State of a activities listed by project for20162016 Activity Review
Yuichi Watanabe – Director, Psychiatric Social Worker
Planning Division, Stem Center, MDMHCC

1.

Introduction
Over the course of around six years, since the establishment of the Stem Center in December 2011 and theestablishment of the Kesennuma Regional Center and Ishinomaki Regional Center in April 2012, the Miyagi
Disaster Mental Health Center (hereinafter, “the Center”) has developed its support projects for areas struck by
the earthquake through their division into six items. Moreover, since 2016, we have taken charge of the“Regional Projects for Children’s Mental Health Care” (kodomo no kokoro no kea chiiki kyoten jigyou) anddeveloped activities aiming to “seamless mental health support from child to adult,” following the fundamental
plan of action set in “A vision for the future of Miyagi: Implementation plan for post-earthquake reconstruction”(Miyagi no shourai bijon: shinsai fukkou jisshikeisaku kihonhoushin).
Likewise, in Miyagi, where the disorder had been extreme at first, little by little over the course of six yearsof activities since the earthquake, we have been able to regain some stability. However, different issues present
themselves in each region each year, and we must carry out the support activities that are appropriate at eachphase.
Below we reflect on the Center’s activities each year based on aggregate results of our operations and focus
on current issues in areas struck by the disaster. Moreover, in our reflections on the trends over the past years,
we attempt to capture issues for the future and how support is carried out in the mid to long term.
2.

Achievements this year: From all figures
Table 1 shows the number of achievements at this Center in 2016. The number of times local residents were
provided support has increased each year since the Center was established, but in 2016 a downward trend
occurred for the first time (7,373 in 2016, vs. 7,680 in 2015). Based on the breakdown, the number of cases
decreased compared to previous years at the Stem Center, Ishinomaki Regional Center, and for relocated staff(for 2015, 2184 at the Stem Center, 1,742 for the Ishinomaki Regional Center, and 2,378 for relocated staff),and increased at the Kisennuma Regional Center (1,030 in 2015), which demonstrates that the methods differ
according to the circumstances in each region.
In other projects, although there was no great change in our achievements from previous years, there was alarge increase in the number of liaison and coordination meetings at the Kisennuma Regional Center. In
previous years, the Kisennuma Regional Center took on projects emphasizing support for all kinds of activities,
so this may be the effect of things like liaison and coordination that accompany an increase in close links with
relevant organizations and support from local residents.

– 17 –

Table 1: Number of activities in each location
Regional support department at each regional
centerMunicipal
Kesennuma IshinomakiStemrelocated
staff
Resident
SupportSupport for
Supporters
Raising publicawareness
Human
resource
development
Support forvariousactivities
Research
Meetings,
liaison andcoordination

3.
(1)

Planning
division

Stem C
management

Part-time orcommissioned

Supporters,
other

Total

1,235

1,341

1,727

2,233

85

71

51

9

6,752

67

188

517

615

7

123

12

20

1,549

148

60

67

26

37

37

3

1

379

10

18

19

8

18

64

11

4

152

5

0

1

1

1

0

0

0

8

0

0

4

0

3

7

0

0

14

633

179

395

556

320

57

4

0

2,144

Changes in each project
Below I reflect on the results of the six main projects for this Center.
Resident support
With the goals of preventing mental illness and improving mental health in areas struck by disaster,
we carried out support activities for local residents.
① Targets for supporta.
Changing numbers of support cases, and comparison by support opportunity and response
methodTable 2 shows the total number of cases for each support method. The largest number ofconsultations were annual visits, and these continued to tend to be high due to outreach.
Although these increased by more than 400 incidences between 2014 and 2015, in 2016 the total
number fell to 6,671 from 7,589 in 2015 (the numbers differ from those in Table 1 because
consultations by letter have been excluded).
Looking at the breakdown, the number of “Home Visits” fell greatly from 4,465 in 2015 to
3,068 in 2016. Moreover, even in the course of the first support time (Table 3), the number ofcases of support triggered by “the health survey and survey of all households” (kenkou chousa,
zenko chousa) fell greatly from 1,425 in 2015 to 926 in 2016. Thus far, follow-ups after thehealth survey of prefecture citizens have led to requests to municipal bodies, many
corresponding to specific case visits. However, since differences arise in the responses ofmunicipal bodies, this has also led to differences in the number of incidences.
On the other hand, the number of cases accompanying medical examinations increased from73 to 120 (Table 2). Among these, the increase at the Ishinomaki Regional Center and by
relocated staff was particularly striking, and the response method and means of forming
relationships varied depending on the department.
Aside from that, amid the downward trend in the number of overall responses, the proportionof requests from administrative bodies increased over previous years, from 429 in 2015 to 477 in2016 (Table 3).

– 18 –

Table 2: Aggregate total number of cases for each support method (excluding written answers; N = 6671)
Support method
Home visits
Walk-in visitors
Telephone counseling
Consultation in group activities
Case conferences
Accompanying medical
examinations
Others
Total

Number of cases
3,068
1,211
1,843
281
21
120
127
6,671

Table 3: Path at first use of the Center (multiple choice; N = 1494)
Consultation pathway
Health survey
From administrative body
From the person concerned
From family or relatives
From support center or
temporary support workers
From medical care or welfareorganization
Others (neighbors, workplace,
unknown, others)b.

