Japan PTSD

Empathy in a Disaster Zone

August 25, 2011

Joseph Halm

Takashi Fujioka, a visiting scholar from Japan who specializes in social work burnout prevention, has designed a new method for monitoring mental health professionals working in a disaster zone. Fujioka spent several months in New Orleans working with the Tulane Traumatology Institute at the Tulane School of Social Work to help mental health professionals in Japan after the recent earthquake and tsunami.

Takashi Fujioka

Takashi Fujioka, a social work visiting professor, develops a disaster-services monitoring method for mental health providers. (Photo by Joseph Halm)

A professor of social work at the Japan College of Social Work, Fujioka survived the March 11 earthquake disaster. “It was like a slow-moving horror show,” he says.

“Trauma is not only a primary experience for those who suffer through it,” he says. “It also affects those who help the trauma victims. It is something that everyone experiences.”

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Prof. Kodama Tokyo University on Radiation Danger in Fukushima Region

Today I just checked on the Japanese Youtube site and there are many uploadings of Dr Kodama's impassioned and expert speach in Japanese. My guestimate is that collectively the number in Japanese is getting up to 1,000,000 views and still growing. The one with the largest number of views is at 549,659
and can be seen here
the one around 300,000 can be seen here:

549,659 and just grew to that number by nearly 200 while I've been writing this comment. If all you good folk here in Tokyo, Japan and around the world who are in support of the truth and concerned about the health of the good people of the Fukushima area and Touhoku disaster region can kindly twitter, facebook, tweet etc on to your social networks maybe we can get this English version to go over 1,000,000 and even more viral too. This would help put world pressure and support getting fast, effective and healthy solutions to this ongoing disaster that threatens so many adults and children now and in the future. Dr Kodama is a medical doctor specialized in cancer treatment and a leading authority on the effects of radiation on people's health at the University of Tokyo and has been working in this field for decades. Spread his words please, for the sake of us all in Japan and our children's children too. Thank you



Depression Japan

Aim:  Major depression is expected to become the leading contributor to disease burden worldwide by 2020. Previous studies have shown that the societal cost of depression is not less than that of other major illnesses, such as cardiovascular diseases or AIDS. Nevertheless, the cost of depression in Japan has never been examined. The goal of the present study was to estimate the total cost of depression in Japan and to clarify the characteristics of this burden.

Methods:  A prevalence-based approach was adopted to measure the total cost of depression. The total cost of depression was regarded as being comprised of the direct cost, morbidity cost and mortality cost. Diagnoses included in this study were depressive episodes and recurrent depressive disorder according to the ICD-10 or major depressive disorder according to the DSM-IV. Data were collected from publicly available statistics and the World Mental Health Japan Survey database.

Results:  The total cost of depression among adults in Japan in 2005 was estimated to be ¥2.0 trillion. The direct cost was ¥0.18 trillion. The morbidity cost was ¥0.92 trillion, while the mortality cost was ¥0.88 trillion.

Conclusion:  The societal costs caused by depression in Japan are enormous, as in other developed countries. Low morbidity costs and extremely high mortality costs are characteristic in Japan. Effective interventions for preventing suicide could reduce the societal costs of depression.

Cost of depression among adults in Japan in 2005 - Sado - 2011 - Psychiatry and Clinical Neurosciences - Wiley Online Library

American Red Cross

American Red Cross Contributions to Japan's Tsunami Recovery Reach $260 Million

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SOURCE American Red Cross

Additional $15 million donation means that almost 88 percent of U.S. pledges have been sent to Japan in less than six months

WASHINGTON, Aug. 22, 2011 /PRNewswire-USNewswire/ -- The American Red Cross today contributed an additional $15 million to the Japanese Red Cross, bringing its investments in the country's disaster recovery to nearly $260 million.

(Logo: http://photos.prnewswire.com/prnh/20090108/RedCrossLOGO)

Less than six months since the earthquake and tsunami struck, about 88 percent of the money donated to the American Red Cross has been transferred to its local partners as they continue to meet the emergency and longer-term recovery needs of families living in evacuation centers and temporary housing. The American Red Cross, for example, is backing more than half of the Japanese Red Cross aid program and has supported the UN's World Food Programme and International Organization for Migration.

"Significant progress has been made since March 11 – the mood has changed, the conditions have improved and the outlook is hopeful," said Alex Mahoney, disaster management advisor with the American Red Cross. "Still, it will be many years before some towns really come back to life."

More than 82,000 families have already received a set of household appliances, including a washing machine, refrigerator, microwave, rice cooker and hot water dispenser, for their prefabricated houses and subsidized apartments. These distributions represent 90 percent of the total appliance packages pledged (90,000) by the Japanese Red Cross.

As of early August, approximately 10,000 people were still living in evacuation centers. In many cases, they turned down housing offers from the government because they do not want to lose the companionship of other people in the centers. This support has particularly helped the elderly in the healing process.

