Social Worker Initiatives for Alcohol-Related Problems in the Wake of the Disaster
Report on the Ishinomaki Support Activities of the JASWA
JASWA
Disaster Area Support Project – Sakae Fujita
1. Introduction
It has been three years since the Great East Japan Earthquake struck. Alcohol-related issues arebecoming significant community problems in disaster areas, increasing the burden of those involved
in mental health care. In Ishinomaki, Miyagi, the JASWA has been working on interventions forpost-disaster alcohol-related issues since September 2011. In FY 2012, together with the MDMHCC,
we began building a collaborative system with local stakeholders. This paper reports on our activities
in FY 2013, presents the results of our support work, and discusses future issues.
2. Project Objectives
The objectives of this project are to provide residents of disaster areas in Ishinomaki who are
dealing with alcohol-related problems with mental health care and reconstruction support to help
rebuild a stable life, and to equip local aid workers, via consultation, with the skills necessary tosupport individuals grappling with alcohol-related problems.
3. FY 2013 Project ContentThe JASWA dispatched a small number of psychiatric social workers to Ishinomaki twice permonth between April 2013 and March 2014 (second Fridays and fourth Wednesdays) to accomplish
the following support work: (1) case consultation, (2) counseling interviews with the affectedindividual or their family, (3) accompanying public health nurses who conduct visitations totemporary housing, (4) attendance at collaboration meetings with affiliated persons in the community,(5) case study sessions, (6) service as lecturers for resident-focused sessions, and (7) planning andmanagement of continued lectures and training workshops for local aid workers. The Ishinomaki
City Health Promotion Division has coordinated these events, whereas the JASWA has provided thenecessary manpower.
4. Project Progress and Results
Continuing from last year, details regarding the support initiatives that fell under the umbrellasof categories (1), (2), (3), and (4) above, all of which are individual support endeavors, are as follows.
(Tables 1 and 2). Our help was sought in 19 cases (10 new and nine continuing cases). These
necessitated a total of 56 activity sessions, which consisted of visitation accompaniment, caseconsultation, and participation in case meetings. Case conferences were held for three of our 19 cases,
with a total of eight conferences being held. Attendees included nurses and social workers from theComprehensive Community Support Center, community welfare coordinators, area chiefs,supporters from the Disaster Recovery Support Measures Division of the city’s SWC, public healthnurses from the MDMHCC, public health nurses from the city Health Promotion Division, welfareofficers, Abuse Prevention Center staff, and trainees. Case studies were implemented for two cases,and two study sessions were held. Participants included city public health nurses, the MDMHCC,
nursing association health coordinators, the Comprehensive Community Support Center, Kaisei
temporary clinics, Karakoro Station, and temporary supporters from the city’s SWC.
Table 1: FY 2013 Caseload Breakdown
Breakdown

Cases

New

10Continuing

9- 85 -Table 2: FY 2013 Support Cases by Content and Sessions
Support ContentCases

Sessions

Visitation and consultation

9Consultation alone1022(3 involved interviews withfamily members only)
26Case conferences3(Among new/continuing cases)

8This year, we continued individual support and simultaneously held the following training
workshops for local helpers.
(1) Foundational Course in Alcohol
Continuing from FY 2012, we carried out the following training programming.
April 2013: “Building Community Relationships”
Lecturer: Eiko Oshima (NPO Recovery), 25 participants
May 2013: “Community-Based Aid for Alcohol Problems (How to Support Individuals
with Their Communities)
Lecturer: Eriko Sako (Recovery House Ichigo), 41 participants(2) Practical Alcohol Training
November 2013: Lecture: “About Alcohol-Related Problems”
Practicum: “Thinking about alcohol-related issues with residents in an easy-to-understand manner”
Lecturers: Naoto Okazaki, Sumie Okada
December: Lecture: “About Alcohol Family Support”
Practicum: “What kind of support should be given to families with drinking problems?”
January 2014: Lecture: “Skills to Convey Alcohol Problems to the Community”
Practicum: “How to interact with people with drinking problems”
Participants in (1) and (2) were the government, the MDMHCC, medical care workers,
temporary support staff of the city’s SWC, the Comprehensive Community Support Center, thenursing association, elderly people, and persons involved in disability welfare. A total of 77
persons took part in the training sessions in (2). Thirty-six individuals attended all sessions. Thisinitiative was motivated by requests from local officials for “training sessions that offer knowledge
about alcohol problems, equipping us with the practical skills to intervene in local alcohol-related
problems and engage in the necessary communication with neighborhood council chairmen,supporters, and residents in general.” The JASWA planned and held training in line with thisrequest. A certificate of completion was issued to the participants who attended all sessions.
(3) Resident Support
August 2013: “How to Properly Use Alcohol”
Location: Ohashi Temporary Housing, Ishinomaki
Targets: Ohashi residents, specifically those with alcohol-related problems or thoseinterested in the topic
This was an awareness-raising training event, held at the request and with the cooperationof public health nurses, support staff, and neighborhood council chairmen, and it was avaluable experience for the JASWA as well.

- 86 -(4) OtherWe were covered by the Alcohol Drug Problem National Citizens’ Association Quarterly
Paper “Be!”, and in issue 113 (published in December 2013), “Countermeasures against alcohol
problems in the disaster area and wanting to develop the ability to change our communities byourselves” was published. The contents described the progress of our projects since 2011 andthe current status of drinking problems in disaster areas.
5. Future Issues and Prospects
The support we have provided since 2011 has succeeded in maintaining the momentum for local
supporters to proactively tackle the alcohol problems that have surfaced after the disaster throughthe organization of workshops for local affiliated persons. Alcohol-related issues are often
considered by local aid workers as “problems that they would want to avoid if possible.” Indeed,
previous responses to these problems have primarily involved calling the police or near-forciblycommitting to specialized hospitals or psychiatric institutions individuals who are visibly drunk andcausing trouble in their communities. In other words, these individuals have simply been recognizedas nuisances to the community and have been dealt with through exclusion. As reconstruction dragson and residents of disaster areas find themselves unable to return to their normal lives, persons
active in the mental health field have come to realize that unseen anxieties and worries are causing
mental health issues in their communities. This trend can be seen in any disaster area, and alcoholproblems are finally starting to become the target of proactive initiatives that seek to solve disasterarea problems that can no longer be overlooked, such as suicide and depression. As a result, there
has been a shift away from exclusion toward collaborative response, a trend that can be seen in thetopics brought up at our case study sessions. In particular, in Ishinomaki, people from various local
aid organizations such as the Public Health Center, MDMHCC, Comprehensive Community Support
Center, SWC, and medical institutions have begun to proactively form collaborative relationships
with temporary housing supporters, neighborhood council chairmen, and other individuals withcommunity roles to work toward educating residents and intervening in their problems.
It has been three years since the earthquake, and it has become clear that reconstruction of theaffected areas will be a very lengthy process. Many survivors are persistently working to rebuild
their lives in temporary housing. Under these circumstances, it can be said that the future task of the
JASWA is to continue to be involved in the process of empowering communities to tackle their own
alcohol problems.

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