Stem Center Research & Planning Division Activity Report

3. Projects of Cooperating Agencies andOrganizations

Tohoku University Graduate School of Medicine,
Department of Preventive Psychiatry
Tohokukai Hospital
Miyagi Danshukai－ 87 －

Research Report

Activities Related to Disaster Psychiatry and the Health Field
Conducted by the Tohoku University Department of Psychiatry
Kazunori Matsumoto - Associate Professor
Department of Psychoneurology / Department of Preventive Psychiatry (concurrent)
Tohoku University School of Medicine
After receiving a contribution from Miyagi Prefecture in October 2011, the Tohoku University
Department of Preventive Psychiatry (hereafter, “Department of Preventive Psychiatry”) was establishedunder the umbrella of the Tohoku University Department of Psychiatry. It has worked to provide support
and conduct research in the aftermath of the Great East Japan Earthquake. The primary active members in
FY 2017 were as follows: From the Department of Preventive Psychiatry, Takahashi, Shoji, Usukura, Kano,and Saito; from the Psychoneurology Department, Matsumoto; and from Hospital Psychiatry, Sakuma, Ueda,
Hamaya, and Sunagawa. Much of our work was conducted in collaboration or cooperation with the Miyagi
Disaster Mental Health Care Center, and we also work as part-time employees of the Center.
With regard to our support efforts for supporters working in their home regions, we continued our
support work for four social welfare councils (Kesennuma City, Onagawa Town, Shichigahama Town, andYamamoto Town). We continued to offer regular health checkups at support bases, health counseling at theworkplace, advice for HR supervisors, and training for employees, among other things. The problems ofeach workplace are different, and we devised and implemented training regimens and support systems
specifically suited to each. In the future, we would like to assist social welfare councils in organizing theirinternal structure such that they are able to continue to offer workplace mental health support in the wake ofa disaster, especially after external aid wanes.
At present, we are slowly strengthening our efforts to broaden understanding of and support methods toaddress psychological trauma. Due to experiences surrounding the Great East Japan Earthquake,
understanding of problems arising from psychological trauma, including post-traumatic stress disorder andcomplicated grief, has slowly expanded. However, the roots of these problems run deep, and touch on avariety of issues beyond happenings directly related to disaster experiences, including abuse and violence.
We believe awareness of psychological trauma is critically important. On May 5 and 6, 2017, we held a“Cognitive Processing Therapy for Trauma Training Session” in Sendai City. Aimed at psychiatrists andclinical psychologists, we invited four professors to give lectures and provide training on the newest
treatment methods for trauma. Additionally, we started the Miyagi Trauma Treatment Research Group andheld joint study sessions twice over Skype with Fukushima Medical University.
We held several training sessions at multiple levels to spread the cognitive behavioral approach to awide range of subjects. Our “Exercise Training for the Mind and Heart” sessions were held twice last year
and primarily targeted lay supporters. The first session focused on communication skills, while the second
focused on problem solving techniques. Persons from a wide range of professions (mostly from Miyagi
Prefecture) participated each time, and we plan to continue spreading basic knowledge of the cognitive
behavioral approach in the future. For specialists who wished to learn the cognitive behavioral approach inmore detail, we invited Professor Yutaka Ono to hold “Psychological Support Skill-Up” lectures twice. This
year, we used case studies to educate participants on an easily applicable cognitive behavioral approach thatcan be used in situations where structured cognitive behavioral therapy is difficult to implement. In addition,
we spread our “Skills for Psychological Recovery” (SPR) program, a support program that uses the
cognitive behavioral approach and is specially designed for the disaster recovery and reconstruction period.
We held the training session over a two-day period in December and invited Tomoko Ohsawa to serve aslecturer. We enjoyed enthusiastic participation, including from veterans in the mental health field in Miyagi
Prefecture, and we believe the training session was quite enriching.
In order to devise better youth mental health policy, we continue to work to strengthen the relationshipbetween mental health care organizations and the school system. In cooperation with Miyagi Prefecture and－ 88 －

