Miyagi Disaster Mental HealthCare Center Management Plan
(2017–2020)－169－

－170－

－171－

Miyagi Disaster Mental Health Care Center
Management Plan
(2017–2020)(Public Interest Corporation)
Miyagi Prefecture Mental Health & Welfare Association
Miyagi Disaster Mental Health Care Center－172－

Contents
1. Purpose of plan

2. Basic principles and policies

3. Reconstruction status of disaster area and future tasks

4. Policy for future initiatives

5. Components(1) Support for local residents,(2) Support for supporters,(3) Raising public awareness,(4) Human resource development,(5) Research studies

6. Plan implementation

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1

Purpose of plan

The Miyagi Disaster Mental Health Care Center (MDMHCC) was founded in December 2011; the StemCenter was then established; and the following April the MDMHCC opened regional centers in Ishinomaki
and Kesennuma. During the period of the restoration plan, within the framework of the restoration period,
activities have advanced around the axes of the following six projects: 1) Support for local residents, 2)
support for supporters, 3) raising public awareness, 4) human resource development, 5) research studies, and6) support for various activities.
Six years after the earthquake, within the disaster area, although each area is different, people are movingfrom temporary housing into public housing and reconstruction is progressing, while at the same time there
are still problems in daily life and many people who have mental health problems. As circumstances change,
there is a need to assess and make needed modifications at this time.
In addition, the reconstruction plan for prefecture, approximately 10 years after the earthquake, has entered
the final stage of the period of regeneration, with a view to the development period from 2018 to 2020, withthe 2020 fiscal year as its final term. The ten-year reconstruction plan has passed the point of no return, andas these activities wind down it is also a time for us to clarify the goals we set as we move forward. Basedon an awareness of these circumstances, the center has clarified its operational goals for its next four years,
formulated an action plan, and compiled a management plan. In the course of this work, we reviewed past
activities and conducted internal studies, asked the local authorities in the disaster area about the current andfuture activities of the center, and also directly exchanged opinions. We also looked at survey results foreach prefecture.
What became clear in this process is that certain evaluations have been made about the activities of ourcenter, and that in the future we will focus on support for both victims and supporters. In constructing a
regional mental health welfare system, there is a strong demand for support for victims and supporters,
human resource development, and related issues. In order to respond to these demands, we need to advanceour activities based on the action plan specific to the end of the term.
In addition to support activities for disaster areas, the center has a historical mission to leave behind thedetails of its activities and lessons learned and to gather and pass along our experience for future disasters.
We summarize the facts and lessons concerning the management and practices of our center, compile andanalyze the data obtained from these activities, examine the quality of these activities, and summarize themfrom the standpoint of reporting and research.
We also have a responsibility to make policy recommendations drawing upon the compilation of activities
on the basis of pre-disaster preparedness, the response at the time of the disaster and thereafter, and theconstruction of a mid- to long-term regional mental health welfare system based on the experience gained
during the disaster.
Mental health care after the earthquake was not limited to support only for the afflicted areas, and has gone
beyond the framework of the reconstruction plan. In the long term, in the wake of the earthquake theregional mental health and welfare system will likely expand to reach a wider area and continue to develop
in form. As a cornerstone of this work, we have formulated a management plan, and we think that we should
first tackle the final phase of the reconstruction plan.

Akira Kodaka, President
Miyagi Disaster Mental Health Care Center－174－

2. Basic principles and activity policies
We have established the following policies, which encompass the basic principles of our center,taking into account both past policies and the entity for which it is being established, the Miyagi
Prefecture Mental Health & Welfare Association (Public Interest Corporation).

“Improving community mental health and welfare in affected areas”

The basic policies that govern the center’s activities have been presented in the context ofmanagement policy until now, but they are laid out once again below.
(1) Support for victims is developed through mental health care activities centered onoutreach conducted through cities and towns.
(2) Support for supporters consists of multilateral support such as consultations and mental
health programs.
(3) Enactment of a plan to provide “uninterrupted support for everyone, from children to
adults” is based on a prefectural reconstruction plan.
(4) Support activities are provided for community mental health according to circumstancesin disaster-affected cities.
(5) Summarize activities that will contribute to future measures and research to deal withlarge-scale natural disasters.