Number of cases
926
477
225
96
24
38
183

Gender, age, and employment status
Comparing men and women and looking at employment status in each age bracket, thenumber of cases of support targeting older people has grown over time, but this year the numberof people in their 60s and 70s declined in the target group (Figure 1). The proportion ofunemployed people also increased in the past year, but this is also characterized by a decrease inpeople in their 30s and 40s.

– 19 –

c.

Victimization
Although the number of cases of bereavement has decreased, the percentage composition isabout the same as in the previous year (Figure 2). Regarding the specifics of bereavement,
although there was an increase in “spouse,” “sibling,” and “neighbor mentioned above,” there
was no characteristic change (Figure 3). The number of injuries to self or close relatives(Figure 4, Figure 5) and damages to the home (Figure 6) also declined between 2016 and lastyear, but there was no great change in the percentage composition.

– 20 –

d.

Living conditions
The number of cases responding to “living environment during support” continued from theprevious year; the number of cases responding to temporary housing or private housing
decreased, and the number of cases in public housing increased favorably (Table 4). Above all,the number in temporary housing fell to less than half that of the previous year, from 1,898 in2015 to 908 in 2016, but the number of cases responding to private housing was about the sameas the previous year.
There was also an increase of private housing in the proportional composition of eachregional center, and in the proportion of family structures that had unmarried people, and asimilar downward trend in private housing and temporary housing, but aside from these there
was no great difference in composition (Figure 8, Figure 9).
Table 4: Current living environment (aggregate totals; N = 6671)
Living environment
Own home
Container-type temporary
housing
Apartment-type temporary
housing
Public housing
Others / unknowne.

Number of
cases
3,054
908
626
1,858
225

Background of consultations
Although in 2014 the most common factor behind the consultations was “psychologicalchanges,” in 2015 a higher proportion cited “health problems.” However, in 2016 the orderreversed again, with “psychological changes” once again being the reason most commonly given(Figure 10).

– 21 –

“Psychological changes” and “health problems” have been consistently high in recent years,
but over time the proportion of respondents citing “problems with family or home” has increased(fifth place in 2014 with 17.2%, third place in 2015 with 24.1%, and third place in 2016 with27.0%).
In addition to this, there was also an increase in the proportion of responses citing“unemployment or work” (8.8%, up from 5.3% in 2014 and 6.9% in 2015) and “education,
childcare, or changing schools” (4.6%, up from 2.8% in 2014 and 3.6% in 2015). Over the years
there has been a reduction in the number of responses citing “changes to living environment”(13.5%, down from 20.7% in 2014 and 18.9% in 2015), which may be linked to the steadyprogress in home construction.

f.

Psychological changes
Reflecting on the items citing psychological changes in the last three years (Figure 11), there
have been no significant changes in 2016 other than anxiety disorder changing places withsomatic symptoms.

– 22 –

g.

Presence or absence of a history of receiving psychiatric care related to disease name, time of
onset, and medical history
The number of reported cases receiving care and cases with current illnesses fell from 7,589
in 2015 to 6,671 in 2016. In 2015 35.8% “received care” (2,716 in total), and while this was
about the same as it had been in 2014, in 2016 it increased to 44.1% (2,948 total) (Table 5).
The number of cases having “received care” increased each year, from 2,653 in 2014 to
2,716 in 2015 and 2,948 in 2016. Looking at these by classification, aside from an increase under“F3: mood (affective) disorders” for both “onset before the disaster” and “onset after the disaster,”
it is also noticeable that “onset after the disaster” was at work in “F4: neurotic, stress-related, andsomatoform disorders,” and “onset before the disaster” in “F7: mental retardation” (Figure 12).

Table 5: Medical history and current medical condition (aggregated totals; N = 6671)
History of psychiatric care
(Treatment ongoing)(Treatment ended)
Received (Treatment stopped)
care(Untreated)(Treatment condition
unknown)
Had not received care
Not known– 23 –

Number of
cases
2114
210
575
4
45
2795
928

② Topics of supporta.
Number of cases of each support method for each relevant department
Classifying by regional support department, with the exception of increases in the number ofcases at the Kesennuma Regional Center, the number of cases decreased across the board, andthe decrease in each department’s “number of cases of consultation due to visits” wasparticularly clear. Also notable was the high number of cases of “telephone consultation” byrelocated staff, and the fact that the proportion of consultations by people visiting the officeincreased (Figure 13).

b.

Classification of people receiving consultations
83.8% of all cases of consultation were for the persons themselves, and in a typical year thisis followed by the next highest proportion of “family or a relative” at 10.4%. In 2016 the numberof cases for “another supporter” increased somewhat, but other than that there was no majorchange (Figure 14).

– 24 –

c.

