Projects of Cooperating Agencies andOrganizations
Medical corporation Tohokukai Tohokukai Hospital
Department of Preventive Psychiatry, Tohoku University Graduate School ofMedicine
MIYAGI DANSHUKAIJapan Social Worker Association for Alcohol-Related Problems
Supporters club members

Disaster support for alcohol-related problems

Medical Corporation Tohokukai Tohokukai Hospital / Community Support Division
Psychiatric Social Worker / Toshihiro Suzuki

１． Support overview
Disaster support for alcohol-related problems has been ongoing by the Medical Corporation TohokukaiTohokukai Hospital (referred to hereafter as “our hospital”) for five years since the earthquake. An overview ofsupport activities is reported below.
There were 620 support cases and a total of 1236 staff members over five years. Changes in the annual numberof cases are shown in Figure 1, with an annual average of 124 cases and a monthly average of 11 cases regarding
support activities. The number of cases by the supported region is shown in Figure 2. Three regions comprised
71% of all care, with the Kesennuma and Minamisanriku regions at 35%, Ishinomaki, and Higashi-Matsushimaregions at 23%, and the Sendai area at 13%. Disaster support in these areas is often conducted in collaboration withthe Miyagi Disaster Mental Health Care Center (MDMHCC).
Figure 1 Changes in the number of support activities, 2011 –December 2015, N = 620
14012010080
6040200
2011

Figure 220122013

2014

2015 (9 months)

Number of support cases by region, March 2011 – December 2015, N = 620

1201008060
4020

Wide-area
activities

Other

Matsushima

Onagawa

TagajoWatari

NarukoShichigahama

IwanumaNatori

Yamamoto

Ishinomaki

HigashiMatsushima

Sendai

Kesennuma

Minamisanriku

Shiogama0* Countermeasure conferences and discussions relating to wide-area disaster area support were counted as activities in
the hosted location of “Sendai” but were separately counted as “wide-area activities” in statistics from March 2015

onwards.

－ 69 －２． Support content
As shown in the primary support content in Figure 3, network coordination activities were the most frequent.
Discussions on the specific content of support with municipalities were the focus of network coordination
support and communicating and sharing how to respond to the requests of municipalities will serve as important
activities relating to the subsequent presence of support and support network-building.
The second most frequent were workshops and case study investigations. This reflected the support
policies of “supporting local caregivers” at our hospital and we placed workshops and case study investigations
as a major pillar of our support. Additionally, individual victim home-visits were similarly frequent. A lack ofmanpower in the disaster area is a serious problem and as a general rule, we conducted individual visits andconsultation activities accompanied by regional caregivers.
Figure 3 Number of cases by type of support(multiple types of support included in a single case), March 2011 – December 2015

Network coordination activities

149

Workshops on support for supporters

124

Case study investigations

120

Individual victim consultations / visits

100

Public awareness53

Caregiver group work

41

Support for mutual support groups

39

Investigation (disaster area statusinterviews)
Victim group work28
7

Disaster resident support

3

Victim rescue

1020

40

60

80

100

120

140160

Number of cases

3. History of support
Changes in the number of primary support cases are shown in Figure 4. Support primarily comprised publicawareness activities, such as the distribution of leaflets at the beginning of the disaster, alongside research toon-site conditions but the following year in 2012 saw more requests on regular individual case responses andhome-visits from municipalities, and the number of these cases increased. In 2013, there were more requests
for training to improve regional caregiver response and in 2014, case study investigations for strengthening
applicable skills increased.
Additionally, we have worked on building the foundations for establishing a mutual support group (“selfhelp group”, SHG) activities in coastal areas since the first year of support.
It has been said that stakeholders must connect among themselves by participating in SHGs to recover fromdependencies. However, SHG activities are insufficiently established in the coastal areas of the prefecture andit was not until the latter half of 2014 in collaboration with SHGs such as AA and the Danshukai that we wereable to help caregivers understand the importance of stakeholder activities. With this, we have been able to lay
the groundwork for regional caregivers to connect stakeholders with SHGs.

－ 70 －Figure 4 Annual percentages of primary support cases
Number of cases in FY 2015
9-month mean)

Number of cases in 2014

Number of cases in 2013

Number of cases in 2012

Number of cases in 2011

Investigation
Support from mutual support groups

Caregiver group work
Public awarenessIndividual victim visits andconsultations
Case study investigations
Supporter support training
Network coordination activities

01020304050

４． Conclusion
There has been increased awareness of disasters and alcoholism, primarily through news media. Attention
given to alcohol-related problems helps with the public awareness of this illness, which has been said to affect1.09 million people. However, it is essential to understand that alcohol-related problems are one of many
recovery-related issues and that vulnerabilities associated with normal periods manifest themselves during
disasters. This problem has been calculated to cost society four trillion yen annually, which highlights the needfor national-level initiatives that treat this as a disaster-scale public health problem during non-disaster periods.
That the Basic Act on Measures against Alcohol-related Harm was established in December 2014 andimplemented in June 2015 is considered as a first step towards addressing this issue. The effectiveness of thislaw is dependent on the functionality of regional networks of stakeholders, families, caregivers, government, andhealth care. We would like to continue providing full support so that these initiatives for alcohol-related problems
during disaster periods can be used during non-disaster periods as well. Activities relating to the disaster
psychiatry and health fields from the Tohoku University Department of Psychiatry－ 71 －