FY 2013 Activity Report
Resident
supportRegarding Our Projects
In FY 2013, the MDMHCC considered all prefecturalresidents psychologically affected by the Great East Japan
Earthquake and all persons forced to evacuate Miyagi
Prefecture targets for mental health care, and engaged in
the six projects seen here (in accordance with theconditions in each region) to ensure that they would be
able to return to life in their communities as soon as
possible.

Raising
publicawareness

Supportfor supporters

Research

Human
resource
development
Supportfor various
activities

1. Raising Public AwarenessWe implemented a variety of initiatives designed to deepen understanding of mental health,including publication of a public relations (PR) magazine, information dissemination via our
website, creation of public awareness pamphlets, training sessions/lectures, and so on.
(1) Publication of our PR Magazine
As we did in FY 2012, we published the “MDMHCC Pamphlet” thrice over the course of FY
2013 (July, October, and February) to inform people about our projects and to communicate thestatus of each region within the prefecture. Copies were distributed to around 500 locations ofaffiliated organizations throughout the prefecture. Newly in FY 2013, we decided to emphasize
disseminating local information, such as introducing new earthquake-related organizations. In
addition, a page for the PR magazine has been set up on our website, enabling it to be viewed at
any time.
<PR Magazine Publication Status>
Volume 5 (published in July)
2,420
Volume 6 (published in October)
2,500
Volume 7/8 (published in February)
2,700(2) Internet-based Public AwarenessIn FY 2012, we created and began to manage a website aimed at widely sharing information
about the MDMHCC and publicizing our activities, including training workshops and lecture
sessions. In FY 2013, the site was accessed 17,464 times.
(3) Pamphlet Creation and Distribution
Since FY 2012, we have been creating and distributing pamphlets on topics of concern in the
post-disaster period, including PTSD, alcohol abuse, and depression. In FY 2013, we reprinted
materials on alcohol-related topics, and newly created and distributed pamphlets on dementia.
We are currently distributing a total of 10 pamphlets.
<Inside the Prefecture>
MDMHCC Pamphlet (for Supporters) (reprint)
3,800
MDMHCC Pamphlet (for the General Public) (reprint)
3,000“Symptoms and Illnesses Related to Alcohol Consumption” (reprint)
3,000
Dementia: Supporting Each Other (new)21,000<Kesennuma Area>
Mental Health and Communication Techniques for Public Service Employees
3,000
Pocket tissues (additional)
1,000<Ishinomaki Area>
Mental health set (stress ball, health check card, tips for a lifestyle geared toward 50 sets
good mental health)
Pocket tissues (additional)
2,000

-3-

(4) Public Awareness Training
In response to requests from municipalities and affiliated organizations, we conducted mental
health workshops for community residents (general public/professional sector).
(5) Salon Activities
We cooperated in the implementation of salon activities for local residents, as well as withsupport groups and administrative agencies that implement such activities. Further, we
entrusted several salon activities to the Miyagi Psychiatric Center.
(6) Information Disseminated Through the Media
Using the radio, newspapers, and so on, we carried out activities to communicate information
about the MDMHCC’s initiatives, mental health issues, and other topics.
(7) Co-hosting/Sponsorship Assistance for Events• Co-hosting: 5 events• Sponsorship: 1 event-4-<Public Awareness Activities>(1)

Distribution of PR goods

No. of
times
8

(2)
(3)

Homepage management/update/information

35

PR training

52

1,769

How the mind responds after a disaster

7

257

About mental illness

10

148

Basic listening techniques243

Addiction*¹ issues (alcohol, etc.)

