[The Present Status of, and Issues Related to, Mental Health Activities in the Ishinomaki Region, with a Focus on Outreach Activities].

The Great East Japan Earthquake was a colossal event, registering a magnitude of 9.0 and causing huge tsunami that in some places were more than 40 meters in height. As of March 31, 2014, the number of dead nationwide stood at 15,882, while 2,668 persons were listed as missing; 3,089 other deaths have also been classified as being disaster-related. There were 5,500 victims in the Ishinomaki area alone. The disaster, comprising the earthquake itself, the subsequent tsunami, fires, and the nuclear power plant accident, was a combined natural and man-made catastrophe of epic proportions, affecting a broad, underpopulated region. Those hit by the disaster were affected not only by the loss of life, but also the loss of homes and livelihoods. These people experience psychological stress, fear, and anxiety as a result of lifestyle and environmental changes associated with moving from evacuation areas to prefab temporary housing, or the homes of parents, siblings, relatives, friends, or acquaintances, followed by attempts to rebuild their own homes. Other changes, such as the loss of employment, the transition to new workplaces, or having to change schools, also take a psychological and emotional toll. Delays in the construction of new housing and the resulting prolongation of life as evacuees only serve to increase anxiety and the sense of stagnation. With the above as a backdrop, the author will report on activities being conducted by his organization, particularly outreach efforts.

[Challenges faced by psychiatric services in Miyagi Prefecture after the Great East Japan Earthquake].

Following the Great East Japan Earthquake and Tsunami, the number of patients with onset, relapse, and exacerbation of mental disorders was expected to increase in Miyagi Prefecture, one of the worst affected areas. The functioning of almost all psychiatric hospitals sharply declined or even ceased. This situation worsened with traffic congestion and crippled public transportation, hindering many patients with psychiatric disorders from accessing mental health services. Among them, patients with schizophrenia and related disorders were affected the most; some could not reach the hospitals and clinics they had regularly visited and had to become new patients of another hospital or clinic. Moreover, an increasing number of patients with schizophrenia needed to be hospitalized because of acute exacerbations of their disorder, due to the experience of the disaster and the consequent drastic changes in their living environment Unfortunately, the support system for psychiatric institutions after disasters is not yet well structured; the system needs to be rebuilt and strengthened in anticipation of future disasters.