were the highest cause, as it was in 2016. This is believed to reflect
our Division’s stance, which is to respond through collaboration with governmental institution
mangers in order to align our efforts, which we have consistently done since opening the Center.

Figure 2: Instigating factors behind consultation requests within the Stem Center operation area (total number of cases)

The background prompts behind consultation requests show that the percentage of psychologicaldisorders, health problems, family issues, and addiction/alcoholism was high, as in 2016. The fact thatthe percentage of women seeking consultation in relation to family/household issues was large did notchange either. The number of consultations attributed to the change in residential environment isshowing a declining trend annually.
Among the issues of persons requiring support have to whom we provided support several times orcontinuously, alcohol-related issues stand out. Each time we hold conferences on the support content
within the Division, we examine case examples. Furthermore, in order to clarify the effectiveness ofour support services from statistical data, we have been analyzing the background of alcohol-relatedcases, how to provide support, and the results. However, we only conducted a simple aggregation of
the status of support cases for 2017 and did not extend it to statistical processing that could be used foranalysis. We would like to continue discussing how the index of support activity evaluation should beconsidered. The state of support for alcohol-related issue cases in 2017 is presented in Table 2.

- 69 -

Community Support Division, Stem Center Activity Report
Table 1: The number of cases within this Division’s area of operation by support method (includes employees that have been transferred
to other regions) (total numbers)
Community Support Division
1,258
286
388
120
25

Home visits
Coming to the center in person
Phone calls
Consultation during a group activity
Contact via letter
Accompanying during a medical examination

17

Others

18

Total

2,112

Table 2: State of support for alcohol-related issues cases handled at the Community Support Division
GenderMale
Item＼ Actual
numberTotalof persons

57

52

Age groupHousehold status

Female

30s

40s

50s

60s

70s

80s

Single Family

Several

5

2

13

9

18

13

2

22

35

Alcohol-related issues severity level

Low-risk consumption Risky consumption

6

Support target

Support other than home visits

HarmfulAL-dependency Person in Family Consu-ltation Abstinenc-e
consumption
question
suppo-rt
meeting
support

14

20

17

49

17

6

AA
Associatio-n
suppo-rt of sobriety

3(2) Support for supporters
The type of help to be provided to supporters was determined first by conducting a survey of theneeds of the departments that manage survivors’ support at the beginning of the fiscal year, with
employees dispatched according to those needs. The composition of the support team and the numberof days support was provided is as follows (Table 3):
Municipality
Matsushima

Table 3: The number of days providing support and the team composition
Number of people and professions
Support format
Frequency
2/ psychiatric social worker, public healthnurse
1/ psychiatric social worker
2–4/public health nurses, psychiatric social
workers

DispatchOnce a week

Temporary transfer
DispatchOnce-twice a week

Shichigahama

2–4/psychiatric social workers, public healthnurses

Dispatch

Tagajō

2–4/public health nurses, psychiatric social
workers2/public health nurse, psychiatric social
worker2/public health nurse, psychiatric social
worker2/clinical psychologist, psychiatric social
worker
2–4/public health nurses, psychiatric social
workers
1–2/ psychiatric social worker, public healthnurse
2/public health nurse, psychiatric social
worker
1/ public health nurse
1/clinical psychologist

Dispatch

Twice a week
(2–4 people)
January 2018 onward
2–3 days

Dispatch

1–2months, 1 day

Dispatch

1–2 months, 1 day

Shiogama

YamatoTomiyaNatori
IwanumaWatari
Yamamoto

Temporary transfer
Dispatch

2–3 times a week

Dispatch

Twice a week

Dispatch

1–2 times a week

Dispatch
DispatchOnce a week
Once a month

The support team of each municipality deals not only with meeting needs directly requested byvarious municipality employees, but also by ascertaining the needs of that region by attending suchmeetings as survivor supporters’ conferences. Furthermore, we aim to establish coordination between
supporters and share information through case conferences and other meetings.
The number of cases implemented to provide support for supporters in our Division is starting toshow a declining trend from FY 2016 (FY2016: 660 cases ➡ FY2017, 430 cases).
In terms of the specific content of help provided to supporters, home visits, sharing the- 70 -

