FY 2018 Bulletin, Issue 7Child Mental Health Care Community
Center ProjectManager, Psychiatric Social Worker – Tetsuro Higuchi
Director, Psychiatric Social Worker – Yuichi Watanabe

Introduction
A basic mental health care guideline in Miyagi Prefecture’s post-disaster reconstruction plan is best encapsulated in the phrase “Continuous Support for All: From Children to Adults.” In April 2016, the Miyagi
Disaster Mental Health Care Center (MDMHCC) took charge of the Children’s Mental Health Care Projectand has continued to manage it to this day.
Following contract specifications, the following report summarizes the results of FY 2018’s Child Mental
Health Care Community Center Project and reproduces data on counseling and other endeavors at our center
for individuals under the age of 20.
1．Terms of Contract and Results(1) Counseling
The MDMHCC provides counseling services to children affected by the Great East Japan Earthquake through municipal agencies, educational institutions, nursery schools, and so on.
Many cases require specialist workers to be dispatched to city-run infant health clinics, counselinghelp desks, and health centers where staff and family members seek guidance on how to deal withchildren’s mental health care needs.
The number of child-related cases handled in FY 2018 numbered 330 in total and involved 138
persons. This is an increase from FY 2017, where a total of 281 cases involving 118 persons werehandled. Table 1 provides a breakdown of case numbers by age group and counseling point of contact,
while Table 2 provides a list of the cases according to age group and area of residence.
The breakdown by age reveals a significant spike in counseling cases involving children 6 years
and younger in FY 2018, relative to FY 2017, when there was a total of 53 cases in this age group.
The reason for this may likely have been the beginning of a partnership with infant screening facilities
in Ishinomaki, which led to even more opportunities for mothers and children to receive parenting
counseling. In FY 2017, the total number of cases in the 7-15 and 16-19 age groups, were 101 and127 respectively; this year’s figures are even higher, echoing the same pattern as was seen in the 6
years and under age group. We believe that this is due, at least in part, to initiatives by the Kesennuma
Regional Center to raise our center’s profile as a counseling destination, such as public awarenessactivities at middle and high schools beginning in FY 2016, and a counseling help desk at a nursing
school that was set up in FY 2017.
As for the number of actual people served, for the 6 years and under age group, an increase ofnearly 20 was observed (6 and under in FY 2017: 51 individuals). In comparison, however, the figures
for age groups 7 and older remained nearly the same (FY 2017, 7-15 age group: 37 individuals; 1619 age group: 30 individuals). We believe that this is because cases in the 6 years and under age grouptend to conclude after one visit, whereas those in the 7 years and older age groups often require continuous counseling.
Table 1: Cases by age group and point of contact（Total 330, actual no. of persons 138）
６ and under

7-15

16 -19

Total

Self

2

70

108

180

FamilyTotal（by point of contact） Other

80

45

23

148

1

1

0

2

Total

83

116

131

330

Actual no.

72

36

30

138

－ 34 －

Child Mental Health Care Community Center Project
Table 2: Cases by age group and area of residence
Residence

Stem
Center(Totals by areaof residence)
Ishinomaki
Regional
CenterKesennuma
Regional
Center(2)