Research Report from the Department of Preventive Psychiatry

Aoba Ward of Sendai City, we held training sessions, etc., for faculty at high schools and vocational schoolsthat involved supervision of meetings with students, knowledge and responses to mental illness, andheightening of communication skills when interacting with students, parents, and other faculty members.
Additionally, this year, we have begun our project from the Japan Agency for Medical Research andDevelopment (AMED), “Research on Mental Health Development and Growth in Childhood and Puberty”(principal investigator: Masafumi Mizuno).
On February 3, 2018, in Sendai City, we held “A Training Session for Collaboration Between Schools
and Mental Health Care: Diagnosing and Working Together on Mental Conditions of Puberty and Young
Adulthood,” which incorporated both a lecture and group work. Individuals including school counselors andfaculty participated. In addition, we implemented a survey that gathered good cases where mental healthcare agencies and schools in Miyagi Prefecture collaborated.
This year, at the request of prefectural municipalities and the Miyagi Disaster Mental Health Care
Center, we have dispatched lecturers to training and lecture sessions. Primarily, these have been suicidecountermeasure projects inside the prefecture and workplace mental health training sessions. In addition tothese efforts, we have participated in academic conferences and symposia where our presentations on thecurrent status of mental health vis-à-vis disaster damage, and our research results have served to transmit
information and raise public awareness within and without Miyagi Prefecture. We have continuously
engaged in public awareness activities for disasters, including serving as lecturers at Miyagi Prefecture
DPAT (Disaster Psychiatric Assistance Team) training sessions, reports of support activities for the
Kumamoto Disaster at the Japanese Society of Psychiatry and Neurology, and lectures in Kumamoto
Prefecture itself. Additionally, we regularly attended conferences of the Research Division of the Miyagi
Disaster Mental Health Care Center, supported its research projects, and assisted with its data-gathering
projects. Finally, we collaborated on the Miyagi Disaster Mental Health Care Forum put on by the Center.
With regard to our research activities, we submitted our research on the mental health of employees ofsocial welfare councils (Ueda et al., 2017) to PLoS ONE, and our research showing an increase in patients
admitted to the Kesennuma Regional Psychiatric Hospital following the disaster (Sakuma et al., 2018) toAsia-Pacific Psychiatry. Additionally, at the 16th Meeting of the Japanese Society for Traumatic StressStudies, Sakuma’s presentation on “Long-Term Progression of PTSD Symptoms Following Large-Scale
Disasters” won the Best Presentation Award, and Shoji’s presentation on “Research on Psychological
Recovery Skill Intervention” won an Outstanding Presentation Award. Finally, in collaboration with the
NEC Solution Innovator, we are engaged in a research initiative to develop a health promotion support
program for community residents that makes use of information communication technology (ICT) andincorporates the cognitive behavioral therapy approach.
In the future, we will hold our relationship with the Miyagi Disaster Mental Health Care Center in highregard, and in order to achieve the expansion of community mental health care in Miyagi Prefecture and thedevelopment of preventive psychiatric approaches, we will continue our comprehensive support, education,and research activities, including support for hometown supporters, spreading of the cognitive behavioral
approach, spreading of support for psychological trauma, strengthening of the relationship between mental
health care agencies and schools, spreading and raising of public awareness of disaster psychiatry, anddevelopment of countermeasures and policies for suicide and workplace mental health.

－ 89 －

Research Report

Support in Disaster-Affected Regions by a Organizationthat Treat Alcohol Addiction
Toshihiro Suzuki – Director, Psychiatric Social Worker
Recovery & Support Group, Medical Corporation Tohokukai, Tohokukai Hospital

