Reconsidering Child Mental Health After the Disaster
Miyagi Disaster Mental Health Care Center
Community Support Department,
Director – Naru Fukuchi
In response to this unprecedented disaster, many organizations began to support the affectedareas immediately after it occurred. In the special role of a child psychiatrist, I joined a mental
health care team early on, visiting evacuation centers, making individual visits, and paying attention
to family situations, including that of their children. Approximately one year after the earthquake,the places I make rounds at have changed from evacuation shelters to temporary housing, and I now
visit schools and kindergartens. The earthquake not only took away what was important to us but
also changed our living environment. There is no doubt that this disaster has had and will continue
to have a great impact on the environment in which our children grow up. There is a possibility thata disaster of the same scale will occur in areas other than Tohoku in the future, and I feel it is theresponsibility of the professionals in the disaster area to report the actual situation so that it may be
a clue that enables prompt support in an emergency.
Every day I ask myself what “mental care” really is. Psychiatric care in Japan is a hospitalcentered system, one in which professionals wait for people to come in for consultations of theirown volition. Therefore, psychiatry as a public health tool that supports community mental healthhas not been fully developed as an academic discipline. However, after the earthquake,professionals went to the affected areas to raise awareness and pick up high-risk local residents.
In other words, there was rapid progress in encouraging people to boost the power of existingregions. My role as a child psychiatrist has shifted to visiting large kindergartens and schools andgiving advice to professionals who are closely associated with children. While this shift tocommunity mental health feels like a special event that has occurred in response to emergency
needs, I think all these activities are natural. I also believe these initiatives should be continued
even after we return to peacetime. Rather than “connecting” children with various emotional andbehavioral disorders to the medical care offered by a few child psychiatrists, professionals should
go to where these children live and consider how to prevent them from needing to be connected
to medical care. It is necessary to reconsider the ideal approach to community and school mental
health in the wake of the earthquake.
No one would have expected a disaster of this magnitude. It is important to be prepared, but
not all events can be dealt with. It is important to take concrete measures, but the focus should beon ensuring that I feel that people and communities can respond to any eventuality. In the eventof a disaster of this scale, the organization that manages the community itself will be destroyed,
and it will be necessary to play a role of “connecting” before regaining normal functions. I feelthat what a community should work together to nurture is not a charismatic leader but anindividual who can act as a “hub” that connects various related organizations. People in these“hub” roles would have a greater degree of freedom; they would go out to various areas and build
relationships with various institutions. Even if given a flexible role in your first job after
graduating from university, it can be difficult to move with such freedom. I feel that it is necessary
to spread these ideas in the prescribed school education and allow them to take root to form aculture that creates “free people.” I believe that developing such human resources from an earlystage and allocating multiple personnel to the region will lead to increased resilience. In the areaof children’s mental health, it would be good to give school social workers a more flexible roleand allow them to become familiar with the characteristics of the children in the area. If you
suddenly say “Let’s work together” to someone you don’t normally work with, it won’t happen.
For children’s mental health, medical organizations such as those related to pediatrics and childpsychiatry, educational institutions such as schools and boards of education, and child welfareorganizations such as child guidance and juvenile justice centers must effectively collaborate.
Ideally, these multiple networks would be organically connected with each other like a living
being.
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I feel that future issues for mental health and welfare will be human resource development,
collaboration and incorporation between various affiliated organizations, and the dispatch of
medical services to affected communities.
(Mind and Heart No. 50 “Toward Tomorrow” Post-Disaster Mental Health. Recorded in the November 2012 issue of the Miyagi Mental Health and Welfare Association.)- 139 -