FY 2018 Bulletin, Issue 7

Kesennuma Regional Center Activity Report
Miyagi Disaster Mental Health Care Center
Kesennuma Regional Center Community Support Division
Manager, Psychiatric Social Worker – Mitsuaki Katayanagi
Assistant Manager, Psychiatric Social Worker – Yuko Arai

Introduction
Previously, we have described our primary initiatives in FY 2018 for each focus area. Furthermore, because thenumber of cases for each of these areas and other such data has already been provided in Section I, FY 2018 Activity
Report, ① Activity Status by Project, here we will provide a brief description of the content of each project andinitiative.
1．Resident Support
The process of providing resident support in FY 2018 was much the same as it has always been in the past. From
home visits to individuals deemed high-risk by health surveys that were administered by Miyagi Prefecture andvarious municipalities, we provided support in response to requests from our affiliates and individuals seeking counsel themselves.
Further, we transferred one employee to Kesennuma and one to Minamisanriku, where they have been instructedto co-operate with psychological health welfare services and provide resident support services as a part of theirwork.
(1) Kesennuma
The number of cases being handled at this center has increased. Support was most commonly solicited by
way of requests from support targets such as administrative agencies, educational institutions, and otherorganizations, and support clients and their families; these trends were largely the same as they had been in
FY 2017. In terms of counseling topics, the same patterns that were observed in FY 2017 persisted: elementary, middle, and high school students continued to have trouble adjusting to school. Other problems included
truancy; family and household issues; workplace counseling for working adults; and trauma counseling forearthquake-related matters. Overall mental health levels declined, and counseling cases in which the client
brought up several issues that would take time to address were common. Many counseling cases therefore
required sustained support, and cases that encouraged inter-organizational coordination with affiliates werealso common.
We also provided home visit support to high-risk Kesennuma residents who had been flagged by theirK6 scores or by their drinking habits and had been polled in a health survey conducted among tenants ofapartment-type temporary housing (Table 1).
Table 1: Survey-prompted home visit support

Summary

Primary support period andprimary support targets

Home visits based on an FY 2017 healthsurvey of tenants of apartment-type temporary housing

Number of support cases conductedby the Kesennuma Regional CenterMay 2018 to February 2019.
Focused on cases with high K6 scores and thoseexhibiting behavior such as “start drinking in themorning.”－ 47 －

5 casesKesennuma Regional Center Activity Report(2) Minamisanriku
We carried out individualized support via home visits and by telephone in response to requests from administrative agencies, other affiliated organizations, and from the support targets themselves. Home visit
support was also provided to high-risk residents as determined by a health survey of disaster public housing
tenants in Minamisanriku (Table 2).
Table 2: Survey-prompted home visit support

Summary

Primary support period and primary support targets

Home visit support based on FY
2017 health survey of tenants ofdisaster public housing

June to August 2018. Focused on
cases with high K6 scores and thoseexhibiting behavior such as “startdrinking in the morning.”

Number of support cases conducted by
the Kesennuma Regional Center
10 cases(3) Discussion
The number of resident support cases handled by the Kesennuma Regional Center (this center) via
home visits, walk-ins, and over the telephone has increased. In this past year, there has been a decreasein the number of health survey-prompted support cases in Kesennuma relative to FY 2017. One contributory factor is the fact that many residents of this area no longer need to live in apartment-type
temporary housing. The growing number of support cases that are not health survey-prompted, can be
attributed to the fact that the direct and indirect effects of the earthquake continue to have an impact oncommunity residents, in the form of burgeoning lifestyle issues. Further, public raising awareness activities over the radio and in the newspapers have increased this center’s renown. We have also madean effort to be flexible about when and where we can provide counseling.
Approximately one year has passed since all the disaster public housing units in Minamisanriku werecompletely outfitted. Disassembly of emergency container-type temporary housing in the town is progressing smoothly. However, on our home visits to mentally high-risk residents—who had been flagged
by a health survey of public housing tenants—we found that residents were suffering from mental instability both because of the disaster itself, but also because of the emotional and mental toll that interpersonal issues in their new communities were taking.
In both Kesennuma and Minamisanriku, counseling requests from residents feeling mental disturbed
spiked after reports of natural disasters throughout the country this year were published.
Both these municipalities are undergoing reconstruction. However, in comparison to the rebuilding ofhard assets, recovery on a more intangible scale will take some time. In the future, we must continue towork with municipal public health nurses, life support advisors (LSAs), and other affiliated organizations
to maintain a system that enables us to respond to our residents’ varied counseling needs.