－175－3. Reconstruction status of disaster area and future tasks

I

Reconstruction status of disaster area

In the six years that have passed since
the Great East Japan Earthquake, thesituation of the area has substantiallychanged. According to a survey
conducted by Miyagi Prefecture, as ofthe end of November 2016, the numberof people in prefectural temporary
housing was 14,465, and the number ofresidents in private temporary housing
was 10,416. As of April 2012, thenumber of people in prefabricatedtemporary housing units was 53,269
people, and the number in private
leased housing was 67,753; since that time, these numbers have declined greatly (Fig. 1).
Meanwhile, the maintenance of post-disaster public housing has also been underway, and within the
21 municipal towns of the prefecture, 12,039 houses underwent maintenance service, with the completion
rate reaching 75.3%. In Miyagi Prefecture the “reconstruction period” is defined in the plan as a period often years from the time of the earthquake, which is divided into three periods: restoration, regeneration, anddevelopment. During the restoration period, the foundation of daily life and public facilities are restored,
and this period focuses mainly on support for victims, not only providing support to those who weredirectly affected but also enhancing support for those whose lives and businesses were indirectly affected;
during the regeneration period we will improve infrastructure within the prefecture; and during thedevelopment period we are establishing a period of intensive advancement. (Excerpt from the “Miyagi
Prefecture Recovery Plan.”) According to this plan, the regeneration period has one year left after having
begun in 2017, and the development phase will be carried out in 2018–2020. The steps toward recovery
appear to be steadily advancing. The actual situation, however, involves several issues. The move fromdisaster housing to public housing is proceeding, but many residents are confused about their new lives andmany feel isolated because they are not familiar with the community.
Mental health factors (K6) in the health survey have not returned to pre-disaster levels, and the abovementioned plan that is advancing each year is not necessarily synchronized with the mental health levels ofresidents.

II. Work to date in the Miyagi Disaster Mental Health Care Center
In response to mental health issues in the disaster area, the Miyagi Disaster Mental Health Care Center(hereafter referred to as the “Center”) opened the Miyagi Disaster Mental Health Care Center Stem Center(hereafter referred to as the “Stem Center”) in December 2011; the following April this was followed by the
Miyagi Disaster Mental Health Care Center Ishinomaki Regional Center (hereafter referred to as the“Ishinomaki Center”) and the Miyagi Disaster Mental Health Care Center Kesennuma Regional Center(hereafter referred to as the “Kesennuma Center”).
By the time the Kesennuma Center and Ishinomaki Center opened and full-scale operation commenced
throughout the entire prefecture, more than one year had passed since the disaster, and at that time several
support groups had already developed activities in various areas. For that reason, the starting point for our－176－activities was to seek the role that would be most beneficial for the region while supporting the activities
that local government officials and regional support organizations had been working on. The circumstancesand needs differed greatly from region to region, and it was a matter of finding our way forward on a daily
basis.
We work in six areas: 1) support of local residents, 2)
support for supporters, 3) human resource development,4) raising public awareness, 5) research activities, and 6)
support for various activities (Fig. 2).
After the earthquake, Miyagi Prefecture conducted ahealth survey among residents of prefabricated and othertemporary housing, and a follow-up was carried out by
each local government. The role of the Center at that time
was often to cooperate with such follow-ups and to
conduct subsequent visits and interviews as needed insupport of local residents.
In addition to providing personal assistance skills andcase studies for supporters such as visiting staff members,
centering on support for individual local residents, outside employees were dispatched to local governments
as support for supporters; in addition, we convened meetings to exchange ideas and conduct various
trainings, including stress management, efforts that were directed toward cultivating human resources.
Also, since concern in the region was high concerning PTSD, alcohol-related problems, grief reactions,and other issues, we issued various brochures and magazines as part of raising public awareness.
Throughout all of our work, while keeping in mind our main focus on post-disaster mental health care, we
flexibly responded to a wide range of support needs not limited to the aftermath of the earthquake.
III. Issues gathered from Community Support Division and opinion exchange meetings with coastal
municipalities
Activities at the Center so far have consisted mainly of projects providing support for local residents,
support for supporters, human resource development, and related issues. From now on, however, for the
purpose of creating a new community, we will be providing support for various local activities, as well assummarizing the problems and practices in the disaster areas that have been encountered until now andconducting research training projects for the purpose of transmitting this information to future generations.
Now that six years have passed since the earthquake, we need to review the priorities and results of ourefforts again, and take actions commensurate with the current situation at this time. In order to understandthe current situation in the disaster area and clarify what the Center will do in the remaining period of thereconstruction plan, the Center issued opinions on regional issues from the Community Support Division ofeach regional support section; in addition, we conducted questionnaire surveys and created opportunities for
opinion exchange for the relevant municipalities.
The following items are particularly noteworthy among the issues identified by the Community Support
Division.