Collocated organizations
The proportion of “people from support centers or temporary support workers” was 27.3% in2014 and 26.4% in 2015, but in 2016 this decreased drastically to 6.4% (Figure 15). In particular,
although the proportion had remained relatively high for the main support department, thisdecreased drastically in 2016.
Regarding this, in 2014 the proportion of collocated municipal staff was 45.6%, and this has
been increasing year by year to 52.8% in 2015 and 65.87% in 2016, and a large gap has emerged
between medical institutions and health care centers or social welfare (Figure 16). According to
the local government, there has been a reduction in the activities of support centers andtemporary support workers who had been active after the disaster, and tendencies have emergedin response to problems with the original structure of local government, and these kinds ofchanges may have had an effect on the data.
Aside from this, it was also notable that the proportion relating to welfare was high forrelocated staff, and the proportion collocated with a health care center differed depending on theCenter.

– 25 –

③ Condition at the end of support
Although there was a gap between the number of cases in 2015 at 7,589 and the number of casesin 2016 at 6,671, no changes worthy of specific mention can be seen (Table 6). Although the highproportion of those whose condition improved, the high proportion of local government referringother organizations, and the proportion composition were similar to previous years, the proportionof referrals by medical institutions has increased every year, from 13.2% in 2014, 19.7% in 2015,
and 27% in 2016 (Figure 17).
Table 6: Outcomes (N = 6671)
Condition being responded toRegular interviews
Continuing (aggregate)
Consulting when needed
Other
Condition improved
Referral to another
Ended (real number)organization
Refusal of support
Other– 26 –

Number of cases
3,014
2,239
1
1,259
111
43
4

④ Conclusion
Regarding resident support outside of the data above, as well as having implemented achildren’s camp project in Matsushima-cho, we also established various kinds of projects to suitthe particulars of each region, such as “Koko Farm” (Ishinomaki Regional Center), a place forinteractions through activities such as growing vegetables in a field; “Utsukushima Salon” (StemCenter Regional Support Department), for people who had moved from Fukushima; and “Salon
for Mental and Physical Health,” a place for interaction and activities that are good for health,such as balanced food.
The total number of cases of resident support decreased within the year, and at first glance it
may seem that the volume of projects was lower. However, the activity time for each project wascomparable to previous years, and we also suspect that it was necessary to relate carefully topeople whose issues are more difficult to resolve, rather than decreasing activity time along withthe reduction in the number of cases.
Six years after becoming victims of a disaster, people are moving to public housing and making
progress reorganizing their communities, and a shift is proceeding toward a reduction in activities
by support workers and the pre-existing municipality responding to the disaster. Amid this, areas
struck by disaster must not be left behind, and their needs must be responded to sensitively.
From now on, resident support must be positioned within our core activities.
(2)

Support for supporters
With the aim of supporting supporters in areas struck by the disaster, we held workshops andconsultations and deployed professionals to municipalities.
① Topics of support
The total number of supporters who we supported was 1,549 in 2016, having fallen year by year
from 1,915 in 2014 and 1,606 in 2015 (Table 7), but there were slight increases in “reports after visits
or interviews,” “guidance and advice from professional positions,” “case conferences,” and “setting
up mental health consulting services.”
In “guidance and advice from professional positions” (Table 8) in particular, aside from the factthat proportion of cases responding to alcohol problems remained high at 90 total cases (120 in 2014
and 107 in 2015), in 2016 the number of cases responding to abuse increased greatly to 119, from 36
in 2014 and 56 in 2015. There has been an upward trend since we took charge of children’s mental
health care, so continuous attention may be necessary.

– 27 –

Table 7: Status of implementation of support for supporters (aggregate totals; N = 1549)
Topic of support
Report after home visit orinterview
Professional guidance andsuggestions
Problem area
Workplace mental health care
Case conferences
Establishing mental healthconsulting service
Support with health checkups
Support with clerical work
Others
Total

Numberof cases

Numberoftargets

246

458

411

1,530

18
17
272

81
62
1,265

61

88

27
457
40
1,549

93
966
225
4,768

Table 8: Details of professional guidance and advice (aggregate totals, multiple choice; N = 411)
Details of professional guidance and advice
Alcohol problems
Gambling problems
Drug problems
Depression
Complex grief
PTSD
Abuse
OthersNumberof cases
90
1
0
36
4
13
119
255

Classifying support for supporters by state of achievement, although no great increase or decrease
could be observed in the total number, the number of cases at the Kesennuma Regional Center and theStem Center Department for Regional Support decreased, and the number of cases with relocated staff
and the Ishinomaki Center increased remarkably (Figure 18).

– 28 –

Classifying these shows that the proportion at the Stem Center Support Department that werecollocated for case conferences was higher than at the Kesennuma Regional Center and the Ishinomaki
Regional Center. The proportion of collocated case conferences for relocated staff temporarily fell agreat deal in 2015, but in 2016 the number of such cases was similar to that in 2014. It is also striking
that there was a lot of clerical work support for the Stem Support Department and for relocated staff.
The local situation and municipal objectives may have had a strong influence on the number of cases.
“Advice and guidance from a professional position,” aside from a high proportion of cases responding
to alcohol problems, specifically had a high rate of cases responding to abuse problems in 2016 inmanagement at the Stem Center (Figure 19).

② Targets for support
As with other years, the proportion of people involved with municipalities stood out from the rest,and support may have continued to gather pace with municipalities. However, “temporary support
workers,” who had constantly constituted a large group, decreased greatly in the last year. The numberof responses citing “support centers” also decreased compared to previous years, and this may be due
to a reduction in duties connected to the earthquake and progress transitioning back to preexisting
municipal functions (Figure 20).

