Second Operation Plan of the Miyagi Disaster Mental Health Care Center (Summary version) FY2021–FY2025 Document I Disaster Mental Health Care Center Miyagi Disaster Mental Health Care Center
Purpose of plan
The prefecture has indicated a policy of continuing mental health care, even after FY2021, and formulated the “Miyagi Prefecture Mental Health Care Initiative Policy for FY2021 Onwards” in August 2020. Based on this, it was decided by the Center to formulate a second operation plan to clarify the basic principles and policies of Center operation during the five-year period from FY2021–FY2025.
Initiatives and issues to date
We engaged in victim support upon request by municipalities by sharing the role of supporting those requiring follow-up after health surveys with support center support staff and others. The number of requests for support for senior citizens living alone and cases with multiple problems, such as alcohol-related problems, has increased, and we support in cooperation with provided related organizations in municipalities and communities. These initiatives were considered indispensable for early detection and early support of various issues.
Resident support
We conducted salon activities for apartment-type rental housing residents, who tend to be isolated, in collaboration with municipalities and related organizations. These initiatives were considered effective in preventing isolation and deterioration of physical and mental health. Relocation to public housing has progressed, and the number of cases that lead to support from health surveys has decreased. However, collaboration and relationships of trust established with municipalities and were related organizations through the activities to date, and there have been more requests for supervising and accompanying visits of difficult cases, such as individuals who are shut-in.
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Support for supporters
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. Projects such as alcohol-related problems and suicide prevention measures have led to the effective development of projects in line with community mental health and welfare issues because of cooperating with municipalities and health centers. The Center adopted a secondment system from an early stage to dispatch staff to municipalities upon their request. These staff members responded to various issues that arose in the disaster area after the disaster, such as overseeing mental health and welfare projects and difficult cases, and they were highly regarded by the municipalities. We established staff member counseling service booths with the cooperation of the Department of Preventive Psychiatry of the Tohoku University Graduate School of Medicine based on requests from municipalities, and we provided individual consultations. We have observed results, such as increased awareness of the importance of mental health measures in the workplace, by continuing to provide support. Danshukai held in each region immediately after the earthquake functioned as important venues for the participants to continue abstinence. In the future, it will be necessary to continue providing support for Danshukai activities in each region, as well as providing support for alcohol-related problems according to each region, while cooperating with municipalities.
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We cooperated with community residents' workshops held by municipalities. The use of picture-story shows and skits so that the topics feel more familiar to the residents was effective in improving the mental health of the inhabitants. We cooperated with municipalities and related organizations to try to understand residents who tended to be isolated, and we held salons and various classes.
Raising public awareness
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This was effective for improving exchanges between residents and the physical and mental health of residents who were isolated due to moving into public housing or relocating. We disseminated various information, such as the Center's activity status and training on the homepage and workshops, which led to an understanding of issues including mental health and alcohol-related problems among residents. Children's Mental Health Care Community Base Project We responded to consultations from children and parents through walk-ins and home visits. The number of handled cases increases every year, and the content is complicated. For the professional dispatch project, which aims to provide professional advice to supporters, we provided staff-based supervision Center upon  request of municipalities, dispatched professionals such as clinical psychologists and psychiatric social workers, conducted case studies with municipal managers and others, and responded to consultations. This was an opportunity for municipal managers to recognize the usefulness of collaborating with external professionals. We invited instructors from outside of the prefecture to conduct training for educators and supporters. There was much interest from public health nurses, nursery teachers, schoolteachers, and others, and there were many participants in each session. We conducted the “Children’s Cohort Study” in three prefectures in the Tohoku region (Iwate Prefecture, Miyagi Prefecture, Fukushima Prefecture) with the objective of evaluating the transformation of children and families and clarifying efficient support. This is expected to be valuable survey data, and it is considered as necessary to continue in the future.
Human resource development
We adopted a wide range of themes in response to requests from related organizations and supported the mental health promotion of victims. There were initially many requests for cooperation in earthquake-related lectures and training, such as stress and PTSD following the earthquake; however, over the years, the topics changed to alcohol-related problems, suicide prevention, and workplace mental health. We have conducted on-the-job training for alcohol- related problems since the opening of the Center after being entrusted by Tohokukai Hospital. There have been many requests received every year, and several officials from community medical organizations and local government have taken the course. However, although the number of graduates increases every year, it has been difficult to raise the level of community supporters due to relocations at the affiliation location. In the future, we consider it necessary to collaborate with municipalities and health centers to continue studying the training content.