"People still have sadness in their hearts but while they still cry they are now able to laugh as well," said Takako Inoue, a Red Cross nurse caring for the elderly in an evacuation center.

Since the disaster, the Red Cross has placed caregivers and psychological support teams in evacuation centers and nursing homes to address the mental health issues amongst survivors. The Japanese Red Cross has established two psychological support centers and deployed more then 465 counselors to work with the affected population. As of early August, more than 13,600 people had benefited from this support.

In addition to providing three meals each day and water services for the remaining residents, the Japanese Red Cross also has equipped evacuation centers with privacy partitions, hospital beds for the elderly, play areas for the children, Internet access, televisions, showers and doctors.

"For the families waiting for temporary housing assignments near their children's school or place of employment, these improvements bring great comfort," said Mahoney. "For the elderly and ill, they bridge the gap while the debilitated healthcare system is being restored."

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Japanese Society of Certified Clinical Psychologists

MSF works with psychologists in aftermath of Japanese quake
The psychologists with whom MSF plans to work come from the Japanese Society of Certified Clinical Psychologists and MSF will assist them in identifying populations in need of assistance, as well as providing logistical support.

MSF plans to support a team of six psychologists who will treat survivors of the devastating earthquake and tsunami that hit northeast Japan on March 11.

A 12-person MSF team has been treating patients with chronic diseases in one of the areas worst affected by the disasters for the last 12 days, and earlier this week sent a psychologist to evaluate mental health needs.



Mental Health Japan

Kaleidoscope of the Heart: A lesson in occupational health
Rika Kayama

There is a field of medicine called occupational health, which involves protecting the health of people working in companies and organizations. Recently I made up my mind to take part in a one-week intensive summer course at the University of Occupational and Environmental Health.

The program included statistics, ergonomics and training involving electrocardiograms and other issues that I'm not too good with, so I felt relieved when the topic of mental health came up. Saying I'm relieved with talk about depression may sound strange, but being a psychiatrist, I guess that's where I fit in.

In a lecture by Jun Nakamura of the university's Department of Psychiatry, one particular phrase that struck me was: "Psychiatric health in modern Japan is an economic issue." In other words, the "emotional problems" that are in the spotlight in present-day Japan are intertwined with economic issues and changes in social structure at some point along the line.

It's true that there is a lot of stress in companies today, with harsh personnel evaluations, a doctrine of competitiveness, and corporate restructuring that could happen any moment. At the same time, job hunting is also becoming tougher for students and some have no option but to become part-time job hoppers or NEETs -- those not in education, employment or training. Others go from one temp job to another and end up losing both their work and their families. But since other people are busy looking out for number one, no one lends a helping hand.

In other words, people in society today can't feel at ease whether they are in an organization or not. Stress levels rise in an atmosphere of uneasiness and tension, and there is no doubt people who suffer from depression and other conditions as a result.

However, no matter how much psychiatrists call for revision of the nation's economic structure, society will never change overnight. Accordingly, there is no option but to handle the situation with preventive measures within the community and companies, and with treatment in consultation rooms.

Professor Nakamura says that when someone in an organization takes leave due to depression or some other reason, he wants the person and those around that person to find significance in the event upon their return to work. In one cited example, when a worker succumbed to depression, the person's department looked back on its approach to work, and decreased overtime and provided more opportunities for communication. The person who had fallen ill also made an effort to increase family time. If such an approach can be adopted, then it should be possible for the person to say, "It was good that I had depression."

I had secretly thought that if occupational health was really interesting, then I might change jobs, but what I learned from taking part in the course was that it was good I became a psychiatrist. I will now aim to become a doctor whose patients can think, "I got ill but there were some good things about that." (By Rika Kayama, psychiatrist)

Kaleidoscope of the Heart: A lesson in occupational health - The Mainichi Daily News


香山リカのココロの万華鏡:産業保健の講座受講 /東京









香山リカのココロの万華鏡:産業保健の講座受講 /東京 - 毎日jp(毎日新聞)


The 30-year-old firefighter combs the riverbanks, rubble-strewn rice fields and weed-choked gullies where he thinks he might find them. He uses the shovel to pry up chunks of concrete, the saw to slice through jagged shards of wood, looking for that chance macabre encounter: the jutting form of a hand, a face.

Oikawa is searching for the bodies of his wife and baby daughter, who disappeared March 11 when the earthquake-triggered tsunami washed across this rural landscape, pulling houses from their foundations and dragging residents to their deaths.

The disaster hit this farm and fishing community of 160,000 hard. Of 8,000 people still missing across northeastern Japan, 2,770 are from Ishinomaki; it also has the highest confirmed death toll, 3,100.

Oikawa knows he will never find his family alive. More likely, if he locates their bodies at all, they will be horribly decomposed, the remains perhaps ravaged by animals. But Oikawa doesn't care. He just wants them back.

Often, in moments of doubt, as he scours country back roads and rarely trodden trails, he takes out the photographs of his 29-year-old wife, Emi, and 15-month-old Atsuki and he talks to them.