Introduction
There is a prayer, known as the “Serenity Prayer,” that has been passed down inside the alcohol addition
self-help group (hereafter, SHG) A.A. (Alcoholics Anonymous).
“God grant me the serenity to accept the things I cannot change, the courage to change the things I can,and the wisdom to know the difference.”
This prayer is attributed to American theologian Reinhold Niebuhr 1). Because of this prayer, themisunderstanding that A.A. might be a religious group has not yet been dispelled. Nevertheless, if one wereto speak without fear of inciting that misunderstanding, they would find it difficult to not acknowledge that
Western-centric Christian culture and the birth of SHGs are inextricably linked 2). The people who
communicated to the world that alcohol addiction is an illness from which people can recover were nothealthcare professionals; they were the patients involved in the founding of A.A.And in the present day,many specialized medical organizations that do not have access to means more effective at achieving
recovery than those of SHGs ultimately end up sending their patients to them. In this article, I would like tofocus on supporting the founding of SHGs and highlight their necessity.
1. Support in FY 2017
(1) Outline
The nature, breakdown, and numerical count of each of our support activities in FY 2017 can be seenin Figure 1.
“Network coordination activities,” essentially a prerequisite for any sort of support, remain acornerstone of our activities.
As for our specific support activities, we were involved most frequently in SHG founding work (asdiscussed in the introduction) and our established support work, “Mutual support group support,”
which we continue to carry out in the Motoyoshi area of Kesennuma City, Ishinomaki City, and Natori
City.
Repeatedly engaging in practice in a particular area is an effective method to strengthen our
relationship with it; therefore, we continue to propose case studies to various areas. These actions haveborne fruit, and we had four times as many case studies this year as we did last year.
Training projects for supporters have decreased in number compared to two years ago, but they still
occur at an approximate frequency of once per month.

－ 90 －

Research Report from the Department of Preventive Psychiatry(2) Cultural Barriers
Our hospital has been involved in SHG founding support in coastal areas since 2013, alongside
MDMHCC and the Miyagi Danshukai, NPO. These efforts included support activities that brought up
the question of why there are so few SHGs in coastal and rural areas.
Soon after the earthquake, the distribution of material goods stopped. I have heard stories ofAmerican and European people taken aback by footage of disaster survivors quietly and naturally
lining up at the doors of large supermarkets that they did not even know would open.
When our disaster survivors are asked about the hardships they have been through, they often say“There are others who are suffering much more…” We have all seen how reluctant they are to give
voice to their own struggles. Here lies a clear difference between our culture and that of the West.
Though we do not voice the ideas that “we will not shame ourselves” or that “we will not complain,”
our culture nevertheless holds them in high esteem.
Christian culture, with its ideal of surrendering oneself to some higher existence, teaches people
that their individual mistakes and weaknesses will be forgiven. This is quite different from theprevailing attitude in cultures where whether an individual’s mistakes can be subsumed or eliminatedfrom the community is of critical importance.
A culture’s tolerance of alcohol is reflective of its subsuming capability, and expulsion, imposed on
individuals who test it beyond its limits, is a severe punishment. I have experienced the reality of that
ideal in support, too.
(3) SHG Founding Support
That SHG activities should be voluntarily engaged in by the people who need that help goes. In orderto maintain their temperance, residents of a particular area who suffer from alcohol addiction form agroup and meet weekly on the same day and at the same time to interact with other patients likethemselves. That is the basic structure of a SHG.
However, it has not been easy for this basic structure to form in coastal areas.
Thus, we first devoted our efforts to incorporating stories of addiction from actual alcoholics into
our alcohol problems training courses for community supporters. We aimed to have these supporters
carry with them specific images of the affliction itself and how people recover from it in their activities.
In order for an SHG to really take hold in a community, participants from a particular region arecertainly necessary, as I have explained before. However, implanting a culture of “coming out,” where
one can share one’s “shame” or “weakness,” is also very important. If we consider how sensitive
addicts can be to others’ opinions and judgment of them, we can imagine just how difficult that mightbe.
It is not uncommon for first-time patients to say things like “What’s the point of exposing myshame to everyone?” That attitude cannot be deconstructed with logic. Showing people who areskeptical the smiles of other individuals who have been through the same things as they have is most
－ 91 －

