Community Support Department / Planning and Research Department Activity Report

2. Departmental Initiatives

Community Support Department / Planning and Research Department
Kesennuma Regional Center - Community Support Division
Ishinomaki Regional Center - Community Support Division
Stem Center - Community Support Division
Stem Center - Planning and Research Division

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FY2019 Bulletin Vol. 842

Community Support Department / Planning and Research Department Activity Report

Community Support Department / Planningand Research Department Activity Report
Miyagi Disaster Mental Health Care Center
Community Support Department / Planning and Research Department
Community Support Department Manager, Public health nurse Sakiko OkamotoPlanning and Research Department Manager, Psychiatric social worker Yuichi Watanabe
1. Introduction
FY2019 is the second year of the development period of the Miyagi Future Vision/Earthquake Disaster
Reconstruction/Regional Revitalization Implementation Plan, and activities have been conducted based on
the basic policy of the “enhancement of continuous mental health care, from children to adults” as well as
the Center’s operational plans. In August 2019, the prefecture issued a document titled “Regarding thefuture of mental care and the Miyagi Disaster Mental Health Care Center from FY2021 onward.” This
stated that the Center’s activities will continue until FY2025, with work focused on resident support, supporter support, and raising public awareness; human resource development and research will be managed
by the Mental Health and Welfare Center from FY2021 onward. Furthermore, “study groups for the futureof mental health care” were hosted at each health center, and the current status and issues pertaining to thearea’s life stages as well as the direction of community psychiatric social welfare activities after FY2021
were investigated together with the municipalities and the Psychiatric Social Welfare Center. Based onthese investigations, each community support division has been engaged in providing resident and supporter
support and raising public awareness, as well as developing human resources in close cooperation withmunicipalities, health centers, and related organizations in anticipation of community psychiatric social
welfare activities after the completion of the Center’s work. Details on each division’s activities are published separately as activity reports, so here we will explain divisional characteristic activities and reporton them, along with a discussion.
2. Characteristics of the activity status of the Planning and Research Division and each community
support division in FY2019(1) Kesennuma Regional Center Community Support Division (henceforth, “Kesennuma”)
. Resident support
There were approximately 280 consultation cases on average per month (total number of cases)
and about 10 new cases per month, many of which required continuous support. Counselees ranged
widely from children to the elderly. Cases that necessitated watching over the patient involved
moving the patient and considering the continuation of support after the conclusion of the Center’soperations, such as transitioning support to other institutions in the region. Furthermore, cases requiring specialized support were advanced, while confirming the direction of support and sharing
information with other institutions.
. Supporter support
The number of health consultations with local government employees has been increasing every
year, cooperation with the human resources side has become closer, and the need for mental healthcare and line care is becoming more widespread. Furthermore, we had opportunities to deepen theunderstanding of assistive technology for health and welfare staff as well as self-care for supporters
through training and conferences.
. Raising public awarenessWe provided information about communication skills and mental illness through radio programs
and newspapers in order to maintain and improve local residents’ physical and mental health. Furthermore, we cooperated with related organizations in the Kesennuma Mental Health, Medical andWelfare Liaison Conference Meeting Working Group to educate high school students about counseling organizations and how to use them through skits.
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FY2019 Bulletin Vol. 8
. Investigation status of the future of mental health care
The objective of community psychiatric social welfare activities for the entire Kesennuma
area until FY2025 has been set as “improving community support,” and a major direction has
been decided, premised upon the following three pillars: “support and skill set improvement formunicipal public health nurses and staff,” “development of regional professionals,” and “improvement of residents’ self-care abilities.” Details and specifics for the future will be discussedwith municipalities, related organizations, health centers, and others.
(2) Ishinomaki Regional Center Community Support Division (henceforth, “Ishinomaki”)
. Resident support
We conducted home visits, such as health surveys of disaster public housing residents, at therequest of the city as well as consultations/home visits on referrals from other institutions. The
activities of Koko Farm, which was implemented as a salon activity, have been carried out, withplanned completion in FY2020 due to the aging of the participants.
. Supporter support/Human resource development
We conducted joint home visits with municipal public health nurses, participated in casemeetings and area meetings, and provided support for Ishinomaki infant health examinations
and municipal housing complex health counseling.
Human resource development was done in collaboration with municipalities and health centers, with consideration of community psychiatric social welfare activities in the future. We held
two workshops on alcohol-related problems in collaboration with municipalities, as well asworkshops on the theme of “cooperation with the community” and which were co-sponsored byhealth centers. We also co-sponsored two suicide countermeasure workshops, also in collaboration with health centers, in order to deepen the understanding of suicide problems and the futureof support in affected areas. In addition, we co-sponsored two mental health care workshops,
jointly with municipal and educational committees, targeting individuals supporting children in
the area and in the prefecture.
. Raising public awarenessWe provided support in the form of Danshukai meetings, which were sponsored by Danshukai
and backed by the Center; these were made possible with the cooperation of Ishinomaki city,and the activities prioritized eventual independence.
. Investigation status of the future of mental health care
The following items were agreed upon with the municipalities, health centers, and mental
health care centers:a. The project team will create a face sheet to continue to support cases.
b. Municipalities, health centers, and the mental health care centers will cooperate to execute joint
home visits and case reviews, and implement them in order to ensure human resource development among young staff.
c. Municipalities and public health centers will appeal on various occasions during manpower
shortages.
d. Requests for the continuation of children’s community base projects will be made for the provision of support to children. Investigations will continue in the future in collaboration withmunicipalities, health centers, and related institutions.
(3) Stem Center Community Support Division (henceforth, “Stem Center”)
. Resident support
Health surveys for residents in disaster public housing have been completed in some municipalities, showing that the number of continued supporters has decreased. There has been an
increase in support requests for difficult-to-handle cases, but we conducted joint home visitswith municipal public health nurses in principle, considering the conclusion of the Center’s work.