488Effects of the disaster on children

1

100

Stress and mental health care/self-care

12

340

Physical health8177Workplace mental health

5553Disaster area status and our activities

3

63

113

1,678

Item

(4)

Salon activities(5)

PR activities through the media

Participants

8

TV/Radio4

Newspaper/magazines

3

Other

1

(6)

Setting up a mental health counseling counter

35

(7)

Presentations at conferences/professional associations

12

(8)

Working with reporting agencies

15

(9)

Working with observation requests

10

(10)

Other
Total

7
295

3,447

Addiction: In other words, a “bad habit.” It refers to dependence on substances, relationships,
or activities like overeating, gambling, work, alcohol, and medicine use despite
awareness of their repercussions.
2. Community Resident Support
We implemented projects aimed at preventing mental illness and promoting mental healthamong disaster-affected individuals.
(1) Counseling Support Provided at the Request of Residents, Municipalities, and Other
Organizations
In response to requests from municipalities, various organizations involved in support
activities in disaster-affected regions, and community residents themselves, we provided
counseling support via home visitations, walk-ins, and telephone. [Appendix] Community
Resident Support Activities*1-5-

<Cases by Support Method>
Support Method

Cases

Visitation counseling

3,807

Walk-in counseling (including counseling counters, etc.)
Telephone counseling

880
1,310

Counseling during group activities

87

Case conference (with subject participation)

12

Checkup accompaniment

115

Other

25

Total
6,236
(2) Camp for Parents and Children from Disaster-Affected Regions
As we did in FY 2012, we implemented a day camp for elementary school children and theirparents and guardians. In FY 2013, our objectives were mental and physical refreshment andmental health awareness. Twenty-six children and three guardians participated. The children
took part in recreational activities and psychological education, while the parents/guardiansparticipated in recreational activities like yoga and socialized.
3. Human Resource Development
We targeted specialists and professionals working in the field of mental health, as well as
supporters, and carried out projects aimed at disseminating knowledge on a variety of topics anddeveloping human resources.
In addition, we hosted various training sessions and dispatched lecturers to municipalities andother affiliated organizations.
(1) Organizing the Earthquake Exchange
In an effort to facilitate sharing of information between administrative staff, supporters, andother involved parties, we organized the “Disaster Mental Health Care Exchange.” We requested
the various civilian organizations that had carried out multiple activities throughout the prefecture
to submit activity reports, conducted lectures and group work with individuals active in advanced
areas, and in FY 2013, organized this event in Sendai, Ishinomaki, and Kesennuma.
(2) Hosting a Media ConferenceWith the co-sponsorship of the National Center of Neurology and Psychiatry, Institute of Mental
Health, Suicide Prevention Comprehensive Measures Center, we conducted this conference with theaim of gaining knowledge of mental health and suicide prevention from the mass media and deepening
mutual understanding between the mass media and the mental health field. In 2013, we exchanged
opinions on the theme of “suicide prevention in disaster areas.”(3) Training Workshops on Disaster-Related Topics
In an effort to assist in the acquisition of the knowledge and techniques needed to respond todisaster-related issues and in the building of professional networks, we organized training
workshops on a variety of themes.
(4) Addiction-Related Training, Including Alcohol• One of the projects we entrusted to the Tohokukai Hospital, which has a specialized
alcoholism ward, was the conducting of week-long training courses once per month for our
staff and the staff of coastal psychiatric hospitals. Additionally, we dispatched Tohokukai
Hospital staff to various areas and had them carry out training sessions for supporters.
• We also entrusted a project to the Japan Alcohol-Related Social Workers’ Association(JASWA) and had them dispatch psychiatric social workers to Ishinomaki and hold training
sessions for supporters.
(5) Training Sessions on Mental Health, Suicide, Mental Illness, Etc.
We implemented lectures and case study sessions about workplace mental health and theimportance of self-care for supporters, who bear a variety of different burdens.
(6) Disaster-Area Status and the Work of the Center-6-

We conducted lectures and training sessions on the status of disaster areas throughout Miyagi
and the activities of this Center.
(7) Co-hosting/Sponsorship Assistance for Events• Co-hosting: 5 events• Sponsorship: 6 events<Human Resource Development Projects>
Item
(1)

Earthquake Exchange

No. of Participants
times
3
221

(2)

Media conferences

1

24

(3)

Addiction-related issues

26

583

About alcohol

25

544

About other addictions

1

39

Support technical training

54

1,123

About listening

28

525

Stress and mental health care/self-care

12

433

Other

14

165

(4)

(5)

Supporter mental health training

10

339

(6)

Workplace mental health training

9

456

(7)

Child mental health training

6

468

(8)

About elderly mental health

1

10

(9)