2. Support for Supporters(1) Kesennuma① Allocation of specialists to various municipalities (transfer staff)
A specialist was assigned to Kesennuma in FY 2018, which was also the case in FY 2017. By assisting them with their tasks, we sought to reduce municipal public health nurses’ operational burdens.
② Mental health support for municipal employees
In FY 2018, just as in FY 2017, a designated staff member ran a health counseling help desk formunicipal employees in the One-Ten Building at the Kesennuma Municipal Office every third
Wednesday of the month, from 10 AM to 4 PM. If employees’ could not avail themselves of theservice during office hours due to work obligations, alternatives such as flexible operating hours andconsultation points were arranged. We provided direct counseling to municipal employees and, inconcert with the Kesennuma Human Resources Division, offered help to those wishing to return towork. This desk handled even more cases this year than it did in FY 2017.
③ Mental health support for Kesennuma social welfare council members
Individual interviews with Kesennuma social welfare council members were conducted based on
the results of the Tohoku University Graduate School of Medicine’s Department of Preventive Psychiatry (hereafter, “the Department of Preventive Psychiatry’s”) 2018 mental health survey of Kesennuma Social Welfare Council employees.
－48－

FY 2018 Bulletin, Issue 7(2) Minamisanriku① Allocation of specialists to various municipalities (transfer staff)
In FY 2018, just as in FY 2017, one specialist was assigned to Minamisanriku. By assisting themwith their tasks, we aimed to reduce municipal public health nurses’ operational burdens.
② Mental health support for municipal employees
Just as we had in FY 2017, we ran a help desk offering municipal employees health counselingon a bi-monthly basis: on the fourth Tuesday of the month, from 2 PM to 7 PM, and on the fourth
Saturday or Monday of the month from 11 AM to 3 PM. To ensure that employees saw it, information
about the help desk was disseminated via a “Hitoiki Column,” in a monthly guide published by the
Minamisanriku General Affairs Office. Unfortunately, we were not able to ensure an increase in thenumber of cases handled by this help desk.
In response to a request from the General Affairs Office, we helped out with and participated in a
meeting between the General Affairs Office and the Kesennuma Health and Welfare Office (at the
Kesennuma Health Care Center), that was aimed at checking municipal employees’ stress levels.
③ Mental health support for Minamisanriku social welfare council members
Support for Minamisanriku Social Welfare Council’s Disaster Survivors’ Life Support Center—the body responsible for monitoring and providing support to disaster-affected individuals in the
Minamisanriku area—concluded in FY 2017. This year, we implemented a support program for
Minamisanriku social welfare council (Minamisanriku SWC) members, who provided the townspeople—including disaster survivors—support for disaster relief work, following a request from the
Minamisanriku SWC.
We also periodically visited counseling centers for the elderly, established in disaster public housing projects across town, where we discussed the residents with the employees who with and about
the current status of disaster public housing overall.
(3) Discussion
In both Kesennuma and Minamisanriku, we implemented complementary measures—such as transferred staff and direct support from this center itself—to assist municipal employees, particularly publichealth nurses, in their official duties.
In Kesennuma, initiatives aimed at reconstruction have been underway since FY 2017, and municipal
employees remain overworked. Compared to FY 2017, there has been an increase in the number of cases
handled by the employee help desks. This is a worrisome indicator of physical and mental exhaustion
among municipal employees.
Reconstruction initiatives continue in Minamisanriku as well, but a decline in support and the numberof relief personnel dispatched by the municipality has contributed to active municipal employees overworking here as well. Mental health support is therefore vital.
In the future, we plan to continue to share information with affiliated organizations and regularly open
counseling to help desks to provide individualized support to municipal employees. Thus, we will haveto redouble our efforts to determine effective methods for mental health improvement and endeavor to
put them into practice.

