Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study.

BACKGROUND: Many local workers have been involved in rescue and reconstruction duties since the Great East Japan Earthquake (GEJE) on March 11, 2011. These workers continuously confront diverse stressors as both survivors and relief and reconstruction workers. However, little is known about the psychological sequelae among these workers. Thus, we assessed the prevalence of and personal/workplace risk factors for probable post-traumatic stress disorder (PTSD), probable depression, and high general psychological distress in this population. METHODS: Participants (N = 1294; overall response rate, 82.9%) were workers (firefighters, n = 327; local municipality workers, n = 610; hospital medical workers, n = 357) in coastal areas of Miyagi prefecture. The study was cross-sectional and conducted 14 months after the GEJE using a self-administered questionnaire which included the PTSD Checklist-Specific Version, the Patient Health Questionnaire-9, and the K6 scale. Significant risk factors from bivariate analysis, such as displacement, dead or missing family member(s), near-death experience, disaster related work, lack of communication, and lack of rest were considered potential factors in probable PTSD, probable depression, and high general psychological distress, and were entered into the multivariable logistic regression model. RESULTS: The prevalence of probable PTSD, probable depression, and high general psychological distress was higher among municipality (6.6%, 15.9%, and 14.9%, respectively) and medical (6.6%, 14.3%, and 14.5%, respectively) workers than among firefighters (1.6%, 3.8%, and 2.6%, respectively). Lack of rest was associated with increased risk of PTSD and depression in municipality and medical workers; lack of communication was linked to increased PTSD risk in medical workers and depression in municipality and medical workers; and involvement in disaster-related work was associated with increased PTSD and depression risk in municipality workers. CONCLUSIONS: The present results indicate that at 14 months after the GEJE, mental health consequences differed between occupations. High preparedness, early mental health interventions, and the return of ordinary working conditions might have contributed to the relative mental health resilience of the firefighters. Unlike the direct effects of disasters, workplace risk factors can be modified after disasters; thus, we should develop countermeasures to improve the working conditions of local disaster relief and reconstruction workers.

Criticism by community people and poor workplace communication as risk factors for the mental health of local welfare workers after the Great East Japan Earthquake: A cross-sectional study.

After a large-scale natural disaster, demand for social welfare services increases, and the mental health of local social welfare workers becomes a matter of great concern because of their dual role as support providers and disaster survivors. We examined whether work-related social stressors, including criticism by community people and poor workplace communication, were associated with increased risk of post-traumatic stress disorder (PTSD), depression, or psychological distress 20-22 months after the Great East Japan Earthquake (GEJE; March 11, 2011) in local social welfare workers. Demographic characteristics, disaster-related risk factors (near-death experience, dead/missing family members, loss of housing), and work-related social risk factors (criticism, lack of communication) were obtained 20-22 months after the GEJE from 822 local workers. Questionnaires measured PTSD, depression, and psychological stress. Bivariate and multivariate regression analyses were applied. More local social welfare workers suffered from mental health problems than would be expected. Criticism by community people was significantly associated with probable PTSD and high psychological distress (adjusted odds ratio = 2.31 and 2.55, respectively). Furthermore, lack of workplace communication was associated with probable PTSD, depression, and high psychological distress (adjusted odds ratio = 3.97, 4.27, and 4.65, respectively). Almost 2 years after the disaster, local relief workers still suffered from mental health problems. Because post-disaster work-related social stressors constitute risk factors for these mental health problems, measures to improve working conditions and prevent and treat mental disorders should be a priority.