Training on problems related to suicide countermeasures

11

558

(10)

About mental illness and disability

8

306

(11)

Disaster-area status and the work of the center

7

251

(12)

Case study

12

169

(13)

Other

19

997

Total

167

5,505

4. Support for Supporters
We carried out support for supporters, including dispatching specialists to municipalities,
providing specialist advice and guidance, and hosting counseling sessions.
(1) Placement of Specialists in Municipalities (Transfer)
In response to requests from local governments, specialists were dispatched to municipalities
as transfer employees. Transfer staff were stationed in the city or town to provide professional
and technical support for mental care and worked to reduce the workload of the person in charge.
Their activities were quite varied in nature, such as cooperation in and continuous response after
health surveys; individual support through visits and calls; and support for projects related todisaster survivors’ mental health care.

-7-

Transfer

Profession/No. of Staff/Activity Period
Psychiatric social worker: 1 (5 days per week)

Kesennuma
Clinical psychologist: 1 (5 days per week) June–August 2013
Ishinomaki

Occupational therapist: 1 (4 days per week)
Psychiatric social worker: 2 (5 days per week)

Higashimatsushima

Onagawa
Shiogama
Natori
IwanumaIshinomaki Public

Clinical psychologist: 1 (5 days per week)
Psychiatric social worker: 2 (5 days per week)
Psychiatric social worker: 1 (5 days per week) July 2013 onward
Psychiatric social worker: 1 (5 days per week) June 2013 onward
Nurse: 1 (5 days per week)
Nurse: 1 (5 days per week)

Health Center※Unless otherwise indicated, transfer periods were from April 2013 to March 2014.
(2) Specialist Advice
We dispatched specialists and asked them to offer supporters specialized advice/guidance on
mental health care, assist them with projects, and generally provide mental health-related support.

-8-

<Support Content and Number of Events>
No.
times

Item

of

Participants

Post-visitation/interview reports

189

357

Specialist advice and guidance (alcohol problems)

129

320

Specialist advice and guidance (gambling problems)

2

5Specialist advice and guidance (drug problems)

1

4Specialist advice and guidance (depression)

125

359

Specialist advice and guidance (complex grief)

1024Specialist advice and guidance (PTSD)

18

60

Specialist advice and guidance (abuse)

36

123

Specialist advice and guidance (other)

326

1,003

Working on community issues

75

390

Working on workplace mental health care

182

334

Attending case conferences (without the subjects present)

226

1,008

Establishing mental health counseling counters, etc.

38

44

Checkup support

68

678

Administrative support

391

513

Other

108

503

Total

1,924

5,725

5. Support for Various Activities
We collaborated with organizations active in the prefecture, such as municipalities, Public HealthCenters, various types of support organizations, and survivor organizations, to implement projects
to aid their initiatives.
(1) Supporting Collaboration Between Civilian Activity Organizations
We assisted civilian activity organizations in holding information exchange meetings and managing their affairs.
• Support for the bereaved: Wakachiai no Kai (Sendai Grief Care Research Association),seven times• Miyagi Prefectural Psychiatric Nursing Research Association implementation support,“Kokoro no Hi” event activity support (Japan Psychiatric Nursing Technology Association
Miyagi Chapter), one time each
• Alcoholics Anonymous (AA)*2 Ojika open meeting, one time
• Iwanuma Satonomori temporary housing residents’ Satonomori playground event, one time
• Other, two times*2 AA: A self-help group for individuals with drinking problems who wish to achieve sobriety.
6. Research (Reprint)
We administered surveys and conducted research projects to better understand the situation indisaster-affected regions and among disaster-affected persons.