– 29 –

Due to requests from municipal bodies, in 2016 eight relocated staff were deployed to sevenmunicipal bodies. Regarding their occupation, many were psychiatric social workers, while there wasalso one occupational therapist and one clinical psychotherapist (Figure 21).
Although so far there have been cases of one municipal body having more than one relocatedstaff member deployed to them, in many of them these had the same occupation. However, in 2016, wedeployed relocated staff of different occupations to one municipal authority (three days a week and twodays a week), and both relocated staff responded jointly to problems according to their own
occupations.

– 30 –

③ Conclusion
In 2015 we were concerned that due to a large reduction in external supporters, the burden on
remaining supporters would increase. In 2016, the numerical value of our support for supporters may
seem to have decreased in terms of the people from earthquake-related occupations such as temporary
support workers. Although one could say that the reduction in people in earthquake-related occupations
is a marker of progress toward reconstruction, on the other hand it may also be linked to a cost increase
for the municipal staff responsible. We must bear in mind the changes in each region when thinking
about how to support supporters in future.
Supporters’ concerns about alcohol problems remain high. Moreover, initiatives aiming to startalcohol abstinence meetings and study groups are ongoing in every area. From now on, one of our aims
will be to cooperate with relevant organizations and bodies, including this Center, in order to train
supporters who will engage in core activities that are rooted in each region and maintain systems thatcan continue to support relevant people in the region.
In 2016, institutional reorganizations were carried out by municipal bodies, and this also changed
the affiliation of relocated staff from our Centers. The many major changes to the numerical value of
relocated staff in support for supporters may be an effect of this.
(3)

Raising public awareness① Status of implementation of raising public awarenessWe aim to disseminate information in many ways, such as by distributing public awarenessmaterials and corresponding with news media and by carrying out public awareness training and salon
activities for the region, and to deepen understanding of post-disaster mental health (Table 9, Table 10).
In 2015 we increased our number of acceptance inspections from nine to fifteen. This may be affectedby the fact that in the previous year we have had observation reports on the April 2014 sinking of MV
Sewol in South Korea and the April 2016 Kumamoto Earthquake.
In 2016, we reprinted our Center pamphlets, as well as the two PR brochures that we published in
March and October that presented the initiatives of the Centers and the conditions in each area.

– 31 –

Table 9: Status of PR brochure publication
Issue no.
15
16

Publication month
October
March

Number of copies
2,400
2,400

Table 10: Status of pamphlet creation
Distribution region

Title / contents

Original / reprint

Number ofcopiesAll regions in theprefecture

Miyagi Disaster Mental
Health Center pamphlet

Reprint

3500② Public awareness training
We maintained about the same number of “Addiction (alcohol problems etc.)” events as thepreceding year, and the need for this seems to remain high. Moreover, as well as seeing an upward
trend in the number of “Stress and mental health self-care” events from 21 in 2014 to 41 in 2015 and
75 in 2016, there was a similar increase for “Workplace mental health” (Table 10). This achievement
may be linked to our tackling workplace mental health in the previous year jointly with the Kyokai
Kenpo (Japan Health Insurance Association).
The salon activities targeted at local residents also showed an upward trend year by year, from 67
in 2014 to 97 in 2015 and 127 in 2016. From this year onwards the Center has also planned to take oversome of the salon activities carried out by other organizations. These circumstances may have led toStem Support Department’s “reducing collaboration with other organizations’ salons” and increasing
the “organization and co-organization of salons” (Table 11).
Table 11: Salon activities (N = 153)
Regional support department at each center
Kesennuma Ishinomaki Stem RelocatedOrganized /co-organized salonsCollaboration withother organizations’salons

(4)

Other

Total

38

40

43

3

3

127

5

0

4

11

6

26

The contents of public awareness projects have changed greatly compared to when the Centerswere first established. Although there has been a reduction in the number of new pamphlets and thelike, the number of salon activities held in each region has increased. As well as the Kesennuma Center
carrying out “mental health social” (Koko café) using kamishibai and musical performances as inprevious years, the Ishinomaki Regional Center also plans to announce other performances. In the
Kesennuma Center Regional Support Department there have also been initiatives tackling the actual
circumstances of the region, such as establishing consulting services at places where residents receive
medical examination, and materials such as the pamphlets previously produced are used within theseplans. The increase in the number of various salons in 2016 occurred in the context of supporters’
major problems with how to prevent isolation as residents relocate to public housing from temporary
housing and build new communities, and they may have been a useful way of responding to this issue.
Human resource development
Targeting supporters in areas struck by the disaster, we held all kinds of workshops aiming to raiseawareness, and activities such as socials aiming to build networks (Table 12).
Although there has so far been an increase in the number of events for “addiction-related problems”
and “support skills training,” this year this shifted to a decrease. However, there was a two-foldincrease in “workplace mental health training” and “suicide prevention issues training.”“Earthquake Disaster Mental Health Care Social Miyagi” was carried out at the Kesennuma
Regional Center, the Ishinomaki Regional Center, and the Stem Center, and different initiatives werecarried out at each Center. At the Ishinomaki Center, this took the form of an executive committee,– 32 –

