The Initiatives of the Miyagi Disaster Mental Health Care Center
Stem Center, Community Support Division
Psychiatric Social Worker – Mitsuaki Katayanagi
Two years have passed since the Great East Japan Earthquake. In Miyagi Prefecture, which
was severely damaged by the earthquake, restoration and reconstruction efforts are progressing
little by little, but the psychological distress of those affected by the disaster is still great, and theneed for care remains pressing.
Under these circumstances, the MDMHCC is providing various types of mental care support
for all residents of the affected prefectures.
[Support for Those Affected by the Disaster]
The MDMHCC has one Regional Center in Kesennuma City and one in Ishinomaki City,
which were heavily damaged, and is active across a total of three Centers, including the StemCenter, which is in charge of other regions. At the Community Support Division of the StemCenter, which I belong to, every day, in cooperation with public health nurses and supporters inthe town, I visit disaster areas in response to requests to provide mental care.
We are providing support to those affected by the disaster by visiting the temporary housing
they currently live in and the private chartered housing that the prefecture has rented (so-called“designated temporary housing”). Specifically, based on the results of health surveys conductedby prefectures and local governments, we visit people whose mental health is believed to be in aconcerning state. There, while listening to the details provided by the individual themselves, wedetermine whether specialized support is needed, and if necessary, we provide care by connecting
this individual with an appropriate contact point or specialized agency.
Residents living in temporary housing may have various burdens because the houses they used
to live in before the earthquake collapsed or were washed away by the tsunami. It’s not hard toimagine. In addition, I feel that a new stress is having a great impact on the mental health of theresidents: one caused by changes in their living environment. For example, family relationships
may deteriorate because of the narrowness of temporary housing, sounds from neighboring houses
may be troublesome, and new human relationships may be formed. In addition, there are manypeople who do not know what kind of people live in the neighborhood, cannot communicate atall, and feel a disconnect between themselves and the original residents due to living in designatedtemporary housing.
It is unlikely that our visits and talks will alleviate all the problems and stresses associatedwith residents’ lives, but they do allow us to understand people’s mental state. The subsequently
decided course of action regarding the provision of care can lead not only to individual recovery
but also to the reconstruction of the town.
[Support for Supporters]
Another major pillar of our activities is support for those who are being supported. We holdtraining and case study meetings on mental care for local government employees, support staff
and counselors who are involved in support in temporary housing, local welfare officers, caremanagers, and staff of private support groups. We are making efforts to expand our knowledge
about support for those who have been affected. We are also actively working toward improving
the mental care available to supporters. Although there are various differences in the positions ofsupporters, we have been providing aid since the beginning of the earthquake. In the process,supporters will naturally accumulate psychological and physical fatigue. However, from thestandpoint of providing support, there are times when you do not notice the changes that are
happening to you, or you continue to work excessively, saying, “I can’t just admit that I’m tired.”Considering that support will yet be needed for a long time, it is essential for the supporters totake proper rest. We are working through training so that supporters can deepen theirunderstanding of the importance of their own mental health.
[From Now On]
From now on, the disaster area will be rejuvenated in accordance with the reconstruction plan.
However, it seems unlikely that mental care will become any less important during this time. Afterall, targeted reconstruction of survivors’ lives is only just beginning, and this process is expected
to bring its own difficulties. I think that the traditional idea of “mental care associated with theearthquake” will change to “mental care associated with reconstruction.”- 134 -

Therefore, at the MDMHCC, as in the past, we will continue to support reconstruction efforts
by visiting disaster areas every day and providing mental care to victims and supporters alike.
(“Mental Health Magazine Kokoro no Genki +” Vol. 7, No. 3 (Vol. 73) 3.11 Earthquake Report (22) Included in the issue of the NPO Community Mental Health and Welfare Organization
Combo.)- 135 -