Department Initiatives
Community Support Division, Kesennuma Regional Center

Initiatives at Kesennuma
Regional Center
Mitsuaki Katayanagi
Psychiatric Social Worker
Manager of Community Support Division, Kesennuma Regional Center, MDMHCCThis paper reports our major activities for each FY 2015 project. The number, etc. of activities of each projectis shown in Part I-3: 2015 Programming Review. Therefore, this paper provides a summary of the activities rather
than the details of them.

1. Resident support
As before, FY 2015 resident support focused on home visiting support services for those who were identified
as high risk in the health survey conducted by Miyagi Prefecture and each municipality. Of those who visited thecenter, those who required support were provided with ongoing support.
In FY 2015, there was an increase in the number of cases of direct consultation in addition to cases ofconsultation support based on a health survey.
Also, one of our staff members (one for each) is seconded to Kesennuma City and Minamisanriku Town toprovide a wide range of consultations on mental health care in collaboration with each municipality.
(1)

Kesennuma CityIn FY 2015, the city started an independent house-to-house health survey of all residents of public
housing. The Kesennuma Regional Center (referred to hereafter as Center) of the Miyagi Disaster Mental
Health Care Center (MDMHCC) provided home visiting support services to the residents of public housing
in Karakuwa district (Table 1).
The number of consultations and requests for support has increased after collaborating with various
support organizations. What characterizes support activity in FY 2015 is the collaboration of supporters inproviding support to victims with various problems.
Table 1. Support such as health survey visits
Support activities

The main support period andmajor patients

Number of support cases
including visits by Kesennuma
Regional Center, etc.

FY 2014 Container type temporary
housing. Home visiting support
services based on health survey ofresidents

February-April 2015 Mainlycases with high K6 scores

20 cases

FY 2014 Home visiting support
services based on Health survey ofresidents such as privately rented
temporary housing

April-July 2015 Mainly caseswith high K6 scores

29 cases

FY 2015 Health survey of residentsof public housing and residents who
were collectively relocated fordisaster prevention

February 2016- All Residents in
Karakuwa district

Public housing 27 cases,
Collective relocation for disasterprevention 32 cases

－9－

(2)

Minamisanriku Town
We shared information at various conferences and meetings held by municipal governments and theLife Support Center for Disaster Victims run by the Social Welfare Council. In the meantime, we
provided support for individual cases by providing consultation to supporters and accompanying visits
by municipal health promotion staff and public health nurses in the branch. We believe that we haveprovided continuous support.
Table 2. Support such as health survey visits(3)

Support activities

The main support period and majorpatients

The number of support cases
including visits by Kesennuma
Regional Center, etc.

FY 2014 Home visiting support
services based on the healthsurvey of the residents ofcontainer-type temporary
housing

February-March 2014. Mainlycases with high K6 score and highscores on items on "daytime
drinking"

37 cases

FY 2014 Home visiting support
services based on the healthsurvey of home-dwelling
residents

June-August 2014. Mainly caseswith high K6 score and high scoreson items on "daytime drinking"43 cases

FY 2015 Home visiting support
services based on the healthsurvey of the residents ofcontainer-type temporary
housing

March 2015-. Mainly cases withhigh K6 score and high scores on
items on "daytime drinking"31 cases

Discussion
In Kesennuma City and Minamisanriku Town, many people still live in temporary housing whilemore people move into public housing, etc. Regarding the support of residents in such a situation basedon health surveys, we received requests from the two municipalities to provide visits to residents withpoor mental health or alcohol problems. To make the most of our expertise, visits were provided by two
persons as much as possible and a staff conference was held after each visit. We were able to make themost of the experience and skills we have cultivated through past activities in our support planning andsupport activities.
As in FY2014, there was an increase in consultations made by residents who were not directly
affected by the Great East Japan Earthquake. Also, requests for consultations from related organizations
such as consultation organizations, educational institutions, and welfare institutions increased. Although
it is less obvious, the earthquake may still affect the mental and physical health of many residents,
making life difficult. Based on these facts, we will continue to solve residents' problems, which are being
personalized and diversified, by collaborating with many related organizations such as municipalities.