6 and under

7-15

Sendai
Shiogama
Natori
TagajoIwanumaTomiyaWatari
Yamamoto
Matsushima

0
0
6
0
0
0
3
0
0

3
0
4
0
0
0
0
0
0

Not listed above

0

26

23

5

54

Higashimatszushima
Onagawa
Kesennuma

6
0
0

12
0
73

12
0
90

30
0
163

Tome
Minamisanriku
Anonymous
Total

0
0
42
83

0
0
1
3
0
0
116 131

0
4
42
330

Ishinomaki

16-19 Total
0
2
11
0
0
0
0
2
0

0

6

3
2
21
0
0
0
3
2
0
6

Specialist Dispatch Services
In FY 2018, we dispatched specialists such as pediatric psychiatrists, clinical psychologists, and public health nurses to a total of 39 institutions, including municipal health centers; nurseries and daycare
centers; and elementary schools, and provided staff members with consultations and training. Table 3
shows a breakdown by host institution type and occupation, while Table 4 shows a breakdown by hostinstitution type and location.
Municipalities constituted the majority of all host institutions and accounted for 221 cases, 127 ofwhich were handled by public health nurses—a significant increase from 75 cases in FY 2017. (Themost commonly deployed professionals were public health nurses, followed by clinical psychologists
and psychiatric social workers.) We believe these patterns can be attributed to greater opportunities for
dispatch workers to help with municipal initiatives, such as infant health examinations. On the other
hand, the number of cases in which a clinical psychologist or psychiatrist was dispatched to a municipality has fallen. “Other” includes clinical developmental psychologists, nurses, and university faculty
members. Whereas dispatches to nurseries and daycares decreased, dispatches to elementary schools(including support schools) and middle schools, increased by 15 and 2 respectively, relative to FY 2017.
The most common destination municipality was Ishinomaki (127 cases), followed by Watari (50 cases)
and Natori (49 cases).
Table 3: Dispatch cases by host institution and occupation

DestiOccupation

Prefecture Municipality

Nursery,
daycareElementary

Middleschool

Other

Total

Psychiatrist

1

6

0

31

6

2

46

Clinical psychologist

3

58

4

0

0

10

75

Psychiatric social
worker

0

18

0

0

6

0

24

Public health nurse

1

127

0

0

0

14

142

Other

0

12

10

0

0

0

22

5

221

14

31

12

26

309

Total

－35 －

FY 2018 Bulletin, Issue 7

Location
市町

Stem
CenterIshinomaki

Table 4: Dispatch cases by the host institution and location

Host

Prefecture

Municipality

Nursery,
daycareElementary

Middleschool

Other

Total

Sendai

0

1

0

4

3

10

18

Shiogama

0

0

0

0

0

0

0

Natori

1

37

10

1

0

0

49

TagajoIwanuma

0

2

0

0

0

0

2

0

11

0

2

0

0

13

Watari

0

47

0

3

0

0

50

Yamamoto

0

7

0

4

0

0

11

Matsushima

0

1

0

0

0

0

1

Ishinomaki
Regional Center

3

104

4

0

1

15

127

0

5

0

6

1

1

13

Onagawa

0

1

0

0

0

0

1

Regional Center

1

1

0

11

5

0

18

Kesennuma
TomeMinamisanriku

0

4

0

0

0

0

4

0

0

0

0

2

0

2

14

31

12

26

309

Higashimatsushima

Kesennuma

Total

5

221

(3) Training Workshops
There were 40 cases in FY 2018 where the center held workshops or otherwise sent speakers to otherevents. Table 5 shows the kinds of specialists that were involved in these events and the municipalities
in which they were held. All events are listed in Table 6.
The workshop events held by the center itself include the “Child Mental Health after the Great East
Japan Earthquake: What We Have Learned from Our Activities Thus Far” event (111 participants) andthe “Mental Health Recovery in Children: Child Support Activities that Foster Self-Affirmation” event(226 participants), both held in Ishinomaki; an “On-Site Lecture for High School Students about Building Mental Health,” was held in Kesennuma (290 participants), among others.
Finally, we held a training workshop on “Psychological First Aid (PFA) for Children” (hereafter, child
PFA training) in four locations in different parts of the prefecture, a total of seven times (this includes
collaborative events with other organizations).
Table 5: Workshop events by lecturer occupation and location

Loca-

Stem
CenterIshinomaki Regional Center
Kesennuma
Regional Center

Lecturer

Psychiatrist

Clinical psy- Psychiatric sochologist
cial worker
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Publichealth nurse

Other

Total

0
0
0
0
0
0
1
1
0
0
1

0
0
5
0
0
0
0
0
0
1
0

10
0
8
1
0
1
1
1
1
3
5

Sendai
Shiogama
Natori
TagajoIwanumaWatari
Yamamoto
Matsushima
SendaiIshinomaki
Higashimatsushima

8
0
3
1
0
1
0
0
1
2
4

Onagawa
Kesennuma
Tome

0
5
0

0
0
1

0
2
0

0
0
0

0
1
0

0
8
1

Minamisanriku
Total

0
25

0
3

0
2

0
3

0
7

0
40

－ 36 －

Child Mental Health Care Community Center Project
Table 6: List of workshops

Primary
participants

No. ofattendees

What We Can Do in A School Setting to
Preserve Mental Health

School counselors

200

Psychiatrist

NatoriInterpersonal Communication

Natorigaoka
Nursery School29

2018. May 9

Sendai

Psychological First Aid for Children

542018. May 22

NatoriInterpersonal Communication

Education officials, etc.
Child welfare
officials, etc.