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(1) Response to alcohol-related problems.
Since the earthquake, local authorities have been concerned about alcohol-related problems, andinitiatives such as workshops for support personnel and self-help groups have been conducted. The
sense of struggle among supporters is still deeply rooted, however, and self-help groups are being
launched in several areas, but there are still situations where local communities have not been able toact on their own initiative.
(2) Issues related to the move to reconstructed housing.
While moving to reconstructed houses in various areas, there have been examples of cases where
human relationships cultivated in temporary housing were truncated, as well as cases of people feelingisolated because they were unable to adapt easily to the new residence. It is necessary to work toward
helping people build new relationships at their new addresses.
(3) Issues due to withdrawal of support groups.
In the six years since the disaster, withdrawal of support groups from the prefecture continues. As aresult, at times the places where people used to gather or mingle are lost. Collaboration with local
support organizations and a smooth transition calls for consideration so that the needs of residents will
not be neglected.
(4) Problems concerning children.
The problems of withdrawal and truancy due to changes in living environment have become apparent;
there have also been reports of bullying and parental abuse. Responses that include educational
officials are needed.
(5) Health administrative staff.
The results of a survey administered for administrative staff from the Council of Social Welfare
showed that although improvements have been observed from the time immediately following thedisaster, the situation is still worse than it was prior to the disaster. Staff have been extremely busy
with their work since immediately after the earthquake, without sufficient recovery from the stress ofthat time.
In addition, from the questionnaire survey and opinion exchange meeting conducted by the Center in
December 2008 for those in charge of the 13 municipalities in the coastal area, the following tendencies
became clear.
(1) Changes in health survey
Among requests made to the Center sofar, many have had to do with prefecturalprojects such as visits and interviews tofollow up on the health survey conductedby the prefecture. This survey was
conducted
amongresidentsofprefabricated and temporary housing; it
made clear that while their numbers havedecreased since they peaked in 2014,
health surveys for those in disaster public
housing peaked in 2017 but are now
gradually returning to normal (Fig. 3).
Since some municipalities do not have
temporary housing, the proportion of follow-up
work after the health survey will likely decreasein the future.
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(2) Changes in the local community
In the question items concerning the local
community, the percentage of respondents who
replied that “the community prior to theearthquake has been maintained” was low, while
many responses indicated that the community isin the process of being restructured, or thatvarious situations require certain specificresponses (Fig. 4).
Respondents noted that it was necessary toconsider individual responses to situations, suchas the organization of indoor appliances indisaster public housing, as well as thecoordination with towns as they had existed
before the disaster and subsequently with thepresence of disaster public housing. Regarding
the features of households, many responses
pointed to an increase in single persons and theelderly (including in-home nursing careproviders and requisite support recipients)(Fig 5).
For residents for whom isolation is a concern,
it was suggested that the response not addresseach individual, but rather that it be directed toward the entire local community. In addition, on the question
on the method for accomplishing this concerning the “content of community support,” it became clear that
responses range from individual support such as the opening of an individual consultation counter and home
visits to flexible responses to local community issues, including salon gatherings and self-help groups(Fig. 6).