3．Raising public awareness(1) Kesennuma① Publication of the “Sanriku Kokoro Tsushin”
In concert with the Kesennuma Health and Welfare Office, we have continued to publish themonthly “Sanriku Kokoro Tsushin” column in the Kesennuma-area Sanriku Shimpo newspaper (Table3). Through this newspaper column, we have managed to provide information on mental health toKesennuma area residents and to notify people of the presence of our counseling desks.
The themes and content of these columns are determined in collaboration with the Kesennuma
Health and Welfare Office and are adjusted to reflect the conditions in the area. Just as they did in FY
2017, most columns addressed the earthquake disaster.
The publication of this column continued in FY 2018 as well; we received questions about andrequests for counseling over the phone following each publication.
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Kesennuma Regional Center Activity Report
Table 3. Content Published in the “Sanriku Kokoro Tsushin” Column of the Sanriku Shimpo

Issue

Date

Title

Written by

54

April 2018

The Start of the New Year:
Getting Used to a New Environment

Kesennuma Regional Center55

May 2018

The May Blues?!
Do You Feel Emotionally Healthy?

Kesennuma Health Care Center

56

June 2018

Promoting Health with Quality Sleep

Kesennuma Health Care Center

57

July 2018

Alcohol and Mental Health:
Do You Drink Too Much?

Kesennuma Regional Center

58

August 2018

The Start of the Second Semester:
To Anyone That Doesn’t Want to Go to School

Kesennuma Regional Center

59

September 2018

A Letter to Anyone That Has Lost Someone

Kesennuma Regional Center

60

October 2018

Are You Working Too Hard? Listening to Your
Body and Mind

Kesennuma Health Care Center

61

November 2018

Taking Effective Breaks:
How Busy People Can Rest Effectively

Kesennuma Regional Center

62

December 2018

Enjoying Alcohol Safely and Responsibly

Kesennuma Health Care Center

63

January 2019

Communicating Skillfully and Effectively

Kesennuma Regional Center

64

February 2019

Understanding and Supporting Those with Dementia

Kesennuma Health Care Center

65

March 2019

Remembering to Take Care of Your Mind andBody: On the Eve of The Anniversary

Kesennuma Regional Center* Issues have been numbered cumulatively since 2013.

② Hosting the Kokoro Café , a mental health interaction project for residents
The Kokoro Café is meant primarily for disaster survivors living in apartment-type temporary
housing. The objective of the project, which Kesennuma has been running since 2012, is to provide
opportunities for residents to interact with one another to prevent them from becoming isolated, as
well as to help them learn self-care techniques that can alleviate stress. Our center has hosted thisproject since FY 2017, with Kesennuma and the Kesennuma SWC volunteer center co-hosting, andwith assistance from the Tetsuhisa Igawa Medical Corporation Mitsumine Hospital (Table 4). Uponobserving an improvement in the mental health of the participants and following the dissolution ofmost apartment-type temporary housing, all organizations involved in this event met and decided to
end this initiative at the end of FY 2018. Organizers spent all of 2018 anticipating and addressing
participants’ varied reactions to news of the Café’s closure and providing them with information onother social exchange and meet-up initiatives taking place in their city.
Table 4. Kokoro Café Event ScheduleDate
1st session

Tuesday, June 19, 2018

2nd session

Tuesday, August 21

3 session

Tuesday, September 18

4 session

Tuesday, October 16rdth

5th session

Tuesday, November 18

6th session

Tuesday, February 19. 2019

LocationContent

Kesennuma Citizens’ Health Management Center Sukoyaka
Kesennuma Citizens’ Health Management Center Sukoyaka

Talks on relieving stress & handmassage experience session
Music and rhythm-oriented exercise

Oshima Community Center

Health and nutrition seminar

Matsuiwa Community Center

Relaxation

Kesennuma Citizens’ Health Management Center Sukoyaka
Kesennuma Citizens’ Health Management Center Sukoyaka