-9-(1) Implemented Projects
Project
Health survey for municipal staff

Content
At the request of the municipality, we conducted ahealth survey of municipal employees in Kesennuma.
Subsequent follow-up and data analysis were carriedout in collaboration with the Tohoku University
Graduate School of Medicine, Endowed Department ofPreventive Psychiatry, and the Kesennuma Regional
Center.
Health survey for municipal Social At the request of the Miyagi Prefecture SWC, we
Welfare Council (SWC) staff
conducted a health survey of the staff of five municipal
SWCs (Kesennuma City, Minamisanriku Town,
Ishinomaki City, Onagawa Town, Sendai City).
Subsequent follow-up and data analysis were carriedout in collaboration with the Tohoku University
Graduate School of Medicine, Endowed Department ofPreventive Psychiatry and each Regional Center.
Stem Center Regional Support
Division
Development of a statistical system

Publication of our bulletin

In order to carry out a survey useful for effective
support, we searched the literature and examined theresearch content.
Continuing from FY 2012, we developed a statisticalsystem to consolidate business reports, clarify overall
performance, and identify local needs and necessary
support.
We published 1,000 copies of Bulletin No. 1 (FY 2012)as a report on the activities of this Center and distributed it to about 700 related organizations.

(2) Collaborative Research
Research Content

Contribution“Research on mental support for “Study on psychological education for trauma recovery
children after a disaster” (Principal in children after a disaster.”investigator: Takashi Igarashi,
Director, National Center for Child
Health and Development)“Study that contributes to grasping “Activity analysis of the MDMHCC” (contributing
information on mental disorders in researcher: Kazunori Matsumoto, Associate Professor,
the disaster area, verifying the effect Tohoku University Graduate School of Medicine,of intervention, and improving Endowed Department of Preventive Psychiatry).
intervention methods”(Representative
researcher:
Yoshiharu Kin, Director, Adult
MentalHealthResearch
Department, National Center of
Neurology and Psychiatry).

- 10 -

(3) Presentations at Academic Conferences, Etc.
ConferenceContent“Practical Report after the Great A poster presentation reporting on “the activities of theEast Japan Earthquake” 38th Japan Miyagi Disaster Mental Health Care Center”.
Psychiatric Nursing Academic
Meeting“Study on Psychological Education A poster presentation as part of the results of thefor Children’s Recovery from Igarashi group’s “Research on Mental Support forTraumaAfter
Disaster” Children After a Disaster” project.
International Symposium
109th Japan Pediatric Psychiatry and
Neurology Society

Special lecture: “About Children in Disaster Areas.”

3rd Asia-Pacific
Disability Society

Participated as a symposiast.

Developmental

Kansai Alcohol-Related Problems
Society

Participated as a symposiast and chair (theme:“Supporting Children’s Mental Health in the Event of
a Disaster”).
Participated as a symposiast and provided topics(theme: “Middle School Suicide Prevention Education
Program: GRIP”).
Participated in the joint symposium and provided
topics (theme: “Interventions for Mental Health andWellbeingforTraumatizedChildrenandAdolescents”).
Presented a report during subcommittee meetings(theme: “The Disaster and Alcohol”).

“Study on Psychoeducation forChildrenin
Tsunami-Stricken
Areas” International Symposium

Participated in the international symposium titled“Disasters and Child Mental Health” as a symposiast
and provided topics.

7th
Psychoeducation/Family
Education Network

Participated as a symposiast and provided topics(theme: “Where Is Psychoeducation Headed?”).

Japan Society for Public HealthSymposium“Sharing
Reconstruction Activities in the
Third Year After the Great East
Japan Earthquake”

Participated as a symposiast and coordinator (theme:“Current Status of and Issues in Child Mental Health”).

31st Japanese Society of Pediatric
Psychosomatic Medicine
77th
Japan
Association

Psychological54th Annual Meeting of theJapanese
SocietyofChild
Psychiatry and Neuroscience- 11 -

(4) Assistance with Surveys/Research
Survey/ResearchContent

Tohoku Fukushi University Research on the mental health of supporters in disaster areas (ProResearch Project Coopera- fessor Sumio Watanabe). After sandplay therapy, we conductedtion (two days)
interviews.

Aid

Participated in an opinion exchange meeting where stakeholders
gathered to cooperate in research on the dissemination of theWorld Health Organization version of PFA.

Cooperation with research
conducted by Professor Ken
Masame,Facultyof
Nursing, Miyagi University

In order to summarize the hearing results in the disaster area in
the Great East Japan Earthquake Life Reconstruction Project,
we provided information on regional issues together with apublic health nurse from Kesennuma City.