(3) Regarding the efforts of the Miyagi Disaster Mental Health Care Center① Issues concerning support for local residents.
We confirmed how we anticipate future project volume prospects for efforts implemented by mental
health care centers in collaboration with each local government (Fig. 7). Factors that were expected todecrease in the future included only “mental changes caused by the earthquake disaster, such as PTSD andgrief responses.” On the other hand, many responses stated that “problems due to changes in the educational
environment, such as truancy, withdrawal, and other childrearing problems” would only be expected toincrease.
Regarding other responses, the percentage of respondents who stated that “generally things will stay as
they are” is high, and it seems that current support efforts should continue.

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② Future tasks and prospects concerning support for supporters
We confirmed how to estimate the shift in volume of work involving support for supporters that we havebeen implementing until now (Fig. 8). Only three items, “consultation with public health nurses and others,”“accompaniment for difficult cases,” and “participation in case study meetings,” were not answered
as having “no need in the future.”

The percentage of answers stating that “2. Things will continue to change as they are” for all topics washigh. In addition to consultations on regional support, we observe a strong need for cooperation and advice
for cases that are difficult to deal with.
③ Issues and degree of support in our human resource development project.
Based on the results of the human resource development project that the Center has been conducting so far,we confirmed the necessity of this work in the future (Fig. 9). Overall there were a small number of
responses indicating “no need in the future”; among the items that drew many responses affirming that it“will be necessary in the future” was “suicide-related problems.” For most other items, most respondents
indicated that they are “fine as they are.”－180－

④ Raising public awarenessWe confirmed the prospects for futureneeds concerning the theme of projects forraising public awareness that we havediscussed (Fig. 10).
In addition to voices of supporters callingfor necessary information such as “basic
listening skills” and “stress care and selfcare,” many others called for raising publicawareness of alcohol-related problems.

(4) For many other
Questionnaire items, although the percentage of respondents who wish to continue receiving support ishigh, in the comments participants listed many specific activities that they would like to see our Center
continue, which has resulted in supporting numerical data.
(5) Survey summary.
In this survey, many respondents indicated that they wanted to continue receiving support in the areas
indicated in the questions. Also, from the results collected from the Community Support Division directors
within each regional division and the questionnaire results from local officials, it was confirmed that thesegroups hold similar views on local issues and their future prospects.

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4.

Policy on future initiatives■ Regarding trends in regional needs
 Improvement of the residential environment and related issues is progressing due to factors such as the
progress of earthquake disaster reconstruction projects, as well as maintenance of basic infrastructure,
movement from temporary housing to public housing, and disaster prevention group relocation; future
health survey support is also gradually declining.
 As local communities change and rebuilding becomes an urgent task, the number of various individual
issues to be addressed is increasing.
 Support for local residents affected by the disaster. Although there are some changes in efforts toward
resident support, there were many requests for the continuation of current support, and it is necessary toconsider prolonging the response in anticipation of the need for disaster public housing.
 As for support for supporters, there were requests for strategies to deal with difficult cases in addition to
the continuation of support, and the needs for support are changing.
 As for human resource development, current support continues in many areas, and there were also many
requests for efforts concerning suicide as a theme of training for necessary future work.
 Regional municipalities and other areas. Reconstruction of regional mental health welfare is in process;as needs diversify and increase, there are active continuing requests for support.