taking the opportunity to link to a number of organizations through their own planning processes.
Various organizations in the region spend time on planning, and they hold discussions with them manytimes before the appointed date.
The three prefectural disaster mental health care center meetings that have been carried out so far
have not been run as human resource development, so that we can plan an academic conference thisyear. However, cooperation between all of the disaster mental health care centers is important forhuman resource development and should continue. In 2016 the Kumamoto Earthquake led to thecreation of disaster mental health care centers in Kumamoto Prefecture. Just as our Centers benefitted
from a great deal of information and know-how from the disaster mental health care centers in Hyogo
and Niigata Prefectures, we hope to create beneficial links with them and share as much of our own
experiences as we can.
Table 12: Status of implementation of human resource development (N = 159)
Contents
Earthquake social
Media conference
Addiction-related problems(alcohol)(other addictions)Support skills training(close listening)(stress and mental health care, self-care)(other)Supporter mental health training
Workplace mental health training
Children’s mental health training
Elderly mental health training
Suicide prevention issues training
Mental disorder and disability training
Circumstances in areas struck by disaster and Center
activities
Case discussion
Other
Total
(5)

Numberof times
3
0
20
(20)
(0)
45
(5)
(7)
(33)
3
18
20
2
18
7

Number ofparticipants157
0370(370)
(0)
1,641
(136)
(194)
(1,311)
56
360
1,194
157
42
551

8

553

7
1
152

197
28
5,286

Other
① ResearchSix years have passed since the earthquake, and we are entering a phase in which we will have to
wrap up the Center’s activities so far, so regarding our research projects, as well as once againorganizing research groups, we have started to prepare and manage a research ethics committee andstrengthen our systems going forward.
Aside from organizing the Japanese Council of Social Welfare health survey projects that wehave carried out over the years in collaboration with the Tohoku University Graduate School of
Medicine Department of Preventive Psychiatry, we are moving forward on multiple fronts withresearch based on support activities such as resident support, cooperation between supporters, andsalon activities. Moreover, we are carrying out “longitudinal support research with children born after
the Great East Japan Earthquake and their families” as a collaborative research project with the Iwate
Prefecture Children’s Center. In 2016 we published our sixth research report and our third symposium(referenced elsewhere).
② Support for various activities
We aim to strengthen cooperation while supporting initiatives for support activities in the region,and cooperate in building the region in the future. In 2016 we jointly hosted three and supported two– 33 –

general plans.

4.

Regional projects for children’s mental health care
At Miyagi Disaster Mental Health Care Center, since April 2016 we have taken charge of the Miyagi
Prefecture-commissioned project “Regional Projects for Children’s Mental Health Care” (kodomo no kokoro no
kea chiiki kyoten jigyou).
Following the Great East Japan Earthquake, children’s mental health care was handled immediately
afterwards at the Department for Health and Welfare, focusing on the General Children’s Center and theChildren’s Welfare Center. Furthermore, at the request of the Ministry of Health, Labour and Welfare, in
October 2011 the “Great East Japan Earthquake Central Children’s Support Center” (Higashi Nihon Daishinsai
Chuuou Kodomo Shien Sentaa) was established at the Social Welfare Service Corporation, Imperial Gift
Foundation Boshi-Aiiku-Kai’s Japan Child and Family Research Institute, and in February 2012 the “Miyagi
Prefecture Office of the Great East Japan Earthquake Central Children’s Support Center.” This was closed in
March 2014, and from April 2014 it was renamed the “Great East Japan Earthquake Miyagi Children’s Support
Center” (hereinafter, the “Children’s Support Center”) and the office moved to the Miyagi Prefecture Medical
Center, where it came to carry out children’s mental health care work. At the same time, within the GeneralChildren’s Center, the “mental health care steering group” was established, and it came to execute mental healthcare functions for children in cooperation with the Children’s Support Center.
In Miyagi prefecture, a basic policy of the reconstruction plan regarding mental health care after theearthquake is to have “seamless mental health support from child to adult” (kodomo kara otona made kiremi nonai shien), and since April 2016, Miyagi Disaster Mental Health Center has been commissioned for “children’s
mental health care tasks.” The Children’s Support Center closed in March 2016, and the Mental Health Care
Steering Group that had been established at the General Children’s Center also closed in March 2017. This
Center has come to shoulder the burden of “child to adult” projects specializing in mental health care after theearthquake.
Below, we represent consultations, etc., with under-20s in the “Regional Projects for Children’s Mental
Health Care” which we took charge of from Miyagi Prefecture in 2016, with statistical materials from thisCenter based on documents such as specifications.
(1)Contents and results of the commissioned projects① Consultation projects
Through home visits, walk-in visits, and telephone counseling, etc., we respond
psychologically and psychiatrically to children, guardians, supporters, etc.
The number of consultations has been an aggregate total of 230, with 89 individuals. The
number of consultations for each age separated by the person seeking consultation is shown in
Table 13, and the number of consultations for each age separated by address is shown in Table 14.
As a general rule, this Center has come to carry out consultations through the cities or towns
with educational institutions such as kindergartens and children who have been victims of thedisaster. Looking at the topics of these consultations, when consulting children under the age of 6,
many have delayed development or behavioral problems, such as not taking to group activities innursey or kindergarten, and their mothers are anxious about child-rearing. These mainly respond tothe mothers’ requests for consultation through a referral from a city or town public health nurse or anursery school teacher. When consulting with 7–15-year-olds, there are many consultations aboutchildren’s truancy, in the context of developmental problems or problems at home. Moreover, when
consulting with 16–19-year-olds, again there are many consultations about truancy against the
backdrop of problems at home, and long-term consultations with the person concerned.

