Efforts toward “handing down”
The basic principle and basic policy of the Second Operation Plan clearly states as follows: “Implementingactivities with the perspective of handing down the experience cultivated in past activities, such assummarizing the ideal way of support that can be utilized in the event of a disaster that will occur in the future,since the activities that the Center has overseen to date will be valuable knowledge of mental health care
activities in the event of a disaster.”Moving toward the conclusion of the MDMHCC in FY 2025, support operations have seen a gradualshrinking in Kesennuma, Ishinomaki, and the Stem Center. Meanwhile, efforts for handing down experiences
have begun in earnest in FY 2022. As a first step, it was necessary to create a framework for deciding theentities responsible for handing over respective tasks, and in what form. We describe the progress of thehandover work done to date and future efforts.
1. Conceptualization and framework of “handing down”(1) Significance of handing down
The MDMHCC has conducted a wide variety of activities according to the needs of the disaster-affectedarea. Similar needs may arise in areas affected by future disasters. Therefore, clarifying what kinds of needs
arise in disaster-affected areas, and communicating and leaving behind activities that the MDMHCC had
conducted in response will prove helpful to future support activities.
There have also been many records and materials regarding support activities in the field of mental healthimmediately following a disaster, but there are hardly any such examples for the medium- to long-term
support activities. When the scale of a disaster is limited, then support immediately following the disasteris the primary focus, but when a large-scale disaster like the Great East Japan Earthquake occurs, there is aneed for medium- to long-term support. Therefore, it is important to communicate and leave behind theknowledge acquired by the MDMHCC.
(2) Handing down “to whom”
We have had repeated discussions on who should benefit from the knowledge acquired by the MDMHCC
through its support activities. The MDMHCC has been conducting activities in collaboration with eachmunicipality in charge, both from the perspective of an external institution and from the perspective ofmental care after a disaster. One extremely important mission is to provide various forms of support tomunicipal public health nurses, who are required to play a role on the front lines in providing psychologicalcare to local residents after a disaster. Thus, when the next disaster occurs, it would be necessary to support
people in charge of the mental care of people affected by the disaster, including municipal public healthnurses, in various forms. Therefore, we set people—such as (municipal) public health nurses, who are incharge of the mental care of local residents in disaster-affected areas—as those to whom this “handing down”
should be targeted.
(3) “What” and “how to” hand down
The next consideration was the content to be handed down. To date, the MDMHCC has publishedbulletins, official activity records, and annual activity reports to provide an overview of support activities.
These describe the efforts of the MDMHCC and may not be directly related to the needs of those in chargeof mental care when the next disaster occurs. Therefore, we decided to hand down knowledge that could
serve as practical guides as well as innovations and efforts for overcoming difficulties to help local
government public health nurses and professionals smoothly provide support for the mental health ofdisaster victims and their supporters following a disaster.
We decided to proceed according to the following four steps to concretely develop these points.
Step 1: Make a list of what the people being handed down knowledge should know.
Clarify the questions and issues that local government public health nurses and professionals
would be expected to consider when implementing support activities.
Step 2: Organize what has been done at the MDMHCC (compile “what has been done at theMDMHCC”).
Organize the experiences of the MDMHCC and clarify results and issues to answer thequestions raised in Step 1.
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Step 3: Organize what should be conveyed for support following the next disaster based on theexperience of the MDMHCC (compile “what to convey for support following the nextdisaster based on the experience of the MDMHCC”).
Compile a summary to answer the questions raised in Step 1 based on the organization in
Step 2.
Step 4: Convey the knowledge obtained from the experience of the MDMHCC.
Hand down knowledge by conveying it through various methods, such as the internet, bookpublication, and on-the-job training.
Additionally, regarding “how to” hand down, since various methods can be conceived, such as bookpublication, online utilization, and on-the-job training, we have examined the feasibility of eachmethod.
(4) Summary and future plans
The handover work was started in earnest from FY 2022, but the framework shown here has taken aconsiderable amount of time to construct. The overseeing manager and management, such as the Vice
President and the Community Support Department Director, played a role in building the framework, but
the work involved thinking about what “handing down” was beyond a mere summary of practice reports
and activity results, and imagining what that would entail. Although the work initially felt like a wild-goosechase, after many discussions, the MDMHCC concluded that “handing down” should take the direction ofwhat people in charge of mental care in disaster-affected areas should do for the mental care of local
residents—and how—when a large-scale natural disaster occurs and when the medium- to long-term isreached. Another conclusion was that responding to the questions and difficulties they have would fulfill
the social responsibility of the MDMHCC. As such, we decided to utilize what the MDMHCC has worked
on, experienced, and seen. The MDMHCC has had three support divisions engaging in a wide range ofactivities, such as the ideal ways of building relationships and collaborating with municipalities and relatedinstitutions, as well as identifying support targets and content, in line with the circumstances of each region.
We believe that this can be conveyed as useful knowledge in this “handing down” process.
In the future, Kesennuma, Ishinomaki, and the Stem Center staff will work together in accordance withthis framework, but the work from here on out will also be an unknown undertaking. In the remaining time
until FY 2025, we aim to engage in efforts toward passing the baton of mental care in disaster-affected areas
to the next supporters in the next disaster.

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