There are diverse needs for raising public awareness and related issues, based on the viewpointof community development, which is a major problem for the future.
■ Perspectives on future initiatives
Regarding the policy for future initiatives, in addition to the results of surveys and opinion exchanges
targeting city municipalities for core activities and regional centers and future plan formulation, we haveorganized them as follows, based on policy trends.
● Advance projects while pursuing consistency within earthquake reconstruction plans● Detailed response to regional needs according to reconstruction status● Promoting unbroken care for all ages, from children to adults● Response to new issues and needs that are becoming more diverse and complex● Strengthen collaboration with universities and specialized agencies to respond with greater
sophistication and specialization● Strengthen support for rebuilding the regional mental health and welfare system● Advance initiatives to build inclusive regional care
● Secure an appropriate management system that responds to the progress of the plan and regional needs■ Direction of project deployment.
The Center has established five projects as a mission from the time of its establishment: local resident
support, support for supporters, raising public awareness, human resource development, and research
activities.
In the course of future development, we will continue to support victims, provide support for supportersfrom administrative and other supporting organizations involved in reconstruction, and raise publicawareness for local residents. Keeping in mind changes in regional needs due to changes in theenvironment and the passage of time, we will develop projects with a focus on our priorities.
In our research activities, we will systematically pursue research projects such as policy
recommendations and analysis for the compilation of results from previous single-year projects and thecreation of activity records as archives for posterity.
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【Support for local residents】
 Since the Center was established, we have been deploying support for victims mainly through outreach,and even now we are engaged in a high level of activity; new tasks and the needs of municipalities havealso increased, so we will position our work with a focus on key priorities.
【Support for supporters】
 Support activities in affected areas are diversified along organizational lines, such as administrative
bodies, welfare organizations, and Non-profit organization (NPO). Although the withdrawal of support
organizations continues, they are still important players in local reconstruction. Therefore, we will deal
with the situation as a priority with highly specialized support that responds to various needs.
In addition, as support by means of dispatching specialist staff directly to municipalities, in the future wewill continue the “seconded employee system” that was implemented in 2012.
Furthermore, although we have decided to eliminate temporary (prefabricated) housing, we areconsidering measures such as prolonging support and securing capable people in from municipalities,
and overall we plan to respond flexibly to future needs.
【Human resource development】
Training is needed to upgrade the skills of those providing support; although the volume of activity is
gradually declining, it is essential to rebuild a sustainable system for regional mental health activities,
and we will continue to advance projects as a priority measure and as a response to new issues.
【Raising public awareness】
Temporary housing has been developed for the general population, and going forward, given the risks I
have pointed out concerning the move from temporary to public housing and disaster prevention group
relocation, we will continue to pursue projects as opportunities arise from a preventive point of view.
【Research activities】
We are systematically engaged in research activities focusing on policy proposals and analysis for thecompilation of past single-year projects and the creation of activity records for archives intended forposterity.

－183－5. Implementation plan
Keeping in mind local circumstances such as the status of reconstruction in the disaster area, we willcontinue our support activities. In addition, the following five projects will be implemented, keeping
in mind the support of the system established for the reconstruction of community mental healthwelfare.
(1) Support project for local residents
Activity policy
As a feeling of isolation deepens from changes faced by residents or communities with the psychologicalburden after the disaster, citizen support activities (visit and telephone consultations, etc) are conductedin cooperation with relevant organization for residents who have psychological burdens due to various
factors, connecting them with necessary social resource in improve mental health.
Project content

Main Responsible
Party

1. Support for prefabricated temporary housing
tenants in response to a request from themunicipally, we will visit residents who require
follow-up based on the results of the necessary social
resources.

Each regional
support section

2. Support for residents temporary rental housing
in response to a request from the municipally, we willvisit the residents who require follow-up as a result of
the health survey, and support them by connecting
them to necessary social resources.