－ 10 －

2. Support for supporters(1)

Kesennuma City
① Deployment of specialists to municipalities (regular support staff members and seconded staff
members)
In FY2015, as in FY 2014, we deployed specialists to municipalities and implemented initiatives
to reduce the work burden of municipal public health nurses through victim support and the supportof public health nurses.
② Mental health support for municipal officials
Based on the request from the General Affairs Division, we discussed with the Department ofPreventive Psychiatry, Tohoku University Graduate School of Medicine (referred to hereafter as the
Department of Preventive Psychiatry), the Department of Nursing, Miyagi University, and theKesennuma Health and Welfare Office about the health support for city officials and implemented thefollowing initiatives.
Based on the results of a health survey on the mental health of city officials (including dispatchedstaff) conducted by the Department of Preventive Psychiatry, we conducted individual interviews withcity officials. Also, to raise awareness of reinstatement support, the city held multiple meetings on theinitiative of reinstatement support, health survey meetings by management, and workshops for
management.
Besides, a health consultation desk for city officials (including dispatched staff) is open from 10:00
a.m. to 4:00 p.m. at the central government office on the third Wednesday of every month.
③ Mental health support for the staff members of the Social Welfare Council
Based on the results of FY2014 and FY2015 health surveys of the mental health of the staff
members of the Social Welfare Council (referred to hereafter as the Social Council) conducted by thedepartment of preventive psychiatry, we conducted individual interviews with the staff members of
the Social Council.

(2) Minamisanriku Town
① Deployment of specialists to municipalities
In FY2015, as in FY 2014, we deployed specialists to municipalities and implemented initiatives
to reduce the work burden of municipal public health nurses through victim support and support ofpublic health nurses.
② Mental health support for municipal officials
Based on requests from the General Affairs Division, we provided support to the town officials
after a discussion with the Department of Preventive Psychiatry, the Kesennuma Health and Welfare
Office, and the Miyagi Mental Health and Welfare Center.
A health consultation desk for town officials is open from 12:00 p.m. to 6:00 p.m. on the fourth
Tuesday of every month. Also, because the consultation desk was open only during business hours
during weekdays, we tentatively opened a consultation desk twice a month on weekends from 10:00
a.m. to 3:00 p.m. in January-March 2015. Because these were conducted on weekends, the consultation
was provided in Tome City, where many staff members live, for three days out of all consultation days.
③ Support for the Life Support Center for Disaster Victims
In FY 2015, as in FY 2014, regular group meetings were held at each satellite. (Table 3) Besides,
as part of the support for the staff members of the headquarters of the support center for disaster victims
that controls satellite offices, we conducted individual interviews of staff members twice a year, in
May and December.