2

10

Community Support Division, Stem Center Activity Report

information with the case manager after a home visit and interview, providing instructions and advice
from a specialist’s perspective, and case conferences account for a large percentage (Table 4). We
aimed to share the status and support required for each municipality and handle cases in collaboration
with case managers.
Table 4: Implementation state for support provided to supporters, number of cases handled within the region of ourDivision’s activities (include those who have been transferred to other regions)Content/number of cases
Reporting after home-visit conference
Instruction/advice from a specialist’s
perspective
Alcohol
Gambling
Depression
Breakdown of specialist’s advice (total
Complex grief
number)PTSD
Abuse
OthersRegional issue
Workplace mental care
Case conference
Opening a mental health consultation
contact point
Assisting with medical examination
Supporting admin work
Others

120
220
32
1
19
2
5
48
158
11
5
160
28
23
277
17

With regard to instruction and advice given from a specialist’s perspective, alcohol, depression,and abuse encompass a large percentage of cases. In particular, alcohol-related problems frequently
become an issue in each region, with the community supporters being highly interested in this. Someof the challenges we need to address include “earlier interventions” and “skills for sobriety support.”
For this reason, this year we held a workshop on sobriety for supporters, which attracted many
participants from all across the prefecture. For other issues, we have had to address cases that are
difficult to handle. For this reason, we held workshops in 2017 on topics including treatment-caremanagement (Table 5).
Table 5: List of training programs for supporters
Municipality

Training content and topics

Main target

Shiogama

Lecture for newly-appointed supporter related
to mental health in Shiogama: The crux ofmental healthWorkshop for newly-appointed Shiogama
employees (mental health-related): The crux ofmental health
Shiogama Municipality new public health carenurse seminar (case example review meeting)
Shiogama consultation skill workshop: WHOedition psychology emergency measure
FY2017 mental health case review meeting
Shiogama consultation skill training: Sobriety
support that can be provided in 10 minutes!
Workshop on listening: On listening

Temporary
housing
residents supporters

Shiogama
Shiogama
Shiogama
Shiogama
Shiogama
Rifu
Matsushima

Association of Helping One Another in Life:
Volunteer Workshop: The minds of the elderly,
their characteristics, and how to communicate
with them

Tagajō

Tagajō Restoration Mutual-Support Center
employee workshop: How to handle people
with delusions (senior citizen)
Seminar for instructing on the topic of alcoholic
consumption: Sobriety support that can be

Tagajō

Number of times
conducted

Government officials
Government officials

5
2

Government officials
Government officials
Government officials

Number ofparticipants7

5 (in total)20

822 (in total)
18

Healthpromotion
officers
Volunteers

40

Temporary
housing
residents supporters

16

Government officials

24- 71 -

24

Community Support Division, Stem Center Activity Report

YamatoNatoriNatoriNatori

Iwanuma

IwanumaWatari

Watari
Watari
Yamamoto
Yamamoto
Yamamoto
Shikama

Kurihara

provided in 10 minutes!
Yamato gatekeeper workshop: Now, you can bea gatekeeper too!: How will you act if someone
asked for your advice?
Natori Masuda Nursery Center Lecture:
Development assessment, sociability, andattachment
Natori Public Health Center, Mother and child’s
mental health care seminar: How to handle a
caregiver who is difficult to support and thecase assessment/How to advance individual
case conferences/Case example review I & II
Natori Public Health Center, Mother and child’s
mental health care seminar: How to handle a
caregiver who is difficult to support and thecase assessment
Iwanuma care manager workshop

Iwanuma Smile Support Center workshop:
Listening to people’s mind/How to approach aperson well: How to provide effective
communication I, II, & III
Watari Welfare Commissioner Children’s
Commissioner Council Regular Meeting: The
understanding and handling of mental
disordersOkuma Preschool Inter-School Training: Mental
care of employees
Watari Residential care support managers
liaison conference workshop: Seminar for
improving communication skills
Workshop for Yamato Welfare Commissioner:
Let’s Learn to Protect It!: Mental health
Yamato Children’s Center employee workshop:
Health-care for supporters and how to watch
over children
Designated resident nursing support managers
liaison council workshop: Responding to
addiction
Shikama regional council workshop on
measures for children requiring aid: Preventing
child abuse and coordinating with relevant
institutions
Kurihara regional welfare support center life
supporter workshop: How to interact withusers