Each regional
support section

3. Support for residents of disaster public housing
in response to a request from the municipally, we willvisit the residents who require follow-up before orafter moving in, and support them by connecting
them to necessary social resources

Each regional
support section☆Priority project

4. Support for residents participating in group
activities etc. We will respond to residents who wantconsultation at social gathering activities such as
exercise classes or medical examination sites, andsupport them by connecting them to necessary social
resources

Each regional
support section

5. Consultation support to residents We will
respond to phone inquiries from residents other than
temporary housing and municipal disaster housing
residents, interview to necessary social resources.

Each regional
support section
Planning division☆Priority project－184－

Yearly Plan

2017

2018

2019

2020

(2) Support for supports project
Activity policy
Professional advice and sell care is administered to municipal officials and supporters who feel a heavy
burden due to the project they are carrying out, with the goal of reducing the psychological burden
through training We also dispatch professionals to coastal municipalities and cooperate in responding tomental health issues faced by local governments.

Project Contents

1. Assistant Consultation we will give
advice from the viewpoint of mental
health concerning difficult cases,
business management, etc., and provide
effective support.
2. Dispatch of professional staff tolocal governments
In accordance with requests from local
governments, we will dispatch theprofessionals necessary to cope withmental health problems after thedisaster.
3. Mental health support for
supporters
In response to requests frommunicipalities and other entities, we will
establish mental counseling staff andprovide self-care training and othermental support.
4. Support activities by agencies
specializing in alcohol-related issues
In order to respond appropriately toalcohol-related problems in the disasterarea, we will rely on specialized agencies(Miyagi

Main Responsible
Party

Yearly Plan
2017

2018

2019

2020

Each Regional
support section☆Priority project

Each Regional
support section☆Priority project

Each Regional
support section

Planning division
Tohokukai Hospital
Miyagi Perfecture
Abstinence society(3) Public awareness project
Activity policy
In order to further deepen residents’ understanding and interested about the mental health issues
raised by the earthquake we actively promote public awareness by disseminating information. Also ,wegive people opportunities learn more about mental health by offering a causal meeting place and talking
to residential who work during the day

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Main
Responsible
Party

Project Contents

1. Lectures and Workshops for local
residents we hold trainings and lectures onmental health, such as training that
addresses requests from municipalities,
etc., and self care for those who work.

Yearly Plan
2017

2018

2019

2020

Each Regional
supportsection

2. Establishmentofmentalhealthconsultation desk We will set up a
Each Regional
consultation desk and promote public
supportawareness at places and events concerning
sectionmunicipal residents’ medical examinations
so that we can obtain necessary supportand information at an early stage.
3. Local community exchange support
We will provide opportunities for salon Each Regional
supportgatherings and productive activities for
sectionresidents who tend to become isolated, inorder to improve physical and mental ☆Priority project
health.
4. Disseminate mental health information
We will utilize information magazines,
distributed items, Internet home pages, etc.
to disseminate information on mental healthand deepen the understanding of citizens

Planning
division(4) Human resource development project
Activity Policy
We will continue to conduct specialized training to improve skills of supporters related to post-disastermental health. In addition, we will offer various opportunities for training that meet the challenge toeffectively address future mental health issues.

Project content

Planning Division

Yearly Plan2017

1. Supporting the mental health of supporters
Supporters themselves deepen their understanding of
mental health after the disaster and hold training tolearn from supporting victims

Each regional
support section☆Priority project

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2018

2019

2020

2. On-site training alcohol-related problems Mainly
targeting municipal officials conduct on-the –jobtraining to acquire professional knowledge and skills
within alcohol specially hospitals

Planning Division

3. Field training on mental health network (new) For
staff who provide interpersonal assistance in disasterarea, training is conducted with the aim of gaining
specialized knowledge and skills in regional mental
and health and regional.

Planning Division

Tohokukai
University

4.

Academic teaching
Planning division☆Priority project

5. Care Exchange Meeting of Disaster Mitigation
Holding Miyagi Sharing Reconstruction issues
information exchanges with the aim of supporters, we
aim to create a network to provide more flexible anddetailed support.
6. Hosting a joint training course for care centers inthree prefecture We will conduct exchange andinformation sharing for mental care centers such
Miyagi, Fukushima and lwate and conduct training to
improve mutual knowledge and skills.