－ 11 －

Table 3. The present status of group meetings at each satellite office
Date

LocationContent

April 21

Minamikata SatelliteGroup meeting

May 1

Tokura SatelliteGroup meeting

May 11

Utatsu SatelliteGroup meeting

May 18, 20, 21

Main Office

Individual interview by staff members

May 20

Shizugawa SatelliteGroup meeting

June 15

Minamikata SatelliteGroup meeting

July 22

Shizugawa SatelliteGroup meeting

July 29

Utatsu SatelliteGroup meeting

August 4

Tokura SatelliteGroup meeting

August 21

Minamikata SatelliteGroup meeting

October 7

Utatsu SatelliteGroup meeting

October 20

Tokura SatelliteGroup meeting

October 27

Minamikata SatelliteGroup meeting

December 14, 16, 17

Main Office

Individual interview by staff members

December 18

Tokura SatelliteGroup meeting

December 22

Utatsu SatelliteGroup meeting

December 25

Shizugawa SatelliteGroup meeting

December 25

Minamikata SatelliteGroup meeting

February 24

Shizugawa SatelliteGroup meeting

March 31

Minamikata SatelliteGroup meeting

March 31

Tokura SatelliteGroup meeting④Development of the summary of the health survey
We provided support for the review of surveys of high-risk individuals with high K6 scores for FY
2012-2014 based on the results of post-survey confirmation visits to the residents of container-type
temporary housing conducted by Miyagi Prefecture and Minamisanriku Town. Our center was
responsible for documentation and discussion, leading to continuing discussions with the healthpromotion staff of the Health and Welfare Division, Minamisanriku Town.
Because interview information varied from one interviewer to another, the tendency of high-risk
individuals with high K6 scores could not be summarized due to insufficient basic data. We developeda "check sheet" that summarized key items in the interview so that any investigator could evaluate thesituation without bias during post-survey verification visits in future support activities by making themost of our expertise. The check sheet has been used since the FY 2015 post-survey visits to theresidents of container-type temporary housing.

－ 12 －

(3) Discussion
Regarding support for the supporters, we seconded staff members to the Health Promotion Divisionof Kesennuma City and the Health and Welfare Division of Minamisanriku Town as health promotion
staff. Also, we were able to provide regular support to the Health and Welfare Division, Karakuwa
General Branch, Kesennuma City for almost the entire year. As a result, the seconded staff members andthe regional center were able to provide simultaneous support to the responsible divisions of eachmunicipality. Because Kesennuma City and Minamisanriku Town are both overloaded with tasks, theworkload of public health nurses in the municipalities may be heavy. The second staff member and theregional center will continue to collaborate to provide support to municipal public health nurses.
In FY 2015, Kesennuma City started providing reinstatement support to municipal officials.
Minamisanriku Town tentatively launched Consultation Days on weekends to improve theconsultation system. It has been five years since the earthquake. During the years, many municipal
officials contributed to their work without adequate rest. Therefore, they may have severe mental andphysical fatigue. Therefore, we will increase our mental health support for the municipal officials incollaboration with the responsible division of the city government and related organizations.

3. Raising public awareness(1) Kesennuma City
① Column postings
Since April, in collaboration with the Kesennuma Health Care Center, we have published a monthly
column, "Sanriku Kokoro Tsuushin," once a month in the newspaper Sanriku Shimpo, which is mainly
read by people in Kesennuma City. Through print media, we have raised public awareness of what
constitutes appropriate mental health and the availability of the consultation desk (Table 4).
Table 4. Sanriku Shimpo (postings, etc. in the column "Sanriku Kokoro Tsuushin")Issue*
18th

Month
4

19th

5

Content
Take the opportunity to grow up in this coming season.
Believe in yourself and move forward.
Post-vacation blues!? You may be stressed.

20th

6

Health is a building block for recovery.

21st

7

22nd

8

Alcohol and drinking habits (Session 1): The reality ofheavy drinking in disaster victims
Alcohol and drinking habits (Session 2): Drink wisely

23rd

9

Keep your mind and body healthy and prevent dementia

24th

10

Take a good rest: How busy people take a rest and break

25th

11

Domestic Violence (DV): Send an SOS without hesitation!

26th

12

27th

1

28th

2

29th

3

Mental health care for children (Session 1): About being
hurt
Mental health care for children (Session 2): What close
adults can do for them
Refresh your mind and body with easy relaxation(Session 1): Let's try breathing
Refresh your mind and body with easy relaxation(Session 1): Let's try stretching while sitting