– 34 –

Table 13: Number of consultations by age and person seeking consultation
Aggregate
Personnumber ofconcerned
peopleFamily(separated by
Otherclient)Total
Real number of people

Under 6

7–15

16–19

Total

2

58

92

152

27
1
30
23

33
0
91
38

16
1
109
28

76
2
230
89

Table 14: Number of consultations for each age, classified by address

Client location

Location
Sendai
Shiogama
Natori
TagajoStem Center
IwanumaWatari
Yamamoto
Matsushima
Other
Ishinomaki
Ishinomaki
Regional
HigashiCenterMatsushima
Kesennuma
Kesennuma
Regional
Tome
CenterMinamisanriku
Anonymous
Total

Under 6
0
0
3
1
0
4
4
0
1
4

7–15
2
2
9
0
0
1
0
1
0
46

16–19
1
1
8
0
4
0
3
1
0
2

Total
3
3
20
1
4
5
7
2
1
52

5

14

1

20

1
0
0
7
30

13
2
0
1
91

52
32
3
1
109

66
34
3
9
230

② Professional deployment projects
We deployed professionals such as child psychiatrists and clinical psychologists to locations
such as municipal health centers, nursery schools, kindergartens, and elementary schools, andcarried out consultations with staff. In 2016, there were deployments to 236 organizations. The
number of deployments for each destination organization and type of occupation is shown in Table
15, and the number of deployments for each destination organization and location is shown in Table
16.
When broken down by organization, municipalities had the most consultations. The topics
were advice on difficult cases regarding health preservation in infant medical examination andadvice on difficult cases regarding the regional council child protection measures. Requests fromnursery schools and kindergartens were often regarding children who had developmental disorders
or suspected abuse, and consultations concerned how to respond to difficult parents.

– 35 –

Table 15: Number of deployments for each destination organization and type of occupation
PrefectureNursery,
Elementary
Municipality
relatedkindergarten
school
Psychiatrist
Clinical psychologist
Mental health andwelfarePublic health nurse
Other
Total

Juniorhigh Other Total
school
3
3
54
0
26
72

2
1

7
39

22
6

17
0

3

23

0

3

2

1

32

5
0
11

61
1
131

0
4
32

0
0
20

0
0
5

4
1
35

70
6
234

Other

Total

25
0
0
0
1
0
6

32
45
2
20
13
20
54

Table 16: Number of deployments for each destination organization and location

SendaiNatori
TagajoStemCenter
IwanumaWatari
Yamamoto
Ishinomaki
Ishinomaki
HigashiRegional
Matsushima
CenterOnagawa
Kesennuma
Kesennuma
Regional
Tome
CenterMinamisanriku
Total

Prefecturerelated

Municipality

Nursery,kindergarten

Elementary
school

1
0
0
0
0
0
9

1
38
2
19
8
19
37

0
5
0
1
4
1
0

3
1
0
0
0
0
2

Juniorhighschool
2
1
0
0
0
0
0

0

6

21

5

0

0

32

0
1
0
0
11

1
0
0
0
131

0
0
0
0
32

0
7
1
1
20

0
2
0
0
5

0
2
1
0
35

1
12
2
1
234

③ Research projects
Staff were deployed to carry out training in municipalities, nursery schools, etc. 43 workshops
were carried out in 2016. The status of implementation of workshops by lecturer occupation andmunicipality is shown in Table 17, and the list of project implementation plans is shown in Table 18.
The venue region was most often Sendai-shi, followed in order by Natori-shi, Ishinomaki-shi,
Higashimatsushima-shi, and Kesennuma-shi.
The topics of training are shown in Table 18, but two large workshops were: “Get close tochildren’s heart: How to bring out children’s power,” held in Ishinomaki-shi (140 participants), and“Children’s responses to abuse,” held in Osaki-shi (180 participants). The former was organized bythis Center, and for the latter we deployed a lecturer. Moreover, “Training in Psychiatric First Aid(PFA) for children” (hereinafter, PFA training), which presented basic methods of psychologicalcare after a disaster, was held five times. “Children’s PFA training” has standardized the important
points concerning children who have experienced major disasters or accidents, and this Center willcontinue to proactively hold “Children’s PFA training” and attempt to popularize it in theprefecture’s educational institutions.

– 36 –

Table 17: Number of workshops by lecturer occupation and municipality
ClinicalMental health andPsychiatrist
Other
psychologist
welfare worker
Sendai7700Natori3
403
Tagajou
0
2
0
0
Stem
Iwanuma
1000CenterKurihara
1
0
0
0
Osaki
0
1
0
0
Watari1000Ishinomaki
0401Ishinomaki
Regional
Higashi
4000CenterMatsushima
Kesennuma Kesennuma
20
10Regional
Tome
1
0
0
0
Center
Total
20
18
1
4

Total
14
10
2
1
1
1
1
5
4
3
1
43

Table 18: List of research projects implemented
No.