Food habits discussion and experience－49－

Refresh with arts and crafts

FY 2018 Bulletin, Issue 7③ Support project for socially isolated residents: “Dankatsu”“Dankatsu” was a project that was initiated, after much consideration, in conjunction with the Health
Promotion Division of the Kesennuma Health and Welfare Department. The idea was first floatedwhen considering alternatives to the Kokoro Café project that maintained its ethos and were designed
to address issues such as isolation among residents who had just been relocated to disaster public
housing, and the longstanding problem of men finding it difficult to connect. The project was piloted
in FY 2017, and with the cooperation of several affiliated departments and offices in Kesennuma (e.g.,
the Comprehensive Regional Care Center, the Elderly Nursing Division, the Karakuwa General
Branch Office, and the Motoyoshi General Branch Office), it was officially implemented in FY 2018
(Table 5).
Table 5: “Dankatsu” Project Schedule
Date

LocationContent

1st session

Wednesday, July 25, 2018

Kesennuma Citizens’ Health Management Center Sukoyaka

Communication mahjong
Mini health seminar

2nd session

Friday, September 14

Kesennuma Citizens’ Health Management Center Sukoyaka

Papercutting event
Mini health seminar

3rd session

Wednesday, November 28

Kesennuma Citizens’ Health Management Center Sukoyaka

Healthy cooking
Mini health seminar

4th session

Tuesday, January 15

Kesennuma Citizens’ Health Management Center Sukoyaka

New sports
Mini health seminar④ Distribution of public awareness materials to city employees
Drawing on Kesennuma’s Health Plan 21 and the Healthy Eating Promotion Plan, the Health Festival
is a project organized by the City of Kesennuma to prevent the lifestyle-, illness-, and stress-related deterioration of physical functions and to promote citizen health.
On the day of the event, a Kokoro Café (Koko Café) Corner session was organized, under the topic“Finding Stress Relief Methods Suitable for You.” In FY 2018, our center set up an Alcohol Abuse Awareness Corner at the event. As usual, we served drinks; conducted experience-oriented programs that included breathing techniques; and put PR posters on display. At the Alcohol Abuse Awareness Corner, participants submitted to an alcohol patch test and were allowed to take an alcohol consumption-related quiz.
Overall, the program was designed to be experiential and engaging.
⑤ Distribution of public awareness materials to municipal employees
Awareness-raising materials addressing mental health were distributed to municipal employees in December 2018 to encourage self-awareness and mindfulness of their health.
⑥ Miscellaneous
As part of our efforts to raise public awareness among community residents, we implemented the following mental health-related support activities (Table 6).

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Kesennuma Regional Center Activity Report
Table 6: Other Public Awareness Initiatives

Support targets(see comment)

Initiative

Number of implementations

Following this center’s contract project, we participated and assisted inregular meetings of the Motoyoshi Danshukai under the guidance of the
NPO Miyagi Prefecture Danshukai

Participated 12 times, hosted 12times

We co-sponsored the Kesennuma District Health-Promotion On-Street
Campaign in FY 2018 hosted by the Kesennuma Health Care Center. As
part of Suicide Prevention Month, we distributed public awareness materials at two supermarkets in Kesennuma and one in Minamisanriku.

1 timeWe co-sponsored Koko-cha, a dementia café hosted by the Miyagi Prefecture Dementia Patient Medical Center. We gave people with dementia, their caregivers, and residents the opportunity to meet, once a month,at either one of the restaurants at Mitsumine hospital; at the One-Ten
Building in Kesennuma Civic Hall; or Yasuragi, Kesennuma Citizens’
Welfare Center.

12 times

At the request of the Kesennuma Health Promotion Division, we delivered lectures on mental health promotion at the Motoyoshi and Karakuwa General Branch Offices.

２ timesAt the request of the Kesennuma Women’s Organization Liaison Council, we delivered a lecture on mental health promotion.

１ timeAt the request of the Benten Neighborhood Association, we put on ahealth picture-show story show and a relaxation event at a tea party
hosted by the Neighborhood Association.