1*1 The issue number is a sequence from the first publication in FY 2013－ 13 －

AuthorKesennuma Health Care
CenterKesennuma Regional
CenterKesennuma Health Care
CenterKesennuma Regional
CenterKesennuma Regional
CenterKesennuma Health Care
CenterKesennuma Regional
CenterKesennuma Health Care
CenterKesennuma Regional
CenterKesennuma Regional
CenterKesennuma Health Care
CenterKesennuma Health Care
Center② Collaboration for "CoCo cafe" a public awareness activity by the city government"CoCo cafe" is a self-care program provided by Kesennuma City for residents of privately-rented
temporary housing affected by the disaster to reduce stress and prevent isolation by going out andcommunicating with other residents. In FY 2015, the "CoCo cafe" was co-sponsored by the Volunteer
Center of the Kesennuma Social Welfare Council, Social Welfare Corporation, and our center, incollaboration with the Mitsumine Hospital, Medical Corporation Tetsuhito Igawa Association.
③ Collaboration in the city project "Health Festival"
The Health Festival is a project led by Kesennuma City for preventing the deterioration ofphysical strength and functioning due to poor lifestyle and stress and maintaining and promoting
public health based on “the second Kesennuma Health Plan 21 ”and “the second food education
promotion plan. ”On the day, we ran the “CoCo cafe corner ”that provided drinks, a relaxing
experience (Sanshin/guitar performance and self-massage), and a health storytime. Also, we
distributed goods for the development of mental health.
④ Distribution of leaflets and aroma cards for city officials
We distributed leaflets on mental health (in August) and aroma cards (in December) to city officials
to raise awareness of their health.
⑤ Other
We provided mental health support to residents (Table 5).
Patients

Residents

Residents
Residents ofcontainer type
temporary
housing inShishiori area

Residents
Residents ofcontainer type
temporary
housing inShishiori area

Table 5. Other initiatives for raising public awarenessSupport Activities
Following a request from the Southern Regional General Support Center,
we dispatched a lecturer for the FY 2015 Motoyoshi District Dementia
Meeting for residents. We held a workshop on music gymnastics andrelaxation as a refreshing exercise.

Number of Events

Once

ParticipatedWe participated and collaborated in the regular meetings of the
12 times /Motoyoshi District Danshukai sponsored by Miyagi Prefecture
Held 12 times
Danshukai.
in total
Under the leadership of Miyagi University, we held a health class incollaboration with the Hyogo Prefectural University, the Health
Promotion Division of Kesennuma City, and the Kesennuma District
5 times
Support Center to maintain a healthy life for the residents of temporary
housing in the Kaori District. In the health class, the Kesennuma Regional
Center provided mental health consultation opportunities.
We participated in the "FY 2015 Street Mental Health Promotion
Campaign for Kesennuma District." During Suicide Prevention Month,
we conducted a "mental health check" and distributed enlightenment
Oncegoods with information on the consultation organization at four shopping
centers in Kesennuma City.
In collaboration with the saloon events held by the Japan International
Volunteer Center, we provided health mental consultation, mental healthlectures using a story, and relaxation training at seven container type
temporary housing locations in Shishiori area.

13 times in
total(2) Minamisanriku Town
① We provided a daytime program, "caregiver workshops and local meetings."
Following a request from the Minamisanriku Social Welfare Council, we provided mental healthlectures using familiar means, such as stories and a Sugoroku game, at the caregiver workshops andlocal meetings held by the Day Service Center Togura and the Day Service Center Iriya. The lectures
were provided as an experience-based program in combination with their facial massage, Tapping
Touch and musical calisthenics, etc. In FY 2015, we provided four mental health lectures at the Day
Service Center Togura and one lecture at the Day Service Center Iriya (Table 6).

Table 6. The status of the implementation of lectures etc. at day services centers
Date