Psychological First(PFA) Study Group

Ministry of Health, Labour, Participated in a panel discussion (discussion meeting) on
and
WelfareScience “International and Interdisciplinary Examinations for theSpecial Research Project Development of Suicide Countermeasures Based on the Review(representative researcher: of the Comprehensive Suicide Countermeasures Charter.”
Professor Hiroe Tsubaki,
InstituteofStatistical
Mathematics)

7. Other Activities(1) All-Hands Meeting/Training
In an effort to share our experiences, thoughts, and feelings about our work; collectively learn
new skills; and preserve staff mental health, we held a total of six all-hands staff meeting/training
sessions, on the fourth Friday of every other month (May, July, September, November, January,
March).
(2) Tri-Prefectural Disaster Mental Health Care Center Staff Training, Etc.
In an effort to allow the staff of the Miyagi, Fukushima, and Iwate Disaster Mental Health Care
Centers, all established in the wake of the Great East Japan Earthquake, to socialize and share
information, we conducted training workshops, study sessions, and more.
• Tri-Prefectural Disaster Mental Health Care Center Staff Joint Training• Tri-Prefectural Disaster Mental Health Care Center Networking Conference• “Postvention After Suicides” Miyagi/Fukushima Joint Study Session- 12 -

[Community Resident Support Activity Report]
1. Counseling Cases

April

May

June

July

Aug

Sep

Oct

Nov

Dec

Jan

Visitation
Walk-in
TelephoneGroup activities
Case conference
Checkup accompaniment
Other

Figure 1-1: Cases by Month

Community Support
Department
Planning Division
Visitation

Kesennuma
Regional Center

Walk-in
Telephone

Ishinomaki
Regional CenterGroup
activities
Case conference
Checkup accompaniment
Other

Transfer
Other(cases)Figure 1-2: Cases by Overseeing Division≤20 years old
20–29 years old
30–39 years old

Visitation
Walk-in

40–49 years old

Telephone

50–59 years oldGroupactivities

60–69 years old

Case conference
Checkup accompaniment≥70 years old

Other

Other
(cases)Figure 1-3: Cases by Age Group- 13 -FabMarch

2. Subject Characteristics(1) Subjects’ Gender Distribution

Unknown 4 (0.1%)

Man 2804(45%)

Unknown
Women
Men

Women 3428
(55%)

Figure 2-1: Subject Genders
Figure 2-2: Subjects’ Gender Distribution by Support Method(2) Subjects’ Ages
≤20 years old79,(1%)

Unknown 142(2%)

20–29 years old282,(1%)30–39
years old
656,(11%)≥70 years old
1728,(28%)
40–49 years
old858,(14%)

50–59 years old1025,(16%)

60–69 years old
1466,(23%)

Figure 3-1: Subjects’ Ages

≤20 years old
20–29 years old
30–39 years old
Employed/selfemployed
Retired40–49 years old
50–59 years oldStudent

60–69 years old

Unemployed≥70 years old

Unknown

unknown(cases)Figure 3-2: Subject Age Groups by Employment Status- 14 -

(3) Counseling Location/Counselee
Own home
Container-type temporary housing
Private chartered housing
Public disasterhousing
Counseling officeWorkplace
Friend/relative’s house
Admitted facility
Hospital
TelephoneOther(cases)Figure 4-1: Counseling Location

counselee is client
family member
neighborfriend or acquaintanceadministrative
personnel
temporary housing
support staff
district welfare officer/
ward headman
other supporters
other(cases)Figure 4-2: Counselee Breakdown(4) Subjects’ Support Status
Referred by anotherorganization,
404,
(7%)

New counseling client,
2321,
(37%)

Follow-up fromprevious meeting,
3511,
(56%)

Figure 5: Subject Support Status- 15 -

(5) Subjects’ Disaster Status (Multiple Answers Possible)
Disaster status
breakdown, total
no. of ppl.

Disaster status
breakdown, total
no. of ppl.

