******** The full report published June 9, 2021.
For more information, please refer to the PDF.

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Health and Global Policy Institute (HGPI)  held Expert Meeting on “Community Building for Disaster Mental Health”.

To achieve the vision of realizing citizen-based health care policy, HGPI has made continuous efforts to reflect the voices of citizens, patients, and other parties most affected in health care policy. In line with that vision, HGPI’s Mental Health Policy Project was launched in FY2019 with the goal of improving quality of life for people with mental disorders, their families, and their supporters. We held a global expert meeting in December 2019 where overarching issues facing mental health policy were identified together with multi-stakeholders including people with mental disorders. Based on the discussions held at that meeting and hearings with various stakeholders, we formulated a policy proposal entitled, “Mental Health 2020 – Proposal for Tomorrow” and presented it in July 2020.

In 2020, Coronavirus Disease 2019 (COVID-19) made mental health an urgent and familiar issue for all. In addition to the mental distress caused by fear of infection, societal factors related to employment and the economy as well as sudden lifestyle changes contributed to the rapid spread of unease throughout society. Mental disorders and mental health issues have diverse causes. In addition to natural disasters, a factor that has received attention in the past, events such as the ongoing COVID-19 pandemic and other pandemics, violent crime, and accidents have a significant impact on mental health in society. The Great East Japan Earthquake that occurred in 2011 was a key moment that started ongoing discussions on the various issues related to mental disorders triggered by natural disasters. Those discussions taught us many lessons. Specifically, we came to understand the importance of considering mental health when developing communities (through measures such as improving mental health literacy among the general public), providing support for supporters, and connecting people undergoing mental health changes with specialists.

With that background, and in light of the fact that 2021 marks the ten years since the Great East Japan Earthquake, HGPI’s Mental Health Policy Project Team believes that the time is ripe to reexamine various aspects of disaster mental health policy in Japan. This symposium served as the starting point of those activities. It brought stakeholders involved in natural disaster response including healthcare providers, the National government, municipal governments, and members of the industry together with members of the public – in other words, the people most affected by natural disasters. Together, we discussed the establishment of long-term, sustainable systems, and policies for disaster mental health.

 

Keynote Lecture 1: “Providing remote mental health support for disaster-affected areas through ICT and collaboration among support organizations”

Dr. Mitsuru Suzuki

• Disaster mental health requires long-term support. In fact, some of the people affected by the 2011 Great East Japan Earthquake are still suffering from the experience of loss.
• NPO Kokorokakehashi Iwate provides long-term support to people affected by the Great East Japan Earthquake and is engaging in multidisciplinary, collaborative efforts with various organizations for community development to prepare for the next disaster. Specifically, they provide in-person mental health support, online support using Information and Communication Technology (ICT), and support for human resource development in communities.
• When providing online mental health support, one issue is that support effectiveness can depend on the user’s ability to use digital tools and similar devices. However, ICT-based mental health support is also important to prevent the worsening of problems related to loneliness caused by drawn-out physical distancing and shelter-in-place measures taken in response to the ongoing COVID-19 pandemic.

 

Keynote Lecture 2: “Gender and large-scale natural disasters, including pandemics”

Professor Natsuko Hagiwara

• Natural disasters and pandemics affect everyone equally. Insufficient understanding toward gender (in both social and cultural terms) makes it difficult to identify what support is needed by each individual who needs support after a disaster.
• To accurately identify the needs of vulnerable groups after disasters and to provide them with the support they require, we must understand gender and change the social mechanisms that create the foundation for those needs. Understanding toward gender is also important for promoting understanding toward all minorities.
• The disease of isolation, which can occur due to large-scale natural disasters, can be treated with social prescriptions. These can be provided by creating links in communities. Links in communities form the foundation for protecting communities from natural disasters and pandemics.

 

Keynote Lecture 3: “Current status and issues in mental health and psychosocial support in natural disasters and other emergencies”

Professor Nahoko Harada

• Mental health is a spectrum without clear boundaries. Individual wellbeing moves along that spectrum over long periods. Consequently, disaster mental health support must be tailored to changes in mental health that occur over long periods.
• Enhancing community resilience by improving absorption, buffering, and response capacities is important for maintaining and strengthening mental health and psychosocial support during natural disasters and other emergencies. Specifically, approaches for developing Business Continuity Management (BCM) plans, improving mental health literacy, and eliminating stigma toward mental disorders are needed.
• While Japan’s disaster response practices have received high recognition from the international community, Japan faces lingering issues that must be addressed. These include the difficulty of verifying activity effectiveness and the absence of support systems for volunteers from private volunteer organizations.