Each regional
support section
Planning division☆Priority project

Planning Division(5) Research project
Activity Policy
In order to contribute to future disaster countermeasures, we will initiate efforts during a concentrated
period of the survey research project review. In addition to consolidating the result of research and policy
recommendations. we will prepare an official record that compiles elements such as forum dissemination of
information for public awareness through long term activities for the sake of succession.
.
Project content
1. Policy recommendation research For the purposeof reflecting on administrative measures, we willconduct investigative research to make suggestions andrecommendations.

Main Responsible
Party
Each regional
support section
Planning division☆Priority project－187－

Yearly Plan

2017

2018

2019

2020

2. Research support activities We will conduct
research to prepare guidelines and manuals forsupporters and related organization working to support
victims.
3. Specific issues for deepening research studies We
will conduct academically valuable research on the
background of special events concerning the Great East
Japan Earthquake..

Each regional
support section
Planning Division☆Priority project

Each regional
support section
Planning Division

4. Database utilization research We will conduct
retroactive research through the use of a database of
project statistics and multivariate analysis from the
Miyagi Disaster Mental Health Care Center.

Planning Division

5. Research on public awareness models The Miyagi
Disaster Mental on Health Care Center will conduct
research on real case studies of the post-disastersupport it provided

Each regional
support section
Planning division☆Priority project

6. Official activity record formulation project We
will summarize and record the past 10 years ofactivities and research of the Miyagi Disaster Mental
Health Care Center.
7.Miyagi Disaster Mental Health Care Centerforum
We will assess the reconstruction of the community
mental health and report on our finding from the
Miyagi Disaster Mental Health Care Center, Tohoku
University and Miyagi prefecture, and create
opportunities to deepen residents’ understanding of thecitizens about post-disaster mental health care.
8. Health surveys for municipalities and social
welfare associations
In response to a request from the coastal municipalities
and mental health status of staff and offer advice onnecessary mesures.

Each regional
support section

Planning Division☆Priority project

Planning Division
Tohokukai Hospital☆Priority project

Tohokukai Hospital
Added lectures
Planning Division

9. Publication of Miyagi Disaster Mental HealthCare Center bulletin
The annual bulletin will publish the activities andresearch of the Miyagi Disaster Mental Health Care
CenterPlanning Division－188－

6. Concerning promotion of the plan

■ As for the operation of the Progress Management Center, planning, deliberation of results, and related
activities have been carried out from its inception by a steering committee established to include
external committee members. External committee members who have participated come from a wide
range of fields, including academic experts, representatives of administrative and professionalorganizations, and the like. The management plan will also be evaluated and deliberated from thestandpoint of transparency and fairness.

■ Flexible operation.
Management plans were formulated based on the situation and needs trends as of fiscal year 2016, andin the future, keeping in mind the changing situation based on a field-oriented approach, decisions will
be based on the needs of prefectures and municipalities as our top priority as we move forward withflexible initiatives.

■ Implementation structure.
As for the volume of work, although the needs of each project are not uniform, it is assumed that there isa gradual trend toward reduction as the recovery plan progresses overall.
At the same time, local governments are concerned that these efforts will be prolonged. With regard to
the implementation structure, based on the needs of various regions we will conduct a range of activities,
aid for supporters, and other work focusing on priority projects, and we will plan organizational
operations keeping in mind the balance of occupations while securing a personnel structure that
corresponds to the volume of work involved.

■ Adjustment to policy trends.
Since the Center is positioned as part of a disaster recovery plan, specific measures are carried out
during targeted periods according to the implementation plan and financial measures are takencollectively; both will be managed so as to ensure consistency with policy trends.
SourceSource of statistical data: Published based on information found on the web pages of Miyagi Prefecture,
the Ministry of Internal Affairs and Communications, and the Ministry of Health, Labour and Welfare.

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