Parent,307

Unknown,
1338,
(20%)

Unknown1559(25%)

Spouse,252
Child,215
Yes
1871,
(27%)

No
3641
(53%)

Sibling,171

Grandparent,24

Other relative,376

Grandchild,48

Subject
themselves,189
Yes
273
(4%)

No
4404
(71%)

Parent,3

Other relative,28

Friend,177

Neighbor,45

Spouse,7Child,6
Sibling,2Grandparent,3Grandchild,1Friend,2

Neighbor,301

Figure 6-1: Subject Disaster Status(Death) *multiple answers

Figure 6-2: Survivor Disaster Status(Injury)※ multiple answers

Disaster status
breakdown, total
no. of ppl.

Disaster status
breakdown, total
no. of ppl.

Unknown,231,(4%)

Unknown,
1942,
(23%)

Completely destroyed,3511

No,
939,
(15%)

Yes
1871,
(27%)
Half destroyed,618
Forced to abandon
home,72
Unknown,626※ multiple answers

Partly detroyed,191
Chose to evacuate,29

No
1480
(18%)

Witnessed thetsunami 2391
Yes
4898
(58%)

Witnessed adead body 796
Life-or-deathsituation 1696

No damage,19

other 15

Figure 6-4: Subjects’ Disaster Status (Disaster Experience)※Multiple Answers Possible

Figure 6-3: Survivors’ Disaster Status (Housing) *Multiple Answers Possible

Disaster status
breakdown, total
no. of ppl.
Life-or-deathsituation 840

Unknown
1333 (15%)

No
1622
(18%)

Loss of community 2022
Yes
3281
(67%)

Loss of assets otherthan home2039
Loss of job 838

Other 59
Figure 6-5: Subjects’ Disaster Status (Effects on
Environment) *Multiple Answers Possible- 16 -

(6) Living Environment and Household Status
Own home
Container-type temporary housing
Private chartered housing
Public disaster housing
SingleFriend/relative’s house

Living with family
Living with people
other than family
Other

Admitted facility
Hospital
Other

Unknown

Unknown(cases)Figure 7: Living Environment and Household Status(7) Reason/Occasion for Receiving Counseling (Multiple Answers Possible)
Picked up via health survey ordoor-to-door visitations
Request from administrative agency
Counseling/requestfrom client
Request from support center/temporary support staff
Request from welfare agency
Counseling/request from family/relative
Request from medical
institutionCounseling/request fromworkplaceCounseling/request fromneighbor
Other/unknown(cases)Figure 8: Reason for Counseling *Multiple Answers Possible

Education/parenting/school transfer
Loss of loved one
Change in living environment
Issues with rebuilding financial lifestyle
Use of social resources
Employment issues
Interpersonal issues
Domestic issues
Radiation
Anxiety about the futureWork-related troubles
Mental disturbance
Aging-related issues
Health-related issues
Addiction issues: alcohol
Addiction issues: gambling
Addiction issues: drugs
UnknownNone
Other(cases)Figure 9: Occasion for Counseling *Multiple Answers Possible- 17 -

(8) Psychiatric Examination Status/Diagnosis
Unknown,
668,(10.7%)

No specificdiagnosis,
10

Diagnosis given
1480
No historyof examination 3703
(59.4%)

Diagnosis
unknown
375 (20%)

Had been
examined1865 (30%)

Diagnosis
unknown
375

Diagnosis
given 1480
(79%)

No specificdiagnosis,
10 (1%)

Figure 10-1: Psychiatric Examination
and Diagnosis Status

Onset before
disaster 1051

Unknown
80
Onset after disaster
349

Figure 10-2: Diagnosis Status andOnset Timing

F0 Organic, including symptomatic, mental
F1 Mental and behavioral disorders due to psychoactive
substance use
F2 Schizophrenia, schizotypal and delusional
disorders
F3 Mood (affective) disorders
F4 Neurotic, stress-related, and somatoform disorders
F5 Behavioral syndromes associated with physiological disturbances and physical factors
F6 Disorders of adult personality and behavior

Onset before
disaster
Onset after
disaster
Unknown

F7 Mental retardation
F8 Disorders of psychological development
F9 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence
G4 Epilepsy
No specific diagnosis/unknown(cases)Figure 10-3: Diagnosis and Onset Timing- 18 -

