Greetings

Support for the Future: From the Perspectives ofCommunity-based Integrated Care and Recovery

Miyagi Prefecture Mental Health and Welfare Association
Miyagi Disaster Mental Health Care CenterPresident – Akira Kodaka

More than eight years have passed since the Great East Japan Earthquake, and as we enter the ninth May since thedisaster, Sendai is as thick with greenery as ever, and the days glow with the warmth of early summer. In disasteraffected areas, disaster public housing has been completed and town halls have been rebuilt. From the outside, 10year reconstruction efforts appear to be progressing smoothly towards their planned end. I get the feeling that in themany meetings and conferences I attended this year, we talked a little bit more about “looking back on the earthquake”
than ever before.
At one meeting, almost as soon as the words “looking back on the earthquake” were uttered, an individual who
had fought day-and-night to keep a hospital that was nearly destroyed by the tsunami up and running, and who continues to work there to this day, spoke up. “We talk about ‘looking back,’ but as far as I am concerned, the shock andstrain of the earthquake are as terrible as they have ever been.” When I speak to people from the areas of Miyagi withthe highest casualty rates, they tell me, “I’ve finally become able to cry when I talk about what happened that day.”
As social and economic support is slowly withdrawn, the burden of the disaster remains on the shoulders of thosethat have survived; in some cases, it may even have grown heavier. Reports of suicides at disaster public housing
facilities continue to reach our ears. For those of us involved in mental health care and support, I believe that thecoming years will be the most trying.
This center’s surveys and activities have brought a great many disaster-related problems and issues to light, including grief due to the loss of loved ones; anxiety/depression/addiction associated with daily life burdens; lonelinessand mental/physical disorders (especially in the elderly); mother/child health and developmental issues; and discordin families overburdened by these and other factors. As we continue to provide conscientious support to those whoneed it, we must also examine the benefits of the support we have provided thus far and determine how we plan toprovide support in the future.
If this disaster has taught my colleagues and me anything, it is that every single one of us faces hardships in theirway, and when times get hard, everyone worries and everyone feels mental and physical unwellness. Through ourhealth surveys and other efforts, we have seen how effectively continued visitation can be at achieving health recovery
and lifestyle support; how necessary diverse, stratified approaches are to addressing the needs of everyone (fromchildren to the elderly); how important collaboration and a sense of duty are between supporters, along with interpersonal connections, daily living necessities, awareness of the importance of mental health, networking, and counselingsystems. Finally, it has been proven beyond any doubt that the basics of community psychiatric social work and caremanagement methods are as effective in the aftermath of disasters as they are normally.
Faced with a declining birthrate, aging, and rapidly shrinking population, and slowing post-disaster support efforts,proposals invoking the idea of comprehensive community care centered on integrated, efficient support have madean appearance in a variety of areas. Bringing these ideas to life is a task for the future. Owing to the many problems
that they face, disaster-affected areas may well constitute the frontlines of this fight—it is there that we will first
confront, and then endeavor to complete, this crucial task. The essence of the various kinds of post-disaster support
we have developed and employed should live on into the future. After having faced and overcome countless hardships,
the countries of the world have collectively agreed to prioritize the concept of mental health recovery, and the ideathat “People face many different kinds of hardships, including disaster, illness, disability, and economic or financial
distress. Together, let us work towards recovering our lives and mental health, and aim for a society in which people
help each other.” After having experienced the horrors of the earthquake, we pray that our homeland, Miyagi, will bereborn as a place of safety and hope. We intend to carefully evaluate our daily activities from the perspective ofcommunity-based integrated care and recovery and plan to continue these practices into the future. Thank you foreverything you do to support us. We look forward to your continued guidance and encouragement.