１ timeAt the request of the Preparatory Committee of the Makizawa Neighborhood Association, we put on a health picture-show story and a relaxation
event at Makizawa public housing.

２ times(2) Minamisanriku① Health picture-show story event
At the request of the Minamisanriku SWC, we conducted a health picture-show story event on the
topic of mental health. This public awareness initiative was held three times throughout the year andwas attended by a total of 37 community residents.
② Alcohol and Health class for residents
Since 2017, we have conducted health classes for residents addressing alcohol consumption andusing health picture-show stories put on at “Free-talk health advice meetings” conducted by the
Minamisanriku and Miyagi Nursing Association as part of Minamisanriku’s alcohol-related, countermeasure project. This public awareness initiative was held eight times throughout the year and wasattended by a total of 54 community residents (Table 7).
Table 7: Schedule of the Alcohol and Health Class for Residents

Session1

Date2018 July 13 (Friday)

Location

Participants

Arato Community Center

10 (10 women)

2August 10 (Friday)

Hiraiso Living Center(Called off due to a typhoon)

3

September 14 (Friday)

Soedama Living Center

8 (1 man, 7 women)

4

October 19 (Friday)

Nakayama Racing Living Center

6 (1 man, 5 women)

5

November 20 (Tuesday)

Okita District Assembly Hall

6 (1 man, 5 women)

6

December 14 (Friday)

Shimizu Complex Assembly Hall

6 (1 man, 5 women)

72019 January 8 (Tuesday)

Minato Chikayoshi Assembly Hall

10 (1 man, 9 women)

8

February 15 (Friday)

4 (4 women)

9March 15 (Friday)

Shizukawa West (West) AssemblyHall
Shizukawa East (East) Assembly
Hall

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4 (4 women)

FY 2018 Bulletin, Issue 7③ Distribution of public awareness materials to municipal employees

Before the holiday season at the end of the year, leaflets promoting mental health were created anddistributed to all employees (approximately 400).
④ Participating in the Minamisanriku Health and Welfare Festival
As we did in FY 2017, we manned a booth at the Minamisanriku Health and Welfare Festival. At
the booth, we displayed posters on stress reduction techniques and set up places for attendees to experience relaxation techniques. Tote bags with our center’s logo printed on it were distributed to approximately 462 festival attendees, and 334 visitors to our booth were given a relaxation massager
and an information leaflet about our center.

(3) Discussion
At the request of residents and affiliated organizations, we implemented a variety of public awarenessinitiatives in Kesennuma, just as we did in FY 2017. As programs to move individuals into disaster public
housing progressed, and residents became engaged in forming neighborhood associations, establishing
relationships with their neighbors, and other community-building tasks, we predicted that some would
feel anxiety in their new surroundings and the interpersonal issues it summoned forth, could cause adecline in mental health. The fact that we were able to create a place for residents to mingle with one
another, learn about mental health care, and be exposed to different counseling opportunities is indicativeof how effective this public awareness initiative was.
Just as we did last year, we were able to use a health picture-show story tool about alcohol-related
issues to raise awareness among tenants of disaster public housing, high-ground relocation areas, andexisting districts throughout Minamisanriku. By staging this program in multiple spots across the town,
we were able to raise public awareness, while also taking each district’s unique characteristics and needs
into account.
In the future, we will continue to raise public awareness about mental health following “Kesennuma
Health Plan 21” and the “Minamisanriku Health Promotion Plan.”
4．Human resource development and training(1) Kesennuma① Listening seminar for those working in the district (e.g., welfare commissioners)
We delivered a lecture titled “Learn to Listen Well and Provide Mental Support to Those AroundYou” at a listening seminar for municipality officials (neighborhood association chairpersons, healthpromotion officers, district welfare commissioners, volunteer club members, etc.) hosted by the
Kami District Social Welfare Council and the city of Kesennuma. We delivered the same lecture inMotoyoshi and Karakuwa as well.
② Mental health training for nursing students
We conducted a talk on mental health self-care for nursing professionals in response to requests
made by the Kesennuma City Hospital School of Nursing.
③ Training for municipal employees
At the request of the Kesennuma Human Resources Division, we delivered a lecture on mental
health self-care at a mental health training workshop for municipal employees.
④ Training employees at Hope Garden, a work transition support facility for disabled persons
We conducted an upskilling workshop for staff at this facility.
⑤ Report presentation at the Annual Symposium of the Japanese Society for Prevention and Early Intervention in Psychiatry
We delivered a presentation on this center’s initiatives titled “Collaboration between school education and mental health and medical welfare in areas affected by the Great East Japan Earthquake.”－50－