Research
The Bulletin that was published annually and the official activity record that was published in FY2020 are also the result of a detailed summary of the activities in the Center to date. The Miyagi Mental Health Care Forum, which was started in FY2017, was planned as a venue for sharing and understanding the current situation of the disaster area, as well as for investigating the reconstruction of community mental health and welfare in the future. As support organizations continue to withdraw from the region every year, there have been fewer places for supporters to gather and exchange ideas, and visitors have reported that these types of plans are necessary. Basic principle
and welfare in disaster areas Basic policy ① Implement "seamless support from children to adults." ② Resident support involves mental health care activities centering on outreach, based on accompanying visits with related organizations such as municipalities. ③ Support for supporters involves implementing activities that contribute to improving the skills of supporters through case studies and consultations, as well as striving for support relating to the mental health of supporters. ④ Raising public awareness involves activities relating to mental health for community residents which prioritize preventive viewpoints to deepen their understanding and interest in the mental health of residents while cooperating with municipalities. (5) Implementing activities with the perspective of transmitting the experience cultivated in past activities, such as summarizing the ideal method of support for use following future disasters, since the activities that the Center has supervised to date constitutes valuable knowledge of mental health care activities in the event of a disaster. ① Conducting activities according to the actual municipalities circumstances of while collaborating and cooperating with related organizations such as municipalities to improve community mental health and welfare activities, and systematically implementing the transition of various projects to related organizations in anticipation of the conclusion of activities in FY2025.
Project plan
Resident support
◇ There is a need to focus on senior citizens living alone, isolated individuals, infants / school children, alcohol- related problems, and those with problems such as being a shut-in. ◇ Support for cases with multiple issues has been increasing, and we will conduct visits and consultations with municipal and health center public health nurses to provide seamless support from children to adults. Furthermore, it is necessary for teams to cooperate with medical and welfare-related organizations in the ammunity and shift to community mental health and welfare activities while responding We will collaborate with related organizations to conduct consultation support activities for community Plan residents that require mental health care, such as residents with psychological burdens after the disaster or residents who have become further isolated due to changes in the community; and we will seek to improve community mental health.
Support for supporters
◇ Supporters who oversee support activities in disaster areas will continue to be important players in reconstruction, and follow-ups on supporters are an important issue. We will supervise individual cases from the perspective of human resource development and provide technical support, such as accompanying visits to improve the skills of supporters. Moreover, we will collaborate with health centers and mental health welfare centers depending on the local circumstances. Plan We will provide professional advice and accompanying visits for supporters so that various supporters can address a wide range of mental health issues. Additionally, we will aim to further improve the skills and reduce the psychological burdens of supporters by providing opportunities for various professional training (including self-care).
Raising public awareness
◇ Activities for raising public awareness among residents to improve the mental health of community residents and preventing aggravation of any illnesses will be conducted in collaboration with municipalities and health centers using various methods that we have cultivated. Moreover, we will further establish the understanding and interest of residents toward mental health. ◇ Regarding places to gather, such as various salons with which the Center has been involved, it is necessary to continuously provide a place where residents can connect and be active, and for investigating the ideal form of such activities in collaboration with municipalities and related organizations. ◇ The Bulletin and its English translation, the official activity record compiled in the final fiscal year, etc., are published on the homepage, and the practices of the Center to date can be utilized for new disasters. It is also important to consider what and how various documents relating to raising public awareness issued by the Center to date will be kept, such as organizing them by phase. Plan We will continue to disseminate information to further establish and deepen the retention of information on mental health that has proliferated following the earthquake. We will provide places where people can casually gather and give lectures to residents who work during the day, and we will use various methods to provide necessary information to all community residents. Furthermore, we will collect the knowledge gained through long-term activities and disseminate the results to contribute to future disaster countermeasures. ssues to be addressed in the next five v
Individual support
We will visit residents who require support upon request of municipalities; for difficult cases, we will collaborate with related organizations to strengthen the team-based support system. We will promote the transition through these activities so  that we can respond as part of the community mental health and welfare activities where local governments, related organizations, and community residents work together.
Community resident exchange project
Regarding places to gather, such as various salons with which the Center has been involved, we will continuously provide places where residents can connect and be active. Moreover, we will investigate the ideal form of such activities in the future in collaboration with municipalities and related organizations.
Supporter consultations
We will provide professional advice from a mental health perspective in response to requests supporters from regarding handling the of difficult cases project and management. Supporter's mental health support We will conduct training and interviews for supporters at the request of municipalities with the aim of and skill self-care improvement. Support for supporters involved in children’s mental health care We will provide consultations and training for supporters through cohort studies so that we can effective support deliver for children's mental health care.
Mental health public awareness
promotion project
We will endeavor to utilize the various methods that we have cultivated to date to further establish the understanding and interest of residents toward mental health. Furthermore, we will provide information on mental health to elementary, junior high, and high school students in the prefecture; and we will disseminate professional knowledge and skills to related parties at the request of local governments. Dissemination of mental health information We will disseminate information on mental health through public relations magazines and the website homepage to deepen understanding among residents. Additionally, we will actively disclose materials to utilize the knowledge that the center has cultivated to date for new disasters. Annual activity report creation project We  will  summarize  the activities for each year provide them and to related organizations as an activity report.
Promotion of plan
(1) Progress management After the end of the half-term, manager-level employees and above will confirm and evaluate the implementation status of the operation plan. The steering committee will also evaluate the implementation status. (2) Promotion system It is expected that the system will gradually shrink as we move toward the conclusion of activities in FY2025. Meanwhile, outreach by multiple occupations and support for supporters must be developed as an important project of the Center. Thus, we will secure a personnel system