Research Reporteffective. “Talking about it makes it easier.” That practice will help change the act of “exposing one’s
shame” to “gathering the courage to change what I can.” “Complaining” becomes “speaking honestly.”
Supporters who listen to the stories of former addicts, etc., often experience a change in theirperception of behaviors that their culture views negatively.
Repeating this sort of experience naturally motivates supporters to want to communicate these ideas
to addicts. In this way, supporters, addicts and other concerned parties invited by supporters, andSendai Danshukai members have come to meet once a month for “Meetings for Temperance.”
The primary organizer of these meetings is the city government. Another important key to thefounding of SHGs in a disaster region is the securing of a venue. Because the government assists us in
holding our “Meetings for Temperance,” we enjoy the benefit of being able to use the facilities ofpublic organizations in good condition.
As a result, we were able to move to the independent holdings of “Meetings for Temperance” asregular meetings of Danshukais in the Motoyoshi area of Kesennuma City and Natori City.
An important part of being a supporter is ultimately yielding to the individual experiences of eachparticipant.
At present, in Ishinomaki City, the Miyagi Disaster Mental Health Care Center, Ishinomaki
Regional Center organizes “Meetings for Temperance” with the support of the city itself and plans tocontinue to do so.
Because of the traditional rule of SHGs, A.A. cannot engage in organizational activities, but I
would like to point out that motivated members have started their own SHGs in disaster-affected
regions independently.
2. The Significance of the Basic Act on Measures Against Alcohol-Related Harm
Seven years have passed since the disaster, and municipalities in various areas have shifted fromrecovery projects to their usual business. However, the question of how to incorporate post-disastermeasures against alcohol-related problems into this usual business remains an important project.
In 2013, the Basic Act on Measures Against Alcohol-Related Harm was passed, and in 2016 theBasic Plan for Promotion of Measures Against Alcohol-Related Harm was drafted. At present, in
accordance with this basic plan, administrative regions throughout Japan and certain designated cities
are in the midst of promoting the formulation of promotion plans of their own.
The changes brought about by this legislation happened to coincide with work on the question of
how to incorporate post-disaster measures against alcohol-related problems into the usual business ofvarious municipal areas.
In order for regional municipalities to become aware of and work towards a solution for this issue, it
is important for them to make use in peacetime of the post-disaster alcohol-related problem support
work we engaged in ourselves over the last seven years.
One important element in solving this problem are SHG resources in coastal areas.
3. Practical Training for Alcohol Addiction Treatment
From May 2012 to August 2014, we held practical training courses for alcohol addiction treatment for
employees of the Miyagi Disaster Mental Health Care Center and employees of coastal area psychiatrichospitals at our facility. Altogether, 97 people took part in these trainings. Furthermore, since January
2014, we have offered training for municipal mental health workers inside Miyagi Prefecture, and wewill continue to do so until February 2018.
By deepening our understanding of the treatment of alcohol addiction and the findings of ourprogram, we hope to be able to put our discoveries to use in our work in the community as well as to beable to communicate a clear, specific treatment image to subjects when they are referred to specialized
treatment programs. Additionally, because this training allowed us to become acquainted withpractitioners in the community, it has strengthened our ability to collaborate with them.
In the sense that we are currently running a specialized program, we are the only medicalorganization in the prefecture that specifically deals with the treatment of alcohol addiction. When
coming up with countermeasures, it is critical that we consider how best to expand both ourcollaborations with the community and the community’s ability to respond to such issues.
－ 92 －

Research Report from the Department of Preventive Psychiatry

Making use of the “weak point” of this issue—the fact that it cannot be treated and recovered fromexclusively through the actions of any one medical organization—we began to implement our training
programs following the disaster, which we believe has led to a strengthening in peacetime anti-alcohol
measures.
Over the last six years, 176 employees from various affiliated organizations have taken our training.
Their training evaluation questionnaires indicate that 98% of them believed it was “very helpful,” andthe remaining 2% found it “slightly helpful.” We received 0 responses saying that the training was, on a
5-point scale, either “neither helpful nor unhelpful” or “unhelpful.” In the future, we plan to continue
this training as one that teaches practical techniques usable in actual situations.
4. Regarding our Seven Years of Support(1) Outline
The total number of support activities we have engaged in over the last seven years is 803, and the total
number of employees who have participated in these is 1,518.
As can be seen in Figure 2, the number of support activities per year has decreased yearly, but in
FY 2017, due to efforts to strengthen SHG founding support, we had 88 support activities, more than in
the previous year.
Figure 3 lists the areas and communities to which we traveled for support activities, and the numberof activities performed in each.