FY 2018 Bulletin, Issue 7⑥ FY 2018 Mental Health Countermeasures for the Young Workshop
At the request of the Miyagi Prefecture Mental Health and Welfare Center, we delivered an activity
report on the center’s counseling work with children entitled “Mental Health Countermeasures for
the Young” to the staff of various administrative agencies, educational institutions, and youth support
organizations.
⑦ Report presentation at the Employment Support Liaison Committee
At the request of Kanae, an employment and lifestyle support center for disabled persons, we reported on this center’s projects and activities.
⑧ Lecture at disaster support staff meeting
At the request of the Elderly Nursing Division of the Kesennuma Health and Welfare Department,
we presented a lecture to city disaster support city hall staff on supporter mental health.
(2) Minamisanriku① Minamisanriku SWC caregiver training
At the request of the Minamisanriku SWC, we conducted a training workshop on teamwork andmental health for 37 Minamisanriku SWC caregivers.
② Municipal employee training
At the request of the town General Affairs Division, we helped conduct a training program for 117
municipal employees titled “How to Avoid Workplace Stress and Develop Communication Skills.”(3) Discussion
Just as we did in FY 2017, we implemented various training programs for affiliated organizations attheir request.
In Kesennuma, we most frequently received requests from affiliated organizations to provide content
related to workplace or supporter mental health.
After much consideration, we were able to provide Minamisanriku SWC’s caregivers with content
tailored to their current needs. As for municipal employees, we tracked their progress with stress checkups and used the results to work towards improving their mental health.
We will continue to provide human resource development and training in line with Minamisanriku’scurrent requirements and in response to any requests that we receive.
5．Support for various activities(1) Kesennuma
In FY 2018, we contributed to numerous initiatives with various groups and organizations operatingin the region, at such venues as the NPO/NGO liaison conference.
We also continued to assist with “Sharing Meetings,” an event held by the Sendai Grief Care Research
Association to provide support for bereaved families.
(2) Discussion
Continuing our relationship with regional organizations enabled us to better understand the communities we work in and the issues facing them from a variety of perspectives.

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Kesennuma Regional Center Activity Report

6．Child Mental Health Care Community Center Project(1) Main activities① Conducting mental health-promotion activities for high school students
At the Working Group, an association of practitioners from the Mental Health and Medical Welfare
Liaison Conference (within the Kesennuma jurisdiction), itself an arm of the Kesennuma Health Care
Center, we conducted mental health promotion activities for second-year students and teachers at
Kesennuma High School in Miyagi Prefecture. Using short skits, we introduced information on healtheducation and counseling organizations within the Kesennuma jurisdiction. In FY 2018, a medical
corporation called Kusanomikai Hikarigaoka Hoyoen became involved in the staging of this event. In
addition to the Kesennuma Health Care Center, three organizations are now involved.
② Conducting training sessions at middle schools
A training session on the topic of communication was conducted for 8th-grade students at Omose
Middle School in Kesennuma.
(2) Discussion
Requests for counseling for children and students continued to mount in FY 2018. The reasons behind
the requests for counseling were numerous, but most of them had to do with the disaster and were theproduct of deteriorating family relationships and problems at school. As for the support itself, it is important to note that in addition to meeting students’ needs, we also provided support to parents and guardians, in partnership with our affiliates.
At the Working project, we made use of themes that were familiar to students, and to engage students
and pique their interest in the topics, we also encouraged school faculty participation. We received positive responses like “I felt more comfortable pursuing counseling after watching that.”
We will continue to work with affiliated organizations to provide individualized support and raise
people’s awareness of mental health issues.

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