Date

Location

Topic1

May 14, 2016

Sendai“Understanding delinquent
children and parent
response”

2

May 27, 2016

Sendai“Children who need social
care”

3

June 8, 2016

NatoriTraining in PFA for children

4June 24, 2016

Natori“How children’s minds
react after a disaster”

5

June 28, 2016

Kesennuma

6

August 1, 2016

Iwanuma

7

August 2, 2016

Iwanuma8

August 4, 2016

Kesennuma

9

August 5, 2016

Kesennuma

10

August 10,
2016

Tome

11

August 17,
2016

HigashiMatsushima

12

September 2,
2016

Iwanuma13

September 17,
2016

Sendai

Course in developing
mental health for highschool students“Workplace mental health,basics of responding tochildren”
Child-rearing assistancehome visitor training course“Long-term psychologicalsupport for children andstudents after a disaster”“State of support for
specific cases”“Start by understanding
adolescent mental health”“Points for relating totroubled parents: A childabuse prevention
perspective”“Understanding andresponding to difficult
parents”“Overcoming difficulty
making a living”– 37 –

Main
participants
Parents ofdelinquent
childrenNongovernmentorganization
Peopleinvolved inresearch andeducation
Peopleinvolved in
education

No. ofparticipants

Lecturer
profession

20

Clinical
psychologist

2

Clinical
psychologist

130

Psychiatrist

30

Psychiatrist

High school
students

100

Mental healthand welfare
workerNongovernmentorganization

2

Clinical
psychologist

Child welfare

8

Clinical
psychologist

35

Psychiatrist

20

Psychiatrist

General15

Psychiatrist

Peopleinvolved in
education

50

Psychiatrist

35

Psychiatrist

40

Clinical
psychologist

Peopleinvolved in
education
Peopleinvolved in
education

Peopleinvolved in
education
Parents withdelinquentchildren
14

September 26,
2016

Sendai“About mental health forchildren and social nursing
care”

15

September 29,
2016

Natori“About attachment”

Child welfare

20

Clinical
psychologist

16

October 14,
2016

Ishinomaki

Peopleinvolved in
education

140

Clinical
psychologist

17

October 14,
2016

Watari“Get close to children’s
heart: How to bring out
children’s power”“Nursery school staff
mental health care”

Child welfare

20

Psychiatrist

18

October 29,
2016

Sendai“About children’s
disabilities”

100

Psychiatrist

19

November 1,
2016

Ishinomaki“Important things forsupporters when children
need support”

15

Development
psychologist

20

November 2,
2016

SendaiTraining in PFA for children

13

Psychiatrist

21

November 9,
2016

Kurihara“How to raise a childpeacefully: Effects of childabuse on childrearing”

Peopleinvolved injustice
Peopleinvolved in
education
Nongovernmentorganization
Peopleinvolved in
education

22

November 11,
2016

Natori“Troubling children”

Child welfare

15

23

November 13,
2016

Sendai

Peopleinvolved in
education

30

Psychiatrist

24

November 13,
2016

Sendai“Children’s reactions attimes of emergency andhow to support them”“Supporting parents toraise children with
empathy”
Training guardians in PFA
for children

General30

Clinical
psychologist

Child welfare

10

Psychiatrist

25
26
27

November 17,
2016
November 17,
2016
November 21,
2016

SendaiJunior college
students

110

Clinical
psychologist

15

Clinicaldevelopmental
psychologist
Clinicaldevelopmental
psychologist

Osaki“Dealing with child abuse”

Child welfare

180

Clinical
psychologist

Ishinomaki“Childrearing in puberty”

Guardians oforphanedchildren1

Clinical
psychologist

Peopleinvolved withauthorities

45

Psychiatrist

28

November 24,
2016

HigashiMatsushima

Matsushima-shi Child
Protection Measures
Regional Conference
Workshop: “How to
consider cases 1”

29

December 15,
2016

NatoriCase conference, “Points on
case conferences”

Peopleinvolved withauthorities

16

Clinical
psychologist

30

December 20,
2016

SendaiTraining in PFA for children

General80

Psychiatrist

31

December 20,
2016

NatoriChild welfare

7

Clinicaldevelopmental
psychology

32

December 26,
2016

HigashiMatsushima

Peopleinvolved in
education

40

Psychiatrist

33

January 6,
2017

NatoriChild welfare

20

Clinical
psychologist

34

January 10,
2017

SendaiChild welfare

40

Psychiatrist“Development disorders
and attachment,
responding to guardians”
Matsushima-shi Child
Protection Measures
Regional Conference
Workshop: “How to
consider cases 2”“About mental health care:
Take care of emotions andself-esteem”“Problems with
developmental disorders– 38 –

and abuse”
35

January 16,
2017

Natori“Diagnosis and response
regarding mothers” (Part 1)

Peopleinvolved withauthorities

11

Clinical
psychologist

Peopleinvolved withauthorities

13

Psychiatrist

36

January 19,
2017

HigashiMatsushima

Matsushima-shi Child
Protection Measures
Regional Conference
Workshop: “How to
consider cases 3”