"I'm sorry," he says softly. "I'm sorry."

In Japanese, Maromu means "to protect," and he chastises himself for failing so miserably with the two people he loved most.

He's sorry that he couldn't protect them; sorry that he wasn't there when the waves took them; sorry that they had such shortened lives.

This region is full of survivors with missing friends and family members. Yet as the weeks and months pass, most slowly relinquish their slim hope of ever recovering the dead.

But Oikawa says he won't stop until he finds his wife and daughter.

"I'll still be looking next year," he said, "and the year after that."


In such a small city, the absence of the dead and disappeared is felt every day: They're the attorney, the grocery store bagger, the mechanic, the woman who sold flowers from the roadside stand.

"The town seems back to normal," said newspaper editor Hiroyuki Takeuchi. "But inside, there's a raw psychological wound that won't heal."

Families still languish in evacuation shelters, breadwinners are without homes or jobs or realistic prospects for either.

Japan quake tsunami: Japanese man refuses to stop searching for his missing family - latimes.com

Japanese Association for Suicide Prevention Yukio Saito

Chair of the Japanese Association for Suicide Prevention Yukio Saito


Yukio Saito, 75, is the Chair of the Japanese Association for Suicide Prevention and CEO of the Japanese Federation of Inochi-no-denwa (Lifeline), Japan's first and largest telephone counseling service. For the past five decades, Saito has been educating the public and lobbying relentlessly to bring an end to Japan's shockingly high suicide rate, which is one of the highest among developed countries. From 1977, the number of suicides in Japan increased steadily until 1998, when suicides claimed one life about every 20 minutes. It took Saito four decades and the publication of more than 40 books on suicide to convince the Japanese government to start paying attention to these numbers. Finally in 2001, Japan's first national suicide-prevention policy was enacted. Still, 2003 turned into an especially tragic year as 34,427 people- about 70 percent of them men — took their own lives, bringing the nation's suicide death toll to a new peak, with one about every 15 minutes. As time is running out for more and more people, Saito does everything in his power to keep reaching out.

News photo
Yukio Saito, chair of the Japanese Association for Suicide Prevention and CEO of the Japanese Federation of Inochi-no-denwa (Lifeline) JUDIT KAWAKUCHI PHOTO

Every day is precious. It might be our last one. Or it could end up as the final day for a loved one. Make it great!

Talking is the most effective coping mechanism. Opening one's mouth is a way to open one's own heart, and the listener's heart, too. Everyone has the power to cope if they express their feelings.

When people are grieving, the feelings that lead to suicide are strong. Since the Great East Japan Earthquake, suicide rates in the Tohoku region have gone up sharply. In Fukushima Prefecture, 217 people killed themselves in May. In 2010, there were 49 suicides there during the same month.

In March, we set up additional counseling lines for northern Japan and in 10 days we received 1,515 calls. Sadly, we couldn't operate longer than those 10 days because we couldn't raise enough funds to cover the incoming calls. So far, the government hasn't done much for people regarding suicide prevention and crisis intervention, so I'm very worried that more tragic news of suicides will come to light within the next few months.

Chair of the Japanese Association for Suicide Prevention Yukio Saito | The Japan Times Online


Earthquake Tokyo Counseling Services

East Japan Great Earthquake and Tsunami 2011

Here is some information that hopefully will be of use to anyone here in Japan or for anyone inside or outside Japan who are concerned for friends and family in Japan who are using the internet to search for help on the earthquake in Japan. Bloggers and websites worldwide please feel free to post and pass this information on. Thank you.

Earthquake Tokyo Counseling Services

Depression Japan Earthquake

Cases of depression and alcoholism are rising in number among evacuees of the March 11 Great East Japan Earthquake, tsunami and the nuclear accident.

A team of mental care specialists from Kyoto Prefecture treated 262 people at seven evacuation centers, including one in Aizuwakamatsu in Fukushima Prefecture, until July.

The team said 51 evacuees, or 19.5 percent, were suffering from reactive depression.

Toru Ishikawa, president of the Tohokukai Medical Hospital in Sendai, says the survivors of disasters have become more susceptible to depression and alcoholism since moving into temporary housing from evacuation centers. That's because many of them now live alone.

"A system is needed in which community nurses can continue to listen to the same people for an extended period, but there is a shortage of nurses in the disaster areas," Ishikawa said. "I hope that those who find people with possible (depression or alcohol) problems advise them to see a doctor."

Post-traumatic stress syndrome is also a problem.

asahi.com(朝日新聞社):Depression, alcoholism take toll on lonely evacuees in disaster areas - English

Report from: asahi.com(朝日新聞社):Depression, alcoholism take toll on lonely evacuees in disaster areas - English

Fears of Suicide Japan's Tsunami Zone | Asia | English

Fears of Suicide Surge in Japan's Tsunami Zone | Asia | English