Part IIIContributions

Panel discussion in New York
Medical Corporation / Hara Clinic / Director
the Natural Disaster Mental Health Care Network Miyagi
Karakoro Station Representative Director
Keizo Hara
(Miyagi Disaster Mental Health Care Center Advisor)
On March 8th, 2016, a panel discussion on the theme of “March 11th and September 11th: Survivor stories”,
sponsored by the Asia Society, was held in New York. Meetings with the September 11th (World Trade Centerattacks) Families’ Association have been held in Ishinomaki City, so the association decided to participate in apanel discussion in New York. There was a total of six panelists, with three from the United States and threefrom Japan, including myself. The panel discussion progressed with a well-known journalist presiding as thechair. One element that left an impression was the statement made by the 9/11 member, who stated that“recovering from a disaster takes a long time. It’s important to have partners who can support each other”. It was
my first time visiting New York. I have been to the West Coast, but it takes another 6 hours to fly to the East
Coast from there. It takes approximately 14 hours by plane from Japan. I left Narita in the morning, and I arrived
in New York the same morning. I was jet-lagged. That evening, I went to a 3/11 (Great East Japan Earthquake)memorial service. There were many individuals in attendance.
In thinking long and hard on what to write after being requested to write this contribution, my deadline forsubmitting this passed me by. I promised my editor that I would submit this by April 18th and spent the past
week dwelling on this. There was a massive earthquake in Kumamoto. Another one in Ecuador. And on the news,
there was non-stop coverage of both of these events. I was reminded of March 11th. On that day, my morning
clinical work had finished at 1:30 pm. I had eaten my lunch, played table tennis at the Psychiatry daycare, andwas preparing for my afternoon clinical work that was to start at 3:00 pm, ordering coffee in the café on the firstfloor. It was at that moment. A heavy shaking struck us, I heard the building creaking, and there was shaking so
intense that I couldn’t even register the sound of things falling. I had this fear of the building collapsing, but I
couldn’t move, I couldn’t do anything. Images of the day the earthquake struck were plastered on the televisionscreen. And images of people seeking shelter or water, rescue scenes, the collapsing of buildings, and so on.
Japan is a country that has seen many disasters. After experiencing 3/11, I couldn’t help but feel that something
must be learned from this. But there are many different disaster conditions, and the same thing will never happen
twice.
I want to introduce the activities of the Mind and Body Station (henceforth, “Karakoro Station”). Shortly after
the Great East Japan Earthquake, I began mental care activities in Sendai City, Yamamoto Town, and Ishinomaki
City in collaboration with the Japanese Association of Neuro-Psychiatric Clinics. It was clear that it was a largescale disaster over a wide geographic area and that problems that cannot be handled with regular mental healthactivities will occur. It was clear that eventually, a disaster mental health care center would need to be establishedin the region. However, even as we prepared, it gradually became clear that we would need time to establish thecenter and upon deciding to do what we could do at that moment, we prepared to launch a general incorporated
association, and we received approval by the end of June. This was the Natural Disaster mental health care
network Miyagi. Using this as a port of entry, we began to accept contract work for activities in Ishinomaki Cityand Miyagi Prefecture. Shelters in Sendai City and Ishinomaki City were closed at the end of July and October,
respectively, and individuals were relocated to container type temporary housing. The activities of the Disaster
Relief Act ended once the shelters were closed. In the Ishinomaki region, the Natural Disaster Mental HealthCare Network Miyagi took up this role, with mental care teams from various prefectures working in the disasterarea taking up individuals undergoing follow-up inspections and we were able to avoid a situation where there
was no central organization. In October of the same year, we established the Karakoro Station in front ofIshinomaki station. The Karakoro station conducts activities 365 days a year. Particularly on holidays, during
which many institutions are closed, the station continues to conduct follow-up work in the region. The main
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activities of the Karakoro station include direct support such as telephone consultations, walk-in consultations,and visits, as well as café activities, lectures, and health consultation meetings, and have a system in place torespond to a wide range of consultations.
I would like to address some mid- and long-term challenges in the future. The current status of the disasterarea is that relocations to recovery housing are slow to progress. Health disorders are also becoming a large
problem. There are major challenges such as the exacerbation of alcohol-related problems and dementia, andthere has been an increase in suicide and anxiety. However, the mental health activities at the Karakoro Station
are currently engaged in seeking to find a solution to these problems. With regards to alcohol-related problems,
we created Al-Col Karuta as a tool for public awareness activities. We periodically hosted “Ojikoro” events asgroup activities focused on single elderly people. Additionally, we provided psychological education programs
on a regional basis for individuals with alcohol-related problems. We hosted research meetings on alcohol-related
problems with regional physicians. It is possible to strengthen mental health activity networks under this type ofcooperation. Mid- and long-term challenges are based on how we can expand local mental health networks. Right
now, Ishinomaki is trying to establish comprehensive community care. It is thought that strengthening theconnections with these types of actions will strengthen the region. Continuity is the father of success.

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