January 17, 2018
It has been 23 years since the Great Hanshin-Awaji Earthquake on Jan. 17, 1995, which resulted in more than 6,400 people dead or missing.
The Disaster Reduction Learning Center (DRLC), jointly established in April 2007 by JICA Hyogo (now JICA Kansai) and Hyogo Prefectural Government to disseminate the experiences and lessons of the quake to the world, has been operating for more than 10 years. One of the achievements of the DRLC is sharing with the world Japan’s experience of mental health care in disasters.
In Japan, the concept of ‘mental health care in disasters’ gained attention rapidly after the Great Hanshin-Awaji Earthquake. A distinguishing feature of mental health care in Japan is the philosophy of linking the activities of various organizations with an increase in the resilience of disaster-affected people. Not being limited to specialized counseling and treatment by a psychologist, it includes quick recovery of food, housing, safety, education and cultural activities, and emphasizes arranging livelihood recovery of disaster-affected people, and also restoring community ties immediately after a disaster. Just like Japan’s overall philosophy of disaster risk reduction, it also emphasizes the prevention stage: efforts made before a disaster strikes.
In August 2017, Chile’s first national guideline related to mental health care during disasters was completed. Like Japan, Chile is a country that frequently experiences earthquakes and tsunamis. It was created jointly by three agencies: The Research Center for Integrated Natural Disaster Management (CIGIDEN), the Ministry of Health (MINSAL), and the National Emergency Office of the Ministry of the Interior and Public Security (ONEMI). The guideline is an outcome of the training program "Modeling Mental Health Care During Disasters," which was implemented by JICA Kansai and the DRLC with the full cooperation of the Hyogo Institute for Traumatic Stress* for three years beginning in 2014.
The guideline consists of nine lines of action. The section on "Technical Guidelines for the Intervention" states the importance of safety and human ties. That on "Strengthening of the Community" emphasizes that strengthening community is a key approach that leads to mental health care. The section on "Education for the Protection of Mental Health in Disaster Risk Management (DRM)" takes up DRM education in ordinary times as a highly effective approach to build the foundation for mental health care during disasters.
In Chile, there was almost no widespread awareness of the importance of mental health care, and close coordination among related agencies remained a challenge. The guideline was the result of collaborative efforts by related agencies, summarizing what to do before, during and after a disaster according to each line of action. These features incorporated in the guideline are a big achievement in the long-term partnership between Chile and Japan.
With the cooperation of the Hyogo Institute for Traumatic Stress, JICA began the training program "Training for Mental Health Services after Disasters” in 2005. The impetus was the 2004 Indian Ocean earthquake and tsunami, which resulted in more than 300,000 people dead or missing.
JICA's training programs triggered the establishment of two mental health care centers in Thailand. In Myanmar, which was damaged by Cyclone Nargis in April 2008, the ex-participants organized a team of psychiatrists in the country. The team worked in disaster affected areas, created a new program responding to the needs of disaster affected people and trained specialists.
In May 2008, less than one month after Nargis struck, the Sichuan Earthquake took place in China, resulting in more than 100,000 people dead or missing. In June 2009, JICA began "the Project for Capacity Development on Mental Health Services for Reconstruction Support of Sichuan Earthquake." For five years, Japanese and Chinese specialists and agencies, including the Hyogo Institute for Traumatic Stress, worked to train mental health care practitioners while incorporating the DRLC training, resulting in raising awareness among local governments and residents.
"In Japan, we have been flexibly revising systems and structures every time a disaster occurred, and we also created Japan's original mental health care model. The most important thing in disaster risk reduction is trying to learn from others, and the training programs carried out by JICA are a platform for mutual learning among countries," says Dr. Hiroshi Kato, director of the Hyogo Institute for Traumatic Stress.
JICA Kansai and the DRLC will continue carrying out training for officials involved in disaster risk reduction in developing countries, and share experiences and lessons learned in mental health care.