Welfare commissioners

70

Employees in the childwelfare field

15

Government officials

Healthofficers

4

41 (in total)

promotion

32

Employees related toregional
generalsupport centers

45

Supportemployees

center3

23 (in total)

Welfare commissioners

65

Employees in the childwelfare field
Employeesintheelderly welfare field20

Welfare commissioners

32

Government officials

8

Employeesintheelderly welfare field13

Welfare commissioners

45

Supportemployees

16

center49

In this period when seven years have passed since the earthquake, there are more municipalities
engaging more often in tasks such as reporting on the content of the support they have given so far andcreating and organizing a support registry and case resource material. Staff members within our
Divisions are also increasingly engaging in such tasks. Here at this Division, we also believe that thisis an important role, given that such material is expected to serve as important resource material for
examining disaster support in the future.
(3) Raising public awarenessThe public awareness-raising activities in which the Community Support Division is involved inare mainly: 1) Regional resident exchange project (salon activities), 2) public awareness-raisingtraining for residents, and 3) opening the mental health consultation contact point.
①

The operation of a regional resident exchange project (salon activity)
The Natori Health Salon (Association of Sobriety) and Watari Men’s Club were projects thatwere created due to supporters wishing to create a place for men, who are prone to becoming
isolated due to the change in their residential environment, where they can mingle with one anotherin a relaxed social environment. Our Center has cooperated and participated with the Shiogama Hot
Salon and Iwanuma Support Center Salon, which are projects sponsored by the city. The
achievement and activity content of the 2017 regional residential exchange projects our Division- 72 -

Community Support Division, Stem Center Activity Reportsponsored are presented in Table 6.
Table 6: Salon activities that we operated or cooperated in
Municipality

Name of the activity

Subjects

Sponsored by

Shiogama

Shiogama Hotto Salon

City of Shiogama

Shichigahama

Shichigahama Ohanashi(translation: “talking“) Salon Dandan(Hanabuchihama District)Natori Health Salon (Association ofSobriety)
Utsukushima Salon (Salon aimed atthose evacuating from Fukushima
Prefecture to Miyagi Prefecture)
Iwanuma Smile Support Centersalon activity
Iwanuma Tamauranishi exchange
meeting
Watari Men’s Club (a gathering of
men under 70 living by themselves)

Other general
citizens
Public housing
residents

City of Shichigahama

1

Other general
citizens
Other general
citizens

MDMHCC

12131

MDMHCC

11

159

Public housing
residents
Public housing
residents
Publichousing
residents

City of Iwanuma

329City of Iwanuma

1

29

MDMHCC

2

22

Natori
Iwanuma

Iwanuma
IwanumaWatariNumberof times2

Number ofparticipants
26【Natori Health Salon (Sobriety Group)】
Objective: Seminar on sobriety (its objective is to maintain physical and mental health)Main target: Natori citizens/residents who are middle-aged men with a tendency to consume
alcohol excessively.
Participants’ age group: 60s: 4, 70s: 8, 80s: 1
Frequency held: Once a month.
The program has a two-part structure, with part one involving salon activities such as men’scooking and mingling with peers and part two involving a sobriety program. The sobriety
program was handled by the Miyagi Prefecture Sendai Public Health and Welfare Office
Iwanuma Branch, in which advice is given to participants while checking their drink journal.
【Watari/Men’s Club】
A gathering aimed at single men aged under 65. Activities such as cooking and exercise
were conducted in collaboration with the Health Promotion Division for mental and physicalhealth purposes. It was concluded in 2017.
【Shiogama/Hot Salon】
Held at two neighborhood associations. Mainly centered on recreation and was dealt withby installing a consultation booth.
【Utsukushima Salon】
This activity was held at the Iwanuma General Welfare Center I-Ai Plaza, for those whohave relocated from Fukushima Prefecture to the southern region of Miyagi Prefecture. In
addition to plans made based on the season, cooking and ikebana flower arrangements werealso conducted. Through such activities, programs to collect information on the state within
Fukushima Prefecture and site relocations to are conducted.
We provided support with the aim of participants becoming familiar with life in their newly
relocated sites.
②