Figure 2: Changes in Support Activity Counts by Fiscal Year, March 2011–March 2018 (N = 803)

－ 93 －

Research Report
Figure 3: Support Activity Counts by Region, March 2011–March 2018 (N = 803)

Figure 4 gives a breakdown of each of our support activities. “Network coordination activities” arethe starting point of our activities, with 208 cases. “Case studies” and “Support for supporters training”
rival each other at approximately 150. As can be seen in Figure 5, a change-over-time graph,“Individual survivor counseling support” was most active in the three years immediately following thedisaster, which is where nearly all of the 108 cases occurred. After the third year, “Mutual support
group support” essentially took its place, and the attention we paid to that gave us 103 cases.

Figure 4: Support Activity Counts by Type, March 2011–March 2018

Figure 5: Changes in Support Activities by Type Per Year(2) Regarding Supporter Group Work
We had a total of 41 cases of “supporter group work” support over the past seven years—by no meansa large amount. In fact, all of these cases took place in the first three years following the occurrence ofthe disaster in 2011; we had 0 such cases after 2014. However, we believe that these cases represent an
important yardstick with which we can characterize the nature of our support activities in the earlyyears following the disaster; we will therefore discuss them in this article.
The beginning of the continuous disaster-area support activities of this hospital too place in a “Good
Sleep Café” run in the emergency temporary housing set up in a particular town. At the time—three tofour months after the disaster—we learned that the primary issue troubling community residents who
had been affected by the disaster was lack of sleep. We believed there was something we could do to
help. Thus, every two weeks, inside the emergency temporary housing area, we set up a café where－ 94 －

Research Report from the Department of Preventive Psychiatry

survivors with trouble sleeping could come to get tea, have someone listen to their worries, and, if
needed, receive mood stabilizers or sleep-inducing drugs from a psychiatrist, all free of charge.
In September 2011, half a year after the disaster, the support groups and supporters who had
gathered from around the country slowly began to leave. We also closed our “Good Sleep Café”
around this time. However, when we offered to provide continued support to the town’s public healthnurses, we received a request for support for survivor lifestyle supporters who could perform support
for residents of temporary housing.
We implemented an emergency hiring plan, recruited residents from the local social welfare council,
and began our survivor lifestyle support activities. We employed a framework wherein survivors wereable to support other survivors.
Normal residents without any particular specialized skills underwent training before participating in
support activities.
The day that we received the support request from the public health nurses of the town, we had totell everyone of the news as soon as possible, so we had them all assemble for a pow-wow.
At our hospital, we implement a daily group work program. We used its methods to have our
supporters speak in turn about the things that were currently bothering them. As they spoke, we sawthat the faces of our supporters had turned hard, calcified by exhaustion.
The origin of the group work carried out in medical facilities as a treatment for alcohol addiction isin the SHG.
It is nothing but an environment in which people can verbalize their problems, worries, andsymptoms, and have the wisdom they use to solve them become part of a “problem book” and acommunity by and for them.
A support staff member said that they were so “worried” about Mr. C, a resident of temporary
housing that had become addicted to alcohol, that they “couldn’t sleep at night.” A facilitator told them,“That’s because you care so much about Mr. C. How would it feel if someone cared about you?” Thestaff member responded “Good…” in a shaky voice. “Isn’t that proof that you’re helping treat Mr. C’s
loneliness?”, the facilitator responded.
This exchange doesn’t happen in SHGs, but by using technique-based support and dealing with thesupporter’s own mental health in this way, we continue to empower supporters.
By creating a community where Mr. C wouldn’t feel alone, that staff member eventually helped
him stop his drinking.
Given the scale of the Great East Japan Earthquake, the reach of private support is limited.3 We
believe that from the perspectives of cohesiveness, functionality, and efficiency (enabling theproviding of knowledge to multiple people while simultaneously working with their emotions, worries,
and other mental health issues), and as a method that empowers disaster-affected regions to help
themselves, group-based approaches should be used in disaster scenarios.
5. Conclusion
After our first group work session ended, we asked support staff to share a comment each on theirexperiences.
“I thought I couldn’t do anything, but I realized I was actually helping.” “By speaking and listening
to others speaking as well, my heart grew lighter.” “It helped me realize that things aren’t that bad. I feelbetter.” The expressions on our supporters’ faces relaxed, and some even began smiling.
It is undeniable that by founding a SHG, these individuals were able to speak and hear of eachother’s experiences, and thereby help each other recover.
Shinichiro Kumagaya, a pediatrician and Associate Professor at the University of Tokyo ResearchCenter for Advanced Science and Technology, says that “Independence is increasing the number ofthings you depend on,” and “Hope is sharing your despair with another.”4
Independence and dependence or addiction are not at odds with each other and hope and despair are
not antonyms. These paradoxes can connect to the wisdom individuals can gain on their own issues. If
you think of alcohol use as a symptom of a disability wherein one finds it difficult to connect with otherpeople, stopping alcohol use is merely symptomatic treatment. It then becomes clear what exactly ought
to be treated.
－ 95 －