(9) Mental Disturbances (Multiple Answers Possible)①Mental Disturbance (Broad Categories)
Physical symptoms
Sleep issues
Anxiety symptoms
Mood-related/affective
symptoms
Dissociative/conversion
symptoms
Compulsive symptoms
Hallucination/delusion
symptoms
Behavioral issues
Epilepsy/seizures
Consciousness disordersChild-specific symptoms
Addiction issues
Other symptoms
No symptoms(cases)Figure 11-1: Mental Disturbance (Broad Categories) *Multiple Answers Possible②Mental Disturbance（Sub Categories）
Loss of appetite
Hypertension
VertigoFatigue
Headache
Back pain
Joint pain
Palpitations
Frozen shoulder
Numbness
Hyperventilation
Diarrhea
Overeating
NauseaDifficulty breathing
Vomiting
Constipation
Cold-like symptoms
Limb tremors
Hot flashes
Coughing
Fever
Incontinence
ChillsFrequent urination
Other(cases)Figure 11-2: Mental Disturbance Details (Physical Symptoms) *Multiple Answers Possible

Difficulty
falling asleep
Awakening
during thenight
Early awakening
Nightmares
Oversleeping
Dreamful
sleep
Other
(cases)Figure 11-3: Mental Disturbance Details (Sleep Issues)*Multiple Answers Possible- 19 -

General anxiety
Anticipatory anxiety
Interpersonal anxiety
Traumatic flashbacks
Panic
Other
(cases)Figure 11-4: Mental Disturbance Details (Anxiety Symptoms) *multiple answers

Depressive affect
Irritation
Hypobulia
Suicidal ideation
Grief
Impatience
Labile affect
Easily angered
Loss of concentration
Guilt
Fear
TalkativenessHyperactivity
Exhilarating mood
Other(cases)Figure 11-5: Mental Disturbance Details (Mood-Related/Affective Symptoms) *Multiple Answers Possible

ObsessionCompulsive
behavioraAphonia
Other(cases)Figure 11- 6: Mental Disturbance Details (Compulsive Symptoms) *Multiple Answers Possible

ObsessionCompulsive
behavioraAphonia
Other

Figure 11-7: Mental Disturbance Details (Compulsive Symptoms) *Multiple Answers Possible- 20 -(cases)Delusion
Auditory hallucinations
Psychomotor
agitation
Visual hallucinations
Other(cases)Figure 11-8: Mental Disturbance Details (Hallucination/delusion symptoms) *multiple answers

Shut-inTalking tooneself
Violence
Suicidalplanning
Cutting
Medication
overdose
Wandering
Other

Figure 11-9: Mental Disturbance Details (Behavioral Issues) *Multiple Answers Possible(cases)

Focal seizures
Generalized seizure
Grand mal seizure
SpasmsPediatric spasms
Other(cases)Figure 11-10: Mental Disturbance Details (Epilepsy/Seizures) *Multiple Answers Possible

Delirium
Other(cases)Figure 11-11: Mental Disturbance Details (Consciousness Disorders) *Multiple Answers Possible

Unable tocalm down
FixationsRegression
Bedwetting
Crying at night
MutismOther

Figure 11-12: Mental Disturbance Details (Child-Specific Symptoms)*Multiple Answers Possible(cases)Alcohol: Binge
drinking
Alcohol: other
Alcohol: Pathologicaldrunkenness
Alcohol: Withdrawal
symptoms
Gambling
Drugs
Other

Figure 11-13: Mental Disturbance Details (Addiction issues) *multiple answers- 21 -(cases)(10)Response Status, Continuing Support, Etc.

Supportconcluded,
1939,
(38%)

Continued
support,
3131,
(62%)

Meetings as
Needed,741

Regularmeetings
2380,

Other support
10

Other
16,
(0.3%)

Figure 12-1: Response Status andContinuing Support

Referred toother institution
184 (9%)Refusedsupport75 (4%)

Situation improved 1680
(87%)

Figure 12-2: Reasons forConcluding Support

Psychoneuro/psychosomatic
medicine department
Other medical organization
Municipality
Judicial organization
Elderly welfare
Disabled welfare
Child welfare
Employment organization
Other

Figure 12-3: Breakdown of Referrals to Other Institutions*multiple answers- 22 -(cases)