Public-awareness raising training for residents
Lectures to raise public awareness among residents and similar activities were conducted
as per requests from the municipalities.
【Yamamoto/Health-promotion class】
This class is to be conducted in all administrative districts for five years, hosted by the Cityof Yamamoto, with 2017 being its second year. The classes involved lectures by psychiatrists,making small ornaments and doing light exercise with an occupational therapist, and a minilecture on stress by a psychiatric social worker.
【Natori municipality employee mental health workshop】- 73 -

Community Support Division, Stem Center Activity Report

A workshop named “Workplace Mental Health: Health Care of the Mind” was conductedwith the cooperation of the Department of Preventive Psychiatry in the Tohoku University
Graduate School of Medicine for all employees. Resource materials on sobriety were
distributed to all participants.
【Watari Dementia Salon Talk】
This activity was conducted for general citizens in response to the request by the regional
general support center. Named Dementia Gatten (translation: “understanding dementia“), it
discussed such topics as how to approach people with dementia and key considerations wheninteracting with them.
【Shiogama Nutrition Class for Thinking about Health】
We were in charge of the lecture on “Tips on Relieving Stress: Mental health you can dofrom today!”【Shikama Town Mental Health Promotion Lecture】
At the lecture titled “Is Your Heart Healthy?” held for the welfare commissioners, healthpromotion members, and city residents, we discussed various countermeasures for dealing
with stress and various other issues.
③ Opening the mental health consultation contact point
We handled consultations at the Mother and Child’s Mental Health Consultation, a Natori
City project (implemented three times). Even during the stress examination conducted during
the Iwanuma Comprehensive Health checkup, we opened a consultation contact point andhandled consultations from residents (implemented five times).
④ Other raising public awareness projects
We provided information on how to deal with stress by appearing on Natori community
radio shows.
We established a consultation booth at the Energetic Yamamoto Everyone’s HealthFestival, held in Yamamoto, conducting an alcohol patch test to disseminate knowledge on
alcohol consumption.
(4) Human resource development
Concerning various issues about which we have received requests from the municipality, we
conducted a human resource development program with the aim of disseminating knowledge.
The content of main activities conducted in 2017 includes four research studies on issues
related to suicide prevention measures (4 cases) and support skill training (14 cases). The
breakdown of support skill training includes dealing with people with delusional disorders, issues
relating to children (e.g., child abuse), psychological first aid (PFA) training, and sobriety. In
particular, there were many requests for cooperation on improving skills for dealing withaddiction-related issues. For this reason, we co-sponsored the sobriety support improvement
seminar with Miyagi Prefecture Sendai Health Welfare Office, Iwanuma Branch. We had
71 supporters participating in this seminar, indicating that they had a great deal of interest in this
topic.
(5) Research
In 2017, we summarized the achievements we had made in conjunction with Tagajō since theearthquake, aiming to present it at an academic conference in 2018.
(6) Support for various activities
We participated in a Natori sobriety association activity. Although in 2017 it was named the
Association for Abstinence, it became a regular Natori meeting in April 2017, being held once amonth in the Natori Health Center. We attended the meeting as a mediator so that residents we
support would have an easier time participating.
Discussion and the community’s future tasks
We found the following to be the key characteristics of our Division’s initiatives after reflecting
on our achievements in 2017.

3.