Clinical developmental psychologist
Psychiatrist

5

2018. May 30

Kesennuma

62018. June 6

Sendai

Psychological First Aid for Children, OneDay Training
What We Can Do in a School Setting toSupport Child Development

7

2018. June 13

82018. June 19

92018. July 11

№

Date

1

2018. April 9

Natori2

2018. April 23

3

10 2018. July 13

11 2018. July 17
12 2018. July 23
13 2018. August 1
14 2018. August 1
15

2018. August 3

16 2018. August 5
17 2018. August 8

18

19

2018. August 92018. August 17

Location

Topic(s)18

Clinical developmental psychologist
Psychiatrist

Education officials
NatoriInterpersonal Communication
Child welfare
officials
Natori
Psychological First Aid for Children in Dis- Education offiaster Settings
cials
Higashimat- Psychological First Aid for Children: One- Education offisushima
Day Training
cials, etc.
Kesennuma Miyagi Disaster Mental Health Care Center Students ofActivity Report
Shishiori Middle
SchoolOn-Site Lecture for High School Students Kesennuma
Kesennuma about Building Mental HealthHigh School
sophomores
Ishinomaki Case study
Child welfare
officials
Kesennuma Understanding and responding to the needs Child welfare
of troubled children
officials, etc.
Kesennuma Mental illness in puberty
Nursing teachers, etc.
HigashimatsuHigashimat- How to Respond When Discovering Child shima Regional
Abuse: A Practical Approachsushima
CouncilforCountermeasures for Children Requiring
Aid
Sendai
Psychological First Aid for Children
School clinicalpsychologistsndSubleader Training for the 2 Hop ☆
Sendai
Middle- andStep ☆ Day Camp
high-school stu-

200

Psychiatrist

40

Other ＊

94

Psychiatrist

24

Psychiatrist

53

Nurse

290

Psychiatric social
worker7

Other ＊

30

Psychiatrist

20

Psychiatrist

30

Public health
nurse

57

Psychiatrist

4

Psychiatrist

Ishinomaki

111

Psychiatrist

30

Psychiatrist

8

Clinical psychologist

30

Psychiatrist

65

Public healthnurse

Sendai20 2018. August 20

Sendai21 2018. August 24

Sendai22 2018. September 11 Watari

Administrative
officials, etc.

dentsChild Mental Health after the Great East Japan Earthquake: What We Have Learned Administrative
officials, etc.
from Our Activities Thus Far

Results of the FY 2018 Survey of the Physical and Mental Health of Schoolchildren, Faculty of elementary andand How to Respond to Children in Needmiddle schools
in Sendai
Faculty ofChild Abuse
Seiyo Gakuin
College
Results of the FY 2018 Survey of the Physi- Rokugo Elecal and Mental Health Of Schoolchildren
mentary School
teachers
District welfare
Watching Over Mother-Child and Fatherofficials/childChild Households
welfare officials

－37 －

29

Speaker occupation

FY 2018 Bulletin, Issue 7
23 2018. September 13 Sendai
24

2018. September 21

What is Family?

Nobisuku Izumi

Higashimat- Responding to and Supporting Victims of
Abuse: Considering Collaborative Support
sushima

25 2018. September 26 Kesennuma

Understanding and Responding to Mental
Illness in Children
Mental Health Recovery in Children:Child Support Activities that Foster SelfAffirmation
The Effect of the Great East Japan Earthquake on Children and Future Directionsfor Mental Health Care
Treasure Both Your Feelings and the Feelings of Others

6

Clinical psychologist

36

Psychiatrist

70

Psychiatrist

Administrative
officials, etc.

226

Psychiatrist

Administrative
officials

24

Psychiatrist

Omose Middle
School50

Psychiatric social
workerChild welfare
officials

19

Clinical psychologist

30

Psychiatrist

31

Public health
nurse

100

Psychiatristpsychiatrist

Higashimatsushima Regional
CouncilforCountermeasures for Children Requiring
Aid, etc.
Education officials, etc.