- 44 -Community Support Department / Planning and Research Department Activity Report. Supporter support/Human resource development
Workshops and case study meetings in the municipalities under the jurisdiction of the Iwanuma
branch provided support jointly with the Iwanuma branch. There was increased participation ofmunicipal staff, other than those in the managing division, and there has been more information
sharing among all staff. Even areas under the jurisdiction of the Shiogama Health Center were able
to cooperate and provide support for municipal case study meetings with health centers, using theinvestigation meetings as an opportunity to plan the future of mental health care. Furthermore, there
have been increased requests for the supervision of maternal and child health cases, as well as joint
home visits, and nursery school and the next-generation comprehensive support center for childcare
staff have also begun to participate in the case study meetings.
. Raising public awarenessWe implemented alcohol patch tests at the health festivals in Matsushima and Yamamoto withthe objective of encouraging moderate alcohol consumption. We also used health picture-story
shows created by Kesennuma at the town health room for residents of Natori disaster public housingto raise public awareness of mental health.
. Investigation meetings regarding the future of mental health care
Having set the target direction of “being able to maintain mental health from childhood to asenior age,” we decided to conduct continuous health activities, improve community mental health,and increase the frequency of welfare activities (on-site human resource development). We participated in joint home visits and case study meetings with municipal public health nurses, while
cooperating with the municipality, health center, and mental health and welfare centers; furtherdetails will be investigated in the future.
(4) Planning and Research Division
The substantial roles played by the Planning and Research Department, Planning and Research
Division include compiling overall business statistics, planning for training with the objectives of supporter support and human resource development, raising public awareness in relation to various postdisaster issues of concern, and implementing various kinds of research projects. The implementationof projects often involves joint work with cooperating institutions such as the Tohoku University Graduate School of Medicine, Endowed Department of Preventive Psychiatry (henceforth, “preventivecourse”) and Tohokukai Hospital.
. Efforts to combat alcohol-related problems
We have conducted “on-the-job training for alcohol-related problems,” with the cooperation ofTohokukai Hospital, since 2012. This has been conducted over three days in the hospital per term,with five terms conducted for this fiscal year. Over 200 attendees have been registered to date, andwe have also hosted follow-up training for those attendees. We have regularly shared information
with Tohokukai Hospital and Miyagi Prefecture Danshukai, and we have also cooperated in casestudy investigations, supporter support training implementation, and Danshukai activities.
. Specialized disaster-related training
Jointly with the preventive course, we offered mental exercise training for community supporters. We delivered lectures and exercises about how to understand the basics of cognitive behavioral
therapy and about how to solve problems twice this fiscal year. These lectures concluded simultaneously with the preventive course, but given that there are many individuals who would like toparticipate further and the fact that supporter awareness remains high, we are considering futurecontinuation.
We have also co-sponsored, jointly with the preventive course, training for the improvement ofpsychological skills, complicated PTSD (C-PTSD) training, and workshops for long-term mental
health during the disaster reconstruction phase. Training for the improvement of psychologicalskills has been taken on as a Center project and will be implemented in FY2020.