Research Report

There are approximately 14,000 psychiatrists in Japan, and I have never even seen a figure for how
many of them are involved in the specialized treatment of alcohol addiction. In contrast, the estimatedtotal number of alcohol addicts is said to be 1.09 million, of which over 1 million are believed to be
untreated. If we were to liken the situation to an ascent of Mount Everest, treatment is Base Camp, andseveral hundred Sherpas—mountain guides—are helping the patient become able to attack the summit.
Base Camp itself will not function without the Sherpas. With Base Camp as their home base, climbers
move back and forth between the first through the fourth camps, acclimating their bodies to the low
oxygen environment. In the climb towards recovery, there is no summit. The back and forth, up anddown process to and from the safe home back at the SHG camp is recovery. It is critical that we use thisbig picture perspective to determine what is most important.
References
1) Oki, Hideo. Eschatological Discussions. Chuokoron-sha. 1970.
2) Saito, Manabu. In Search of a Family for the Soul: My Self-Help Group Theory. Nippon Hyoron
Sha. 1995.
3) Otsuka, Kotaro, Hiroshi Kato, Yoshiharu Kim, Kazunori Matsumoto. Mental Health in Disaster
Situations. Igaku-Shoin. 2016.
4) Kumagaya, Shinichiro. The Night of Rehabilitation. Igaku-Shoin. 2009.
① Kumagaya, Shinichiro & Ayaya, Satsuki. Methods of Connection. NHK Publishing. 2010.

－ 96 －

Research Report

Projects for Alcohol-Related Problems in FY 2017
Takao Ohira - President
Non-Profit Organization Miyagi Prefecture Danshukai

Introduction
Seven years have passed since the Great East Japan Earthquake. The reconstruction of houses has allowed
many to move from emergency temporary housing to disaster public housing. However, the physical,
psychological, and social problems caused by this disaster continue to grow ever more serious.
We of the Miyagi Prefecture Danshukai believe it to be quite possible that in a disaster-affected region,
the various problems survivors have to bear and their inability to be sure about their futures might lead to
the worsening of alcohol-related problems. Thus, we have worked in collaboration with the Miyagi Disaster
Mental Health Care Center (hereafter, “Mental Health Care Center”) and governmental/medicalorganizations to undertake various projects related to our establishment of programs to educate the public on
alcohol abuse and to hold regular temperance meetings.

