The Great Hanshin-Awaji Earthquake(1995) and Mental Health Issues

The role of psychiatric aid station following the Great Hanshin-Awaji Earthquake

Emergency mental health services had two unique characteristics in the immediate aftermath of the Great Hanshin-Awaji Earthquake. First, the disaster-affected areas had a high density of psychiatric outpatient clinics, creating an urgent need to restore their function. At the same time, there were compelling demands for assisting disaster-related mental health issues in the impact and confusion of the disaster's aftermath. Shortly after the disaster, the agony and desperation of the disaster victims were so visible through media that the psychological aspects of disaster victims drew the attention of general public. However, many community-based mental health professionals took more interest in the functional recovery of psychiatric clinics.

Many mental health related professionals in and outside of the area recognized the instant need for mental health services for survivors, and began to offer assistance. For the first few months, it was the networks existing prior to the disaster that took leading roles. Local public health centers remained as bases and continued to deliver mental health services in collaboration with professional support teams from outside the area. As bases for the professional support activities, 10 psychiatric aid stations were established, one at each public health center.

Mental health service delivery operated independently from station to station due to the varying nature of the professions and disaster situations. For example, almost all four psychiatric clinics at Nagata Ward were completely destroyed. By the time the clinics re-opened again, psychiatrists and local psychiatric social workers organized a temporary clinic at the public health center. In Nishinomiya City, where the recovery was relatively quick due to their resourcefulness and easy access to outside assistance, mental health outreach teams were organized and made multiple visits to shelters. Since there were no psychiatric facilities in the Tsuna District of Awaji Island, psychiatric hospitals located in adjunct areas made visits to shelters.

Many mental health professionals from all over Japan participated in activities of psychiatric aid stations. The Ministry of Health and Welfare (currently the Ministry of Health, Labour and Welfare) approved the requests of the disaster affected area, and immediately sought the assistance of other municipalities. The whole process was carried out successfully, and highly appreciated. Moreover, scientific societies and related organizations responded in a timely manner to dispatch support teams for the psychiatric aid stations in the disaster affected areas. Coordinators were particularly needed in order to organize relief workers' efforts more efficiently in the early stages of the recovery.

The activities were carried out based on on-site, field-oriented, and overall co-ordination. The coordinators were in charge of: collecting information from each region and forwarding it, communicating with national or local government bodies and related organizations, and distributing the outside manpower, and establishing and running the psychiatric emergency system and the night-shift on-call systems. At the time this group was called the Hyogo Prefectural Mental Health and Welfare Center and aiding medical doctors were primarily in charge of it. On-site, field-oriented decisions were given priorities in their activities, and it contributed to the efficacy of its functions.

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