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. Hosting the Miyagi Mental Care ForumThe Miyagi Mental Care Forum was hosted with the objective of widely sharing the actual
situation of the affected area and the issues to be addressed among supporters. Superior practices
incorporated in each area within the prefecture following the disaster were reported, and Dr.
Masayuki Noguchi (Okayama Prefectural Mental Health and Welfare Center director) spoke on
the topic “Thinking about a comprehensive community care system based on the experience ofcommunity support in Okayama Prefecture.” Participants discussed the future of community
mental health and the importance of outreach, while also keeping in mind the introduction of acomprehensive community care system.
. Raising public awarenessWe have established a website since the opening of the Center and used it to disseminate
information, but we have also been updating English translations of the bulletins that have been
published until now since the previous fiscal year. We have posted pamphlets and lecture reports
on various issues that have been published to date. We have used this website as a tool for
disseminating various kinds of training and recruitment information, as well as community center initiatives. In the future, we would like to use it as a tool for listing the Center’s performancemilestones and achievements (e.g., business statistics), as well as a tool for disseminating information about our performance to date.
. Children-related projects
We have sent professional dispatches to municipalities and nursery schools as part of theChildren’s Mental Care Community Base Project, which we have been contracted to execute
since FY2016. We have also hosted psychological first aid (PFA) for children training five times
per year and co-sponsored children’s PTSD assessment training jointly with the preventivecourse. We have also distributed pamphlets on children’s mental health care and clear files on
self-care written for children while hosting these events.
Additionally, we have continued to implement cohort surveys of children born immediately
after the earthquake disaster, alongside Iwate and Fukushima.
3. Discussion
We conducted each of the abovementioned activities while keeping the future of community mental
health and welfare activities after the conclusion of the Center’s operations in mind. Resident support
has seen decreased home visits relating to health surveys but increased numbers of complicated or difficult-to-handle cases with multiple problems. As in FY2018, Kesennuma has had many consultations,
ranging from children to the working generation, while Ishinomaki and the Stem Center have increased
support for parents, i.e., in maternal and child health, who are raising children. Therefore, there has been
increased collaboration between many related institutions such as nurseries, schools, workplaces, hospitals, and consultation offices, including the associated municipal divisions. There have also been more
supporter support activities such as requests for the supervision of case study meetings or lecturers atworkshops.
All disaster public housing in the prefecture was completed in March 2019, and health surveys implemented jointly by the prefecture and municipalities are slated to end in FY2020, although some municipalities have completed this in FY2019. It is thought that public awareness of mental health andalcohol problems among disaster public housing and community residents as well as a population approach via exchanges between residents are important. We have printed and bound the Health PictureStory Show created in Kesennuma and distributed it to municipalities in the hope that it can be used asa tool for raising public awareness among residents.
There should also be investigations into each of the sponsored training programs conducted to date as
the preventive course comes to an end. There will also need to be coordination with associated organizations regarding the ideal form of each project listed above as the Center’s functions taper off after
FY2021.
Each area’s investigation meetings on the future of mental health care will be continued in FY2020,
so we would also like to continue discussions with municipalities, health centers, and mental health andwelfare centers in order to carry out activities, while giving due consideration to the future of community
mental health and welfare activities after the conclusion of the Center’s operations.

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