One of the greatest challenges faced by the people of the Fukushima Prefecture (and the people of Japan) in the aftermath of the Fukushima ‘triple disaster” does not involve the clean-up and rebuilding, or even the prevailing fear of radioactive contamination. Perhaps the greatest long-term challenge may be coping with the psychological impact of the disaster.
The issue is twofold: Getting enough Mental Health Care experts, and persuading the sufferers that having a mental health issue does not make them inferior.
Japan still struggles with a heavy stigma against mental health issues. For most Japanese, having a relative, who is “mental”, isl considered shameful. As published on PubMed.gov, Koizumi and Harris found in 1992 that
Although the [Japanese] government has encouraged and supported the integration of mentally ill people in the community and the development of rehabilitation programs since enactment of the Mental Health Law of 1988, implementation of such programs has been slow.
The situation was dire even shortly before the Fukushima Nuclear Disaster.
As Japan Today reported in March, 2009, a 2008, a study by the Japanese Ministry of Health, Welfare and Labor found that
24% of Japanese people had suffered from some kind of mental health problem. Another report found that one in five adults had considered killing themselves, with actual suicide rates at 51 per 100,000 people — twice as high as the U.S. and three times that of the UK.
Today there are precious few facts available about how Japan, and in particular the Fukushima Prefecture, are coping with the severe emotional trauma following the Fukushima Dai-ichi disaster. It would appear that the local news media still does not consider mental issues a topic to be discussed.
But we should. As the Centers for Disease Control and Prevention (CDC) so accurately states in their Disaster Mental Health Primer:
No one who experiences a disaster is untouched by it.
After the incident of March, 2011, survivors and evacuees were hit not just with grief for loved ones who had so suddenly died, but also with the loss of friends, homes, belongings, and employment.
And fear. Fear that the nuclear plant may explode all together. Fear of another natural disaster. Fear of cancers and other radiation-related diseases, now and in future. Fear that they may never be able to return home. Fear that they may not have a home to return to.
Fear, depression, and stress have replaced normal every-day life for thousands of people of all ages and all genders.
On Marts 1st, 2014, an editorial in The Japan Times found that
The latest report from Fukushima revealed that more people have died from stress-related illnesses and other maladies after the disaster than from injuries directly linked to the disaster.
In the Fukushima Prefecture, 1,607 people died from injuries sustained during the disaster. Another 1,656 people have since died from stress-related conditions in its aftermath.
The prevailing mental health issue facing the survivors and evacuees is Post-Traumatic Stress Disorder (PTSD) – anxiety and fear due to excessive stress. This sometimes causes the sufferer to acquire one or more specific phobia(s), and almost always leads to major depression. Concurrent feelings of grief just fuel the fire.
Without proper treatment and support, PTSD can easily lead to:
- Alcohol and substance abuse,
- Estrangement from loved ones
- Decreased self-esteem.
Adding to the problem, the continued displacement of victims in temporary housing. In March, 2014, 136,000 people were still living in these temporary quarters.
The College Women’s Association of Japan, which is running the Mental Health Care Projects in Soma City, Fukushima Prefecture said in their International Symposium in August 2012:
Without healthy mind and spirit, there is no hope for physical health, reconstruction, or recovery from the disaster, let alone furthering education.
In comparing all post-disaster risks, including long-term radiation risks, The World Nuclear Association concludes:
The most important health effect is on mental and social well-being, related to the enormous impact of the earthquake, tsunami and nuclear accident, and the fear and stigma related to the perceived risk of exposure to radiation.
And on January 16, 2013 Geoff Brumfiel wrote on Nature.com:
In the immediate aftermath of the nuclear accident, public-health experts worried about the possible risk from radiation ….. [The] prompt, if frantic, evacuation of areas around the reactors probably limited the public’s exposure to a relatively safe level ….. But uncertainty, isolation and fears about radioactivity’s invisible threat are jeopardizing the mental health of the 210,000 residents who fled from the nuclear disaster.
Researchers and clinicians are addressing the problem, but the Central Japanese Government either cannot or will not come up with the necessary money for the support needed to fully implement a functional post-disaster mental health recovery effort. Or even to increase the efficiency of existing mental health provisions. Add to that the average person’s reluctance to accept and assist mental health care, and the fact that the survivors and evacuees are continuing to lose trust in the Central Japanese Government.
This all combines into a cocktail far more deadly, also in the long run, than any number of physical disasters, as evidenced by a continuing increase of prolonged PTSD among the survivors and evacuees , with all its attendant conditions – from depression to substance abuse to suicide.
So what does this mean for the future and what is the answer?
A look back in time shows that 25 years after the Chernobyl nuclear power plant disaster
The unmet need for mental health care in affected regions remains an important public health challenge…
Regardless of whether a person suffers from mental health illness or emotional trauma, that person is still a person, a human being.
Perhaps what it comes down to, is this: Unless we human beings start realizing the importance of a healthy mind and spirit and start accepting that those among us suffering from a mental illness are no different than those suffering from physical disease, then full recovery from disasters of any kind will never be possible.
In 2013, Japanese documentary filmmaker, Kazuhiro Soda produced the documentary “Seishin” (Mental) . There is a hope that this documentary, and other similar efforts, will aid in encouraging people with mental health problems to seek help, and make others more tolerant towards people suffereng the burden of mental illness.