26 2018. October 5

Ishinomaki

27 2018 October 18

Tagajo28 2018 October 25

Kesennuma

29 2018 November 1

Tome

30 2018 November 1

Kesennuma

31 2018 November 5

Murata32 2018 November 9

Natori33 2018 November 29

Osaki

Psychological First Aid Forfor Children,
One--Day Training

Education officials, etc.

21

Psychiatristpsychiatrist

34 2019 January 10

Higashimat- Parent-Child Communication Class: HowsushimaToto Respond to The Needs oOf Children
Going ThroughIn Puberty

Higashimatsushima residents

40

Psychiatristpsychiatrist

35 2019 January 18

Sendai

Education officials, etc.

36

Psychiatristpsychiatrist

36

2019 February 17

The Current State of Child Abuse andHow to Respond: What Counselors Can
Do
Understanding and Working with Children
with Issues

Education officials
Municipal pubInterview Techniques <Practicum＞
lic healthnurses of the
Sennan HealthCare Center
Child Emotional Responses In Emergency Nursing teachSituations: Studying Psychological First Aid ers(PfaPFA)

Psychological First Aid Forfor Children,
One-Day Training

The 32nd Japan Society for Pediatric PsyHealth care
Matsushima chiatry <JSPP> Matsushima Conference:
Mental Health Care for Children as Commu- workers
nity Development

60

Psychiatrist
psychiatrist

37 2019 February 19

Sendai

How to Approach Emotionally Vulnerable
Children: Perspectives Fromfrom Trauma
Care

Administrative
officials, etc.

41

Psychiatristpsychiatrist

38 2019 February 25

Natori

Making Parenting Fun

Parents of children at Natorigaoka Nursery
School13

Clinical developmental psychologist

39 2019 February 27

Higashimat- How to Understand Children with Emosushima
tional Baggage: Vol. 2

After-school
child support
club members

50

Psychiatrist

40 2019 March 13

NatoriParents of children at Masuda
Nursery School

15

Clinical developmental psychologist

Making Parenting Fun－ 38 －

Child Mental Health Care Community Center Project＊University faculty(4) Raising Public AwarenessIn FY 2018, we continued to use our website and the Miyagi Disaster Mental Health Care Report toinform the public about the Child Mental Health Care Community Center Project and to communicate
the importance of child mental health care in a post-disaster environment. Further, we created file folders for children containing self-care illustrations and distributed them to participants at the training sessions listed in Table 7.
№
Dateviduals receiving materials

Location

1 2019 January 18

Sendai2 2019 January 19

Sendai2

Higashi-2019 February 27
matsushima

Table 7: List of public awareness projects

Topic(s)Number of indi-

Distributed PR material and folders to participants of the psychological first aid for children
one-day training workshop
Distributed PR material and folders to participants of the FY 2018 workshop “How to approach Emotionally Vulnerable Children: Perspectives
from Trauma Care”
Distributed PR material and folders to participants of the FY 2018
workshop organized by the Higashimatsushima after-school children’s
club supporters training association “How to Understand Children with
Emotional Baggage”

345(5) Research
Detailed information on the “Study of Longitudinal Support of Children Born After the Great East Japan
Earthquake and their Families” and the “Parent-Child Survivors Camping Project” research initiatives canbe found in Section II of this issue, “Research Reports & Other Manuscripts”
Presentations given at conferences, etc., on the research we have done have been listed in Table 8.
Table 8: List of research projects

№

Date

Activity description

Topic(s)Overseeing
specialists

1

2018 June 2

The 60th Annual Meeting of the Japanese Society of Pediatric Neurology
Public Open LectureChildren with Developmental Disorders andEvacuation Shelters

Psychiatrist

2018 June 9

The 17th Meeting of the Japanese Society for Traumatic Stress Studies, Poster
Presentations

Study of Longitudinal Support for Children
Born After the Disaster ① – The Results of a
Health Survey in Miyagi Prefecture of Children Born After the Disaster

Psychiatrist

32018 June 9

The 17th Meeting of the Japanese Society for Traumatic Stress Studies, Poster
Presentations