① Sobriety support- 74 -

Community Support Division, Stem Center Activity Report

Each municipality has several case examples of alcohol-related issues, with there being
many supporters who felt that it was difficult to cope immediately after the earthquake. In
order to address such needs, here at the Center we have been providing in-hospital training incooperation with Tohokukai Hospital. In 2017, we have been engaging in several more
initiatives focusing on sobriety.
First, in order for several employees of our Division to learn the HAPPY program, asobriety program, these employees attended the “2017 Brief Intervention & HAPPY Program
Workshop” at the Hizen Psychiatric Center, National Hospital Organization. In addition toutilizing the concepts here to support residents, we also continuously conducted sobriety
programs in a salon activity held once a month. Furthermore, training for the “sobriety support
you can provide in 10 minutes,” which is essentially a shortened version of the HAPPY
program, was hosted in collaboration with the Iwanuma Branch of the Miyagi Prefecture
Sendai Public Health and Welfare Office. Here, we invited Dr. Takahiro Fukuda from theSaga Prefecture Medical Center Kosei-kan as the lecturer. We saw attendance that far
surpassed our predictions from across the prefecture, as well as receiving requests fromvarious municipalities to conduct lectures for public health nurses and nutrients. These results
proved the high level of interest in sobriety support programs.
Even among those who have obstinately refused to practice abstinence, there are a quite anumber of people who are more willing to moderate their alcoholic consumption. Even
supporters who kept being rebuffed when they proposed abstinence anticipated this programas an opening to establish a relationship. Alcohol-related issues require various types of
support in accordance with each phase. By expanding the understanding of sobriety support,
we expect to see a spread of secondary prevention in alcoholism-related support. This is
expected to also prevent an increase in serious alcoholism (alcohol use disorder). We areplanning several initiatives related to sobriety support in 2018 as well and would like tocontinue working to disseminate the relevant knowledge and knowhow.
On the other hand, handling people who have already attended the training is also an issue.
Only when attendees of sobriety training use what they learned during their daily routine andbecome fixed practitioners in the community can we gain credibility for the workshop. By
examining the possibility of holding follow-up training for attendees and establishing
networks in different areas, we would like to increase the number of practitioners capable ofhandling alcohol-related issues within the prefecture.
② Handling difficult example case
Each municipality deals with various complex cases. Our Division’s staff members have
put these cases together as case examples. In addition to securing the time to reflect on thesecases regularly along with municipality employees and other relevant parties, we aim to
reduce our workload burden by tackling these cases as a team from a management perspective.
We secured time for supervision and case reviews in order to prevent the work burden of eachof our Division’s employees from growing too large.
In the municipality we work at, there are many occasions on which our Division’s staff
members accompany workers from the municipality during home visits as part of the support
provided to supporters. We receive feedback stating that having knowledge and know-how
being passed on by our Division’s employees makes this practice worthwhile. Furthermore,
we have been told that exchanging opinions with others from various professions, including
clinical psychologists and psychiatric social workers, helps determine policies after
considering information from a wider perspective.
Because our organization has a limited timeframe, it is to be expected that the issues we
handle will be passed on to employees of the region in the future. We believe that handling theissues that the community faces together with local institutions and reporting on ourachievements is a significant task we need to undertake.
③ Various issues caused by community restructuring
As people relocate from temporary housing to public housing, the human relationships they
had formed at temporary housing become severed, which may result in residents losing- 75 -

Community Support Division, Stem Center Activity Reportopportunities to engage in daily activities and feeling more isolated.
There still remain many people impacted by the change in living conditions, including
people who face extreme difficulties in their daily lives due to difficulty traveling (e.g.,grocery shopping) and those who have moved from one prefecture to the next to avoid harmcaused by radiation and finally decided to settle in Miyagi Prefecture.
On the other hand, we have lost some opportunities to conduct outreach support (e.g., home
visits) due to many external aid institutions leaving and decreases in health surveys, which had
been conducted more frequently in the past. We are losing opportunities to find, intervene, andresolve issues within the community.
Currently, salon activities targeting these people are still being held. However, based on ourdaily practice we keenly feel that latent needs remain high besides those of the current
participants. How we will approach these latent, potential needs is an issue that we cannot
continue to overlook. We would like to examine how to address this issue by referencing the
response policies of each municipality and community regeneration plan.
④ Research
Summarizing the achievement of support activities that we have conducted in different
municipalities will serve as important information when examining the state of natural disastersupport in the future. We believe that summarizing our past initiatives in various formats andpublishing this will be a significant task for the future.
4. Summary
Seven years have passed since the Center began conducting our activities. At the afflicted sitewhere we had worked, self-housing restoration, construction of restored housing, and other relocation
measures were being steadily conducted. At the same time, the so-called Scissors-like Gap,
discrepancy of recovery, in the current state is becoming more serious. For this reason, the issues ofeach region are starting to become latent, in which case we fear that they would become even moredifficult to see.
In particular, issues related to alcohol are deeply rooted in each municipality. When we listen to
the life stories of people with alcohol abuse issues, we learn that each of them have stories of a harshpast. We can see that despite feeling that life is difficult, they are attempting to overcome yet anotherrough trial from the natural disaster. As we provide support for their restoration process, which is by
no means simple, we cannot help but feel the importance of time and of people helping one another.
Natural disasters greatly change peoples’ living environment, highlighting various issues related toregional mental health welfare. We believe that the issues that we face right now and how each
community will face these issues, which are becoming difficult to see, will greatly impact the future of
regional mental health welfare.

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