Other Initiatives①②③④⑤Tohokukai Hospital
Tohoku University Graduate School of Medicine, Endowed
Department of Preventive Psychiatry
Miyagi Psychiatric Center
Japanese Association of Psychiatric Social Workers
Japan Social Worker Association for Alcohol Related problems

Disaster Support for Alcohol-Related Problems
Tohokukai HospitalToshihiro Suzuki
1. Introduction
In November 2011, as substantial efforts were made toward the establishment of the MDMHCC,
three staff members from Tohokukai Hospital were appointed to the Center as part-time staff to takecharge of the support measures that would make use of their expertise in alcohol-related problems.
It was predicted that post-disaster alcohol-related problems would become a critical issue forearly support, and thus the alliance between the MDMHCC and Tohokukai Hospital began.
In terms of our own work, in June 2011, just three months after the disaster, we began to visit
public health administrative agencies in tsunami-affected coastal areas, and in collaboration with theKurihama Medical Center (formerly the Kurihama Alcoholism Center), took stock of the situation
while also handing out awareness pamphlets on alcohol abuse in disaster situations.
2. Tohokukai Hospital Disaster Support Initiatives
Tohokukai Hospital’s previous disaster support activities were shifted to collaborative endeavors
with the MDMHCC after April 2012.
Figure 1 depicts our activity results in terms of monthly support cases over the past two years,
stretching from immediately after the disaster to March 2013. These data depict the number of times
we were dispatched for support-related work. The total number of cases we worked on over thisperiod numbers 299.

Fig. 1: Support Cases by Year and Month2013 Fav2013 Jan2012 Dec

2012 Nov

2012 Oct2012 Sep

2012 July2012 AugMarch 2011 March 20132013 March

Changes in Case Numbers by Month Year and month2012 June2012 May2012 April

2012 March2012 Fav2012 Jan2011 Dec

2011 Nov

2011 Oct

2011 Sep

2011 Aug2011 July

2011 June

2011 May

2011 March

Number ofcases

Figure 2 is a graph of the number of support cases we went out to deal with organized by area.
Minamisanriku began a regular support program in June 2011 and is the area in which we have been
active for the longest. Our next most long-lived venture has been collaborative support in our homearea of Sendai, where we have worked with the Tashiro Ward Authority and the Personal Support
Center (an NPO contracted by the city of Sendai to provide support to temporary housing residents,etc.). Finally, in terms of regular, continued support, our work in Higashimatsushima, individual
support for survivors with alcohol-related problems, is also a large part of our caseload achievements.

- 80 -Fig. 2: Support Cases by Area

Minamisanriku

Sendai

Support Cases by Area

March 2011 March 2013

Kesenn Higashima Yamauma tsushima moto

IwanumaIshino Shichiga
maki hama

Naruko Watari Tagajo

Natori Shiogama OtherFigure 3 depicts cases by support type, and Figure 4 depicts these same data as a pie chart. Reflecting
our aforementioned efforts in Higashimatsushima, our most common type of support was individual
visiting consultation for disaster survivors. Networking refers to the discussions undertaken with local
authorities and the relationship building between supporters, both of which are necessary to manifest
various support initiatives; when it comes to community-level responses to alcohol-related problems,such face-to-face networking activities are indispensable. At Tohokukai Hospital, we have devised a
policy whereby disaster support for alcohol-related problems is ranked from primary to tertiary
prevention, centered around support for supporters; we have held disaster support meetings anddisaster-affected area case study sessions on a weekly basis in accordance with these guidelines.
Fig. 3: Cases by Support Type
Cases by Support Type(one case can include
multiple types)

Individual visiting consultation fordisaster survivors
Networking activities
Case studies
Support for supporters training
Public awareness
Surveys (asking about disaster damage)Supporter group work
Survivor group work
Resident survivor supportSurvivor aidCases- 81 -March 2011 March 2013

Fig. 4: Percentage of Cases by Support Type
Percentage of Cases by Support(one case can include
March 2011 – March 2013
multiple types)

Resident survivor support 1%
Individual visiting consultation for disaster survivors
21%

Survivor aid
0.4%

Survivor group work2%

Supporter group
work 8%

Surveys (asking aboutdisaster damage)
9%
Networking activities
17%

Public awareness
12%
Case studies
15%

Support for supporters training
15%

3. Acknowledging Powerlessness
There are myriad alcohol-related problems, and they link to a vast array of other issues. Even if
we examine only alcoholism, its connections with domestic violence, abuse, unemployment, familial
dissolution, and loneliness, among other issues make it quite clear that it is actually a disease ofinterpersonal relationships, one that could never be captured by a mere description as “continuousalcohol consumption.” This perspective is indispensable on the road to recovery. After all, issues withbasic stress responses, where individuals find themselves unable to talk to others or to seek help whenin trouble, often lie at the root of alcoholism.
The Specialty of working with alcoholics is not the specialty of spersuading them to stop drinking.
What they do is work beyond the realm of medical treatment, with interpersonal relationships:
between the addict and their family, the addict and their supporters, the addict and their community,and, at times, all these parties at once. The reason we have placed such an emphasis on group workin our support for supporters is that we know that this sort of “network therapy” 1) can change
community relationships; it is in these changed community spaces that addicts can recover. The roadto recovery is one that the addict must walk on their own two feet; they cannot be carried down it bydoctors or supporters.
Yet we are wont to forget these truths and fall prey to assumptions of complete self-sufficiency.
The support necessitated by this disaster has given us frogs a chance to crawl out from our medical
wells and rethink our view of things. The road ahead is long, and we still have many miles to go.
“That’s it! I’m done with being yanked around by alcohol!” From this chaos, support begins.

References1) Satoru Saito. “Network Therapy: Escaping Alcoholism.” Ayako Publishing, 1985.

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