Place

Content

May 23

Day Service Center Togura・Lecture about stress; Myofascial massage

July 18

Day Service Center Togura

・Myofascial massage; Sleep lecture and storytime

November 14

Day Service Center Togura

February 6

Day Service Center Togura

February 21

Day Service Center Iriya

・Lecture on self-expression that respects you andyour partner; Tapping Touch
・Story time on nutrition and health; Sugoroku Quiz;and Relaxed musical calisthenics
・Lecture on self-expression that respects you andyour partner; Tapping Touch② Community workshops
Five times a year, we sponsored a physician from the Medical Corporation Tohokukai Tohokukai
Hospital (referred to hereafter as Tohokukai Hospital) to deliver a lecture for the residents of container
type temporary housing as well as welfare commissioners. In FY 2015, on the suggestion of publichealth nurses, the lecture was provided to the Fishermen's Association for the first time.
③ Distribution of leaflets for town officials
We distributed leaflets on mental health (in August) to town officials to raise awareness of theirmental health.
(3) Discussion
We focused on the high-risk approach in residents with poor mental health and population approaches
to improve the mental health of the residents. Specifically, we tried to provide flexible support throughvarious approaches, such as music, storytelling, exercise, skits, to raise public awareness of mental healthissues as easy-to-understand and familiar issues. We tried it on various occasions and were able to raisemental health awareness. We will continue to raise awareness of these mental health activities. We will
also start to develop educational materials so that each municipality can use this knowledge after thecompletion of our support activities.

4. Human resource development training for supporters(1) Kesennuma City・ "Mental health care meeting for disaster victims in Kesennuma, Miyagi"
The meeting was held at the Urban Guest House for networking opportunities for supporters in
Kesennuma City and Minamisanriku Town.
・ Supporting training around mental illness
Following a request from Hearlink Kesennuma, an independent support consultation organizationin Kesennuma City, we conducted workshops on mental health support. To raise awareness ofmental health and welfare, we provided training depending on the skills of supporters and－ 15 －
organizations.

(2) Minamisanriku Town
・Workshops for the staff of the Life Support Center for Disaster Victims
In FY 2015, the staff from our center conducted workshops for the staff at the Life Support Center
for Disaster Victims that used to be conducted by Tohokukai Hospital as a project commissioned by
the Miyagi Disaster Mental Health Care Center (MDMHCC). We took requests for workshops inadvance. In FY2015, we conducted the first workshop mainly on familiar alcohol-related issues andthe second workshop on daily interactions. To avoid providing a passive experience, we also
conducted an alcohol-related questionnaire and provided the experience of an aromatic massage forself-care.
(3) Discussion
In FY 2015, as in FY 2014, we raised awareness of self-care through support activities. Besides, we
conducted workshops on mental illness. The above activities were provided following requests fromclients.
Although the community is still in the process of recovery, more support organizations and relatedorganizations are expected to stop their support or reduce the scale of their support in the future. On theother hand, related organizations and groups that provide ongoing support may have various difficulties
and problems related to long-term support activities. Therefore, we will continue to conduct workshops
to support the supporters based on their needs.
5. Support for various activities(1) Main activities
In collaboration with the Sendai Grief Care Study Group, we provided support assistance for
Wakachiai no Kai (the Association of Sharing) for disaster victims, which was sponsored by the Sendai
Grief Care Study Group. Also, throughout the year, we developed a network (e.g. the NPO and NGO
liaison council) of various organizations and groups to provide support in various forms to the community.
As an activity in the area, in collaboration with the Miyagi Prefecture Dementia Disease Medical
Center, we held, "a dementia research meeting," where lectures on dementia in the general populationand on supporters of those with dementia were provided. Regarding the specific activity of the
Kesennuma Mental Care and Welfare Liaison Council, a working group was established as a secretariat
in collaboration with the Kesennuma Health and Welfare Office. We also participated as committee
members and conducted workshops on mental health at Motoyoshi Hibiki High School in collaboration
with the staff members of related local organizations.
(2) Discussion
In FY 2015, in addition to the collaboration with related mental health and welfare organizations,our center actively contributed to activities for building a relationship and collaborating withorganizations that provide various forms of support in the community. These activities were
provided based on the need to identify various issues, such as post-disaster local mental health care,of Kesennuma City and Minamisanriku Town by obtaining local information with a wide
perspective. Through these activities, we were able to interact with people we did not know and toraise mental health awareness in the community. Besides, regarding our activities, we were able toimplement co-operation and collaboration with other organizations. On top of that, we provided
support in collaboration with other organizations, to residents who required observation.
The challenges of post-disaster local mental health care are closely related to daily life challenges.
Therefore, to raise public awareness in the community and solve problems in local mental health care,we will continue to strengthen cooperation with organizations that provide support in various fields.

－ 17 －