2. Department Initiatives

Community Support Department
Kesennuma Regional Center, Community Support Division
Ishinomaki Regional Center, Community Support Division
Stem Center, Community Support Division
Stem Center, Planning and Research Division－ 40 －Community Support Department Activity Report

Community Support Department Activity Report
Miyagi Disaster Mental Health Care Center
Community Support Department
Manager, Public Health Nurse – Sakiko Okamoto

1.

Introduction
The Miyagi Disaster Mental Health Care Center comprises the executive office, the Planning and Research
Department, and the Community Support Department. The Community Support Department carries out its duties under the auspices of three divisions: the Ishinomaki Regional Center Community Support Division (Ishinomaki), the Kesennuma Regional Center Community Support Division (Kesennuma), and the Stem Center,Community Support Division (Stem). Each Community Support Division treats the basic guideline from the“Miyagi Prefecture Reconstruction Plan,” the “fulfillment of initiatives to achieve ‘Continuous Support for All:
from Children to Adults’” as the end goal. To that end, they participate in activities in six core focus areas:“resident support,” “support for supporters,” “raising public awareness,” “human resource development,” “research,” and “support for various activities.” In response to the progress being made in reconstruction work or
the needs of a specific area, these divisions work alongside municipalities, health care centers, and affiliatedorganizations to implement their activity programming. The details of the activities of each Community Support
Division will be listed separately; in the meantime, here is a list of each Community Support Division’s mostcharacteristic activities and a brief discussion of each of them.
2.
(1)

Characteristics of Each Community Support Division in FY 2018
Kesennuma Regional Center Community Support Division① The number of individual counseling cases at this division has increased. Particularly cases involving
children and working adults, with walk-in visits becoming more commonplace than home visits.
Additionally, the volume of multi-issue, complex cases is relatively high, and the number of individuals needing consistent support has also increased. More cooperative initiatives involving families,schools, and workplaces have enabled the center to provide support to people of many different age
groups.
② This division carried out activities designed to raise public awareness, which included writing
newspaper articles and appearing on radio programs. Collaborating with other municipalities
on their programs has given them access to even more opportunities to raise public awareness.
For example, there is “Dankatsu” at Kesennuma, which is a support project targeting socially
isolated community residents, and “Minamisanriku”: an alcohol picture-show story project forresidents).

(2)③ This division has also increased participation in similar conferences and meetings, by working
alongside administrative organizations and institutional affiliates such as municipal authorities
and health care centers in areas such as case response and project assistance, among otherthings.

Ishinomaki Regional Center Community Support Division① This division has seen a fall in the number of requests for post-health-survey, follow-up visitsamong disaster public housing tenants. Municipal authorities and their affiliates, on the otherhand, frequently request assistance from this division in addressing several overlapping problems, including mental illness, mental disability, and hikikomori. Furthermore, given recent suicide countermeasures, this division is evaluating the standards that are being used to determine which cases require continuous support.
－44－FY 2018 Bulletin, Issue 7② This division held several training workshops, including a skill-building “Support for Supporters”
program about responding to alcohol-related issues, and initiatives organized in collaboration withthe health care center that seeks to foster cooperation between internal medicine specialists and psychiatrists. It also conducted child mental health care training workshops for individuals involved inlocal public health, childcare, and education.
(3)

Stem Center, Community Support Division① As health surveys of disaster public housing tenants indicate what appears to be a fall in the numberof high-risk support targets, this division is gradually adopting a more population-centric approach.
This involves organizing public awareness activities concerning mental health, for disaster public
housing tenants and community residents.
② Complex, multi-issue cases that require continuous support, including those involving hikikomori,alcohol-related problems, mental illness, and mother-child relationships, are rising. For this reason,case study conferences that involve not just public health nurses from the division directly overseeing
the case, but from other divisions and affiliated institutions as well, have been held in several municipalities. This division has functioned as an advisor at many of these events, and this activity itself is
a form of “Support for Supporters.”③ This year, as part of a countermeasure against alcohol-related problems, we held a “temperance support training workshop” with the mental health and welfare center, for supporters throughout theprefecture. We also implemented a follow-up training session for individuals who had attended theworkshop held in FY 2017, and practical reports from the participants clarified how and where temperance support was being utilized.

3.

Discussion

Reductions in temporary housing have caused a decline in the health-survey-related, home visit aspect ofresident support. The multi-issue cases such as those involving “hikikomori” and “alcohol abuse”, however,are on the rise among children and working adults, particularly in Kesennuma,. This is why we have increased
our “Support for Supporters” activities, including participating in case study conferences with representatives
from other municipalities, schools, workplaces, and affiliated organizations.
In FY 2017, the percentage of disaster public housing tenants who scored 13 points or more on the healthsurvey’s K6 scale, was higher than it had been in FY 2016. The worsening of resident health is thus a salient
concern. Based on analyses conducted by the prefecture, factors influencing the K6 score include “the presenceor absence of someone to confide in” and “social participation.” In light of this situation, and in addition toproviding support to high-risk individuals, we have begun to shift towards preventative initiatives like publicawareness drives addressing mental health and alcohol abuse, for disaster public housing tenants and community residents. As we continue to build new communities; apply population approaches like rebuilding socialcapital; and establish social ties between residents, public awareness activities become more important thanever.
Alcohol-related issues often require private counseling and case supervision. In addition to providing support
under the guidance of, and in concert with, Tohokukai Hospital and the Miyagi Prefecture Danshukai, we havecarried out a variety of measures designed to: arrest the onset, halt the progress, and prevent the recurrence ofalcohol dependency. This includes public awareness-focused “health picture-show stories” (Kesennuma); training workshops to facilitate collaboration between internal medicine specialists and psychiatrists (Ishinomaki);
and workshops for temperance support (Stem). In the future, we intend to continue to work with administrative
organizations, medical institutions, the Danshukai, and other self-help groups, as well as educational institutions, to provide continuous support for all.
－45－Community Support Department Activity Report

4. Summary
Eight years have passed since the disaster, and while reconstruction efforts—like the building of disasterpublic housing and attempts to relocate groups to common housing areas—are progressing, the worsening ofpeople’s health indicates the increasing complexity and severity of the issues that our communities will cometo face.
There have been proposals to continue the activities of this center into FY 2021 and beyond. In the future, wewill strive to create communities and neighborhoods where residents can live together in peace. Based on previous experience, we intend to work with municipalities, health care centers, and mental health and welfare
centers to shape communities’ futures. This process will depend on various mental health and welfare initiatives
and the roles that each of these agencies will play, especially with regards to primary, secondary, and tertiary
preventative measures that will allow children to grow and flourish at each stage of their lives.

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