Study of Longitudinal Support for Children
Born After the Disaster ② – The Results of a
Health Survey in Miyagi Prefecture of Parents
and Guardians with Children Born After theDisaster

Clinical psychologist

42018 June 10

The 17th Meeting of the Japanese Society for Traumatic Stress Studies, Symposium

The Effects of the Great East Japan Earthquake on Child Mental Health and Development – A Cohort Study of Disaster-Affected
Areas

Psychiatrist

52018 July 24

The International Association for Childand Adolescent Psychiatry and Allied
Professions

Child Psychoeducation in the Outdoor
Camps for Children who were Affectedby the Great East Japan Earthquake

Psychiatrist

62018 September 8

36th Annual Meeting of the JapaneseSociety of Psychosomatic Pediatrics
Disaster-related Session

Human Support Guidelines in Emergency Sit- Psychiatrist
uations – Focusing on Psychological First Aid(PFA) for Children

72018 December 15

Japan Pediatric Psychiatric Neurology
120th Anniversary Conference
Theme 2 [Disaster and Trauma]

The Effect of Large-Scale Disasters on Communities and a Discussion of Future Preparations – Disaster Mental Health as a Public
Health Issue

2

－39 －

Psychiatrist

FY 2018 Bulletin, Issue 782018 December 16

Japan Pediatric Psychiatric Neurology
120th Anniversary Conference
Poster Session

Community-Based Preparation for Future Dis- Psychiatrist
asters – The Significance of Training in Psychological First Aid (PFA) for Children

92019 February 9

Japan Psychology Education and Family Classroom Network 22nd Research
Meeting in Osaka
Subcommittee [Psychological Education for Children, Schools, and Teachers]

Psychological Education for Parents and Chil- Psychiatrist
dren in the Wake of Large-Scale Disasters

10 2019 February 16

The 32nd Research Conference of theJapan Society for Pediatric Psychiatry(JSPP), Matsushima

What Child Psychologists Can Do in Emergency Situations

Psychiatrist

11 2019 February 22

The 7th World Congress of Asian Psychiatry

What Training Program was Needed in Japanese Communities after the Great East Japan
Earthquake and Tsunami of 2011?

Psychiatrist

2．Discussion

Compared to FY 2017, there was an increase in the number of counseling and specialist dispatch cases in
FY 2018, reaching the highest levels in our three years of project contracting. In FY 2017, we fielded 281
counseling cases, but that number rose to 330 in FY 2018. Likewise, the number of people we worked withrose from 118 to 138. Two hundred and sixty-six of our cases in FY 2017 involved the dispatch of specialists;
this number rose to 39 in FY 2018. While the number of training workshop cases fell from 51 to 40, the numberof participants in these workshops rose to totals exceeding 300 people.
This is the third year since we began accepting contracts from other organizations. An increase in requests
from the administration improved awareness of our work among affiliated organizations, and residents’ cognizance of our programs have all been factors contributing to our growing caseloads. At the Kesennuma Regional
Center, which boasts the highest caseload of any of our centers, key drivers of this growth include publicawareness activities at local middle and high schools, as well as the introduction of a counseling desk in a local
nursing school. Similarly, a new cooperative initiative involving infant health examinations increased the caseload at the Ishinomaki Regional Center.
As we continue to develop and implement limited time activities, we have begun to notice the constraints
on our current system’s capacity to continue supporting the status quo of our many projects. We, therefore,
believe that it is vital that we consider what form a truly forward-looking system may take as we forge ahead
into the future.
3．Summary

FY 2018 marked the third year since the beginning of the Child Mental Health Care Community Center
Project. More than eight years have passed since the Great East Japan Earthquake. At that time, the Kesennuma
Regional Center, the Ishinomaki Regional Center, and the Stem Center have continued to uphold the ideal of“Continuous Support for All: From Children to Adults.” Owing to our sincere dedication to the center’s support
activities, our counseling and specialist dispatch project caseloads have continued to rise. While it is difficult
to shake the feeling that the end is nowhere in sight, particularly when it comes to the public need for this kindof support, our organization itself has an expiration date. Thus, while continuing to respond to the requests we
receive and prioritizing support for disaster-affected residents and supporters themselves, we must work withaffiliated institutions and organizations to consider how best to structure regional systems moving forward.

－ 40 －