1. Outline of Activities in Each Prefectural Region(1) Regular Temperance Meetings in the Motoyoshi Area of Kesennuma City.
<Visitations temporary housing ⇒ meetings to discuss temperance ⇒ regular meetings of theDanshukai>
After the disaster, in FY 2012, we began to get involved in alcohol abuse awareness and theformation of a Danshukai in the Motoyoshi area of Kesennuma City. Thanks to the passionate
discussions of participants and the contributions of other individuals affiliated with the project, in May
2014, we were able to change our little “Talks about Temperance” meetings into regular temperance
meetings—the Motoyoshi regular meeting—overseen by the prefectural Danshukai and held on thethird Monday of every month. Since then, we continued to hold these meetings once per month throughFY 2017. We were also generously gifted the use of the volunteer room at the Motoyoshi Health andWelfare Center, “Rest,” by the Motoyoshi General Branch.
The attendees of these meetings included the participants and their families who had attended theprevious “Talks on Temperance” meetings, public health nurses, local medical organization affiliatedpersonnel, the Mental Health Care Center, the social welfare council, and staff from the Tohokukai
Hospital Community Support Division. Some came all the way from Sendai.
(2) Ishinomaki Alcohol-Related Problems Training Session
In February 2015, we began this project in collaboration with governmental and medical officials as apart of the post-disaster alcohol-related problem countermeasures enacted by the Ishinomaki City,
Kahoku Town General Branch Office. We met on the second Thursday of each month at the Kahoku
General Branch Office Health Center, and used the regular temperance meeting model, with theaddition of the comparison of guidelines and examples.
Attendees include participants and their families, the Mental Health Care Center, governmental
officials, local support organization staff, and staff from the Tohokukai Hospital. These people
discussed their feelings and thoughts, and more than 15 people turned out to each meeting. Valuable
experiences were had, including the meeting of new friends in a new place, and new relationships
through deep mutual support. In our discussions of our directions for FY 2017, we brought up the ideaof selecting a location easier for participants and their families to access and realizing future“lunchtime meetings” for the Danshukai. Additionally, given the rise in the number of individuals
suffering from alcohol-related problems in the Ishinomaki area and the worsening effect the move into
disaster public housing may have on their problems, we changed our meeting place in May 2017 to the“Conference Room” of the Ishinomaki City Health Counseling Center. Throughout FY 2017, the－ 97 －

Research Report from the Department of Preventive Psychiatry

Ishinomaki City Alcohol-Related Problems Training Sessions were held on the second Thursday of
every month. They continued to be based on the regular temperance meetings model, and included
comparisons of guidelines and examples, as well as honest discussion of each participant’s self.
(3) Natori Area Regular Temperance Meetings
This project, begun in March 2015, happened in response to increasing demand for regular temperance
meetings in Natori City, Iwanuma City, and Watari Town.
In FY 2015, we met at 2 PM on the second Monday of every month in the Natori City HealthCenter. In line with our theme of “Let’s listen to the stories of people who have stopped drinking
alcohol,” we began by first listening to the personal stories of participants. At the time, the project was
primarily overseen by the local government, with the Danshukai participating in a cooperative capacity.
In FY 2016, we held “Meetings for Temperance” (every second Monday) in a similar fashion, withthe local government as the primary organizer and the Danshukai cooperating.
After discussions regarding the nature of the project moving forward into FY 2017, we decided in
April 2017 to shift to adherence to an original goal of the project since its founding: Regular meetingsof the Danshukai. Natori City provided us with a conference room on the second floor of the Natori
City Health Center as a venue for our activities, and we began to hold regular Natori area temperance
meetings every month. Attendees included local participants and their families, Natori City HealthCenter employees, Mental Health Care Center staff, public health nurses from the Iwanuma City Social
Welfare Council, and Tohokukai Hospital Community Support Staff.
2. Looking Forward
We of the Miyagi Prefecture Danshukai believe that our activities are yet insufficient in comparison to theextent of the damage caused by the disaster. However, we strongly affirm our duty as participants in ourcollaborative groups to “continue speaking about experiences and recover together.”
Looking forward, we plan to strengthen our relationships with governmental and medical officials andheighten the mutual trust between ourselves and the supporters who work so tirelessly in the difficult
conditions present in disaster regions. We wish to end this report with an affirmation of the fervent hope that
our efforts may lessen even slightly the plight of those affected by alcohol-related problems.

－ 98 －