Other Initiatives
Medical Corporation Toghokukai, Tohokukai Hospital
Tohoku University Graduate School of Medicine, Endowed
Department of Preventive Psychiatry
Miyagi Psychiatric Center
Miyagi Danshukai, an NPO
JASWASupporters’ Club (Heart and Mind Counseling/Relaxation
Salon Project)Disaster Support for Alcohol-Related Problems
Medical Corporation Tohokukai, Tohokukai Hospital, Community Support Division
Psychiatric Social Worker – Toshihiro Suzuki
1. Introduction
The number of support cases for alcohol-related problems in disaster areas handled by thishospital has reached 423 in the last three years. The monthly average is about 11 cases.
Approximately 70% of that total has been carried out under contract from the MDMHCC.
Three years have passed since the disaster, and the needs of the affected areas have changed
depending on the situation.
At our hospital, we hold weekly disaster support meetings to discuss the ideal form of support,
centered around support for supporters, and to examine case studies. Whenever I have traveled todisaster areas to provide support, I have been reminded of how difficult it is for alcohol-related
problems to become apparent, and of how difficult it is for the region to respond even when they do.
I would like to report on a part of our work and on our support performance statistics.
2. Disaster Support by Tohokukai Hospital
Figure 1 shows the number of monthly support cases for the three years from immediately after
the earthquake to March 2014, and Figure 2 shows the number of support cases by region.
Figure 3 shows the number of cases by type of support, and Figure 4 shows how the content ofsupport changed by year.

2011 March2011 April
2011 May
2011 June
2011 July
2011 Aug2011 Sep
2011 Oct
2011 Nov
2011 Dec
2012 Jan2012 Fab2012 March2012 April
2012 May2012 June2012 July2012 Aug2012 Sep
2012 Oct2012 Nov
2012 Dec
2013 Jan2013 Feb
2013 March2013 April
2013 May
2013 June2013 July
2013 Aug2013 Sep
2013 Oct2013 Nov
2013 Dec
21014 Jan2014 Fab2014 March

N (total)=423; 3/2011–3/2014

Figure 1: Support Cases by Month- 76 -N (total)=423; 3/2011–3/2014

SendaiIshinomaki
Shichigahama
Minamis Kesen Higashim
Naruko Watari Tagajo Natori Onagawa othernuma atsushima Yamamoto Iwanuma
anrikuShiogama

Figure 2: Support Cases by Region(One case can encompass multiple types); 3/2011–3/2014
Networking activities
Support for supporters training
Individual survivor counseling/visitation
Case study
PR activities
Supporter group work
Surveys (Pre-Activity Oral Surveys and Health Surveys)
Survivor group work
Disaster-affected resident supportSurvivor aidCases

Figure 3: Cases by Support Type- 77 -Research
Supporter group work
PR activities
FY 2013
FY 2012FY 2011

Individual survivor counseling/visitation
Case study
Support for supporters
training
Networking activities

Figure 4: Support Cases by Type and YearIn FY 2011, in the earliest days of the post-disaster period, our activities were primarily
groundwork oriented: we obtained information on the problems of individual cases while handing out
PR flyers throughout the region, consulted on individual cases as necessary after coordinating
cooperation, and visited with local supporters. In FY 2012, the number of regular case studies andindividual visits/consultations increased through our collaboration with the MDMHCC, which led toa request for the improvement of supporters’ technical skills, thereby causing an increase in supporter
workshops in 2013. In recent years, the World Health Organization’s “Global Strategy for Reducing
Harmful Use of Alcohol” has led to major changes in intervention methods and ways of thinking
about alcohol-related problems, which has helped raise awareness about the gravity of these issues.
3. Empowerment of Local Supporters
From FY 2012 to FY 2013, we have put more effort into our training; specifically, we haveincorporated the experiences of recovered persons with the cooperation of members of AA and theDanshukai, both alcoholism self-help groups. The purpose of this was to give local supporters animage of recovery from alcoholism. Our training sessions have thus become opportunities forsupporters to learn that pre-technical support relationships will change significantly depending on
the presence or absence of this image.
We have held a total of 81 training sessions incorporating a variety of topics, including thefollowing: “What are alcohol-related problems?” “Intervention and response to alcohol-relatedproblems,” “Treatment and recovering from alcoholism,” “Recovered addicts’ stories,” and“Support for families.” In addition, we conducted a one-week intensive practical training at ourhospital for supporters and medical staff in disaster areas, where we accepted a total of 57 people
and focused on regional human resource development and technical guidance. We have also
continued activities to support the establishment of self-help groups in affected areas.
4. Wrap-Up
The average number of new patients with addiction admitted to our hospital in the three years
after the earthquake was 57, an increase of 21% from three years before the earthquake. This is justthe number of patients with addiction at one medical facility. In Japan, there is still a lack of scientific
data on alcohol-related issues after a large-scale disaster.
According to Dr. Isao Nukada, a physician who provided treatment to temporary housing
residents after the Great Hanshin Earthquake in what was once the largest district of Kobe, Seishin,when alcohol becomes a factor in cases of middle-aged men who live alone and are in dire financial
straits, many fall prey to “death by loneliness” 1).
Alcohol-related problems, as the name implies, are not merely issues related to the disease called“alcoholism.” Individuals affected by these problems are those who seek to temporarily reduce thepain and hardship they feel in their everyday lives with the drug called alcohol. However, this shortlived salve will eventually damage their physical and mental health, deprive them of their social- 78 -

position and connections, and lead to the collapse of their lives. The footprint of the problems thatarise through this process is large. It is necessary to understand the entire structure of this issue andto build a regional network of intervention and response. We would like to continue to support
endeavors that seek to do so.
1) Isao Nukada, “Death by Loneliness: Human Reconstruction in the Disaster areas of Kobe.”
Iwanami Shoten, 1999.

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