37

January 21,
2017

Ishinomaki“Childrearing in puberty”

38

February 9,
2017

Tagajou

Tagajo case conference,“how to examine cases,
how to cooperate”

39

February 27,
2017

Ishinomaki“Attachment disorder”

40

March 10,2017

Natori“How to raise children who
are active in thecommunity”

41

March 13,2017

Natori“Children’s condition andfamily support”

42

March 23,2017

SendaiTraining in PFA for children

43

March 23,2017

Tagajou“Supporting families withcomplex problems”

Guardians oforphanedchildrenPeopleinvolved withauthorities
Peopleinvolved witheducation

8

Clinical
psychologist

15

Clinical
psychologist

25

Clinical
psychologist

General10

Psychiatrist

9

Clinicaldevelopmental
psychologist

30

Psychiatrist

25

Clinical
psychologist

Peopleinvolved withauthorities
Fire
department
Peopleinvolved withauthorities④ Public information projects
a. We distributed pamphlets about children’s mental health care after earthquakes,
such as “Understanding and responding to children’s mental health,” “Children’s mental healthcare (for parents/guardians),” and “Children’s mental health care (for educators),” and began tospread information and raise public awareness about children’s mental health.
b. We worked to publicize mental health consultations and accepted consultations for children
in the correspondence consultation corner.
c. We came to implement regional projects for children’s mental health careat this Center from April 1, 2016, taking over children’s mental care from the Great East Japan
Earthquake Central Children’s Support Center that had been carrying it out until March 2016,
so we have worked to publicize this by attending meetings in the prefecture, sending
information to the municipalities, nursery schools, etc., and making sure that we are wellknown.
d. We implemented four projects for children’s mental health outreach.
A list of our activities is shown in Table 19.
Table 19: Summary of children's mental health outreach activities
No.
1

Date
May 28, 2016

Location
Natori2

June 17, 2016

Kesennuma

3

July 25, 2016

Natori4

December 10,
2016

Natori

Topic
Salon project for Natori children who were victims ofdisaster, “Natori Genkikko”
Collaboration with Kesennuma nursery school event“Creating parent-child candle holders”
Salon project for Natorii children who were victims ofdisaster, “Natori Genkikko”
Salon project for Natori children who were victims ofdisaster, “Natori Genkikko”– 39 –

Number of people
10
41
55
70

⑤ Surveys and researcha. Longitudinal support research for children born after the Great East Japan Earthquake andtheir parents“2016 children’s mental health regional project survey and research report: Longitudinal support
research for children born after the Great East Japan: Report on baseline results in Higashi
Matsushima, Miyagi-ken”
b. Children’s daycamp project“2016 children’s mental health regional project survey and research report: Research at a camp
project for children and parents in areas struck by disaster”
5.

Conclusion
Six years have already passed since the earthquake, and changes are progressing, such as the change from
temporary housing to public housing. We must respond to those residents who have still not yet settled into
their change of residence, as they face many problems. However, we often hear that by moving to public
housing, their connections in their temporary housing are cut off and they don’t fit in with the community inpublic housing. As the work of rebuilding communities continues, this is a time when there may be a new riskof becoming isolated.
However, the withdrawal of outside supporters of years past is continuing, and this year there has been adownward trend in temporary supporters, so there are concerns that administrative officer costs will also
increase due to the response to local residents. In local resident support “pathways during initial support at theCenter” (Table 3), although there has been a reduction in referrals from health surveys, door-to-door visits, andsupport centers or temporary support workers, this may be an effect of this kind of situation, in the context ofwhich referrals from administrative organizations have actually increased.
Moreover, salon activities have been proactively carried out in all regions (Table 11). Althoughcollaboration with other organizations on these salons has reduced, the number of salons organized or coorganized by the Center has increased over previous years. Aside from salons, we have developed various
interaction projects, and the need for opportunities for people who tend to be isolated to form connections andopportunities to build new communities is even greater now.
Moreover, in addition to traditional subsidized projects, from this year onwards we began regional projects
for children’s mental health care, and the Center took responsibility for the prefecture’s basic policy forreconstruction plans, “seamless mental health support from child to adult.”
Our breakdown of the aggregate total of 230 cases of consultation demonstrates how common truancy
problems are in the context of developmental problems and family problems. Training and consultation also
bring together a variety of needs, such as responding to developmental disorders and abuse problems, andrelating to difficult parents. Aside from having pointed out that the rate of truancy was high in Miyagi
Prefecture before, this may be additionally affected by environmental change due to the earthquake. We believe
it will be important to respond to these continuing problems in the next year.
Moreover, the “Training in PFA for children,” a method of psychological support after a great disaster, washeld five times in 2016, and many relevant people participated, asking questions that really concerned them. We
hope to proactively hold these in future as well, and widen the group of relevant organizations and bodies.
With the passage of months and years, the problems of each region and the problems faced by residents havechanged from moment to moment, but problems identified at the start, such as alcohol-related problems, havecontinued. We would like to carefully and humbly respond to the continuing needs of the region, where thedifferences in conditions are striking.

– 40 –