 

Panel discussion: “Community Building for Disaster Mental Health”

• To engage in community building for disaster mental health, we must understand the needs of those most affected and build permanent community-based support frameworks.
  • For many years, Japan has relied on a hospital-centric mental health and welfare system. However, frequent disasters in recent years have created an opportunity to develop community-based care activities. A decade has passed since the Great East Japan Earthquake. It is time we examine methods for community building that take every aspect of mental health and welfare, including disaster mental health, into account.
  • Disaster mental health support in Japan is likely to improve if a permanent base or structure for mental health is established in every community. One method of doing so would be to establish mental health care centers* for activities encompassing various aspects of mental health, including providing support, conducting research, and engaging in awareness-raising activities, and that provide access to mental health support for long periods after disasters.

*Mental health care centers: Organizations that perform various functions for mental health in communities, including consultation and treatment from specialists, research, human resource development, and public awareness-building for mental health and welfare. Mental health care centers established in response to large-scale disasters include the Hyogo Institute for Traumatic Stress, the Niigata Mental Health Welfare Association Mental Health Care Center, the Iwate Prefectural Mental Health and Welfare Center, the Miyagi Disaster Mental Health Care Center, the Fukushima Center for Disaster Mental Health, and the Kumamoto Mental Health Care Center.

• It is important to keep an up-to-date understanding of the characteristics of each organization and related party in the community, to continuously develop the human resources needed to link each organization and related party, and to maintain an environment in which supporting organizations and people can be readily introduced to a region during and after disasters.
  • Continuously building and maintaining relationships among support organizations or various specialists that are closely linked to the community will improve resilience during and after disasters.
  • Relationships among individuals and organizations grow more important during and after disasters. Therefore, it is necessary to train human resources and prepare the local environment by improving tolerance. Improving tolerance in the community will improve support for minorities during and after disasters and contribute to building a society that is friendlier to everyone, including minorities.
• Addressing the personal and psychosocial issues rooted in feelings of loss and loneliness caused by large-scale disasters and pandemics will require efforts from the entire community, including those most affected, supporters, and specialists.
  • There are various social and cultural aspects to issues such as stigma toward minorities or supporters or suicide after natural disasters. It is important that every member of the community accepts multiculturalism and takes evidence-based actions to enhance everyone’s ability to seek, receive, and provide support during and after disasters.

 

■Overview
Date and time: Friday, March 26, 2021; from 10:00 to 12:00
Format: Online (Zoom webinar)

■Program: (Titles omitted; in no particular order)
Opening remarks and explanatory introduction
Shunichiro Kurita (Manager, HGPI)

Keynote Lecture 1: “Providing remote mental health support for disaster-affected areas through ICT and collaboration among support organizations” 
Mitsuru Suzuki (Chairman, NPO Kokoro-no-Kakehashi Iwate; Counsellor and Medical Officer for Regional Mental Health, Embassy of Japan, Thailand)

Keynote Lecture 2: “Gender and large-scale natural disasters, including pandemics”
Natsuko Hagiwara (Professor, Graduate School of Social Design Studies, Rikkyo University; Chairperson, Japan NPO Center)

Keynote Lecture 3: “Current status and issues in mental health and psychosocial support in natural disasters and other emergencies”
Nahoko Harada (Professor, Department of Psychiatric and Mental Health Nursing, School of Nursing, University of Miyazaki)

Panel discussion: “Community Building for Disaster Mental Health”
Panelists:
Mitsuru Suzuki
Natsuko Hagiwara
Nahoko Harada
Naru Fukuchi (Executive Vice President, Miyagi Disaster Mental Health Care Center)
Hironori Kuga (Associate Director, Mental Health and Disability Health Division, Department of Health and Welfare for Persons with Disabilities, Social Welfare and War Victims’ Relief Bureau, Ministry of Health, Labour and Welfare)
Moderator:
Tomohito Shibata (Senior Associate, HGPI)