Suicide Rates in Evacuation Areas After the Fukushima Daiichi Nuclear Disaster

Background: Associations between nuclear disasters and suicide have been examined to a limited extent. Aim: To clarify the suicide rates in evacuation areas after the nuclear disaster in Fukushima, which occurred in March 2011. Method: This descriptive study used monthly data from vital statistics between March 2009 and December 2015. Suicide rates in areas to which evacuation orders had been issued, requiring across-the-board, compulsory evacuation of residents from the entire or part of municipalities, were obtained and compared with the national average. Results: Male suicide rates in evacuation areas increased significantly immediately after the disaster, and then began to increase again 4 years after the disaster. Female suicide rates declined slightly during the first year and then increased significantly over the subsequent 3-year period. Moreover, male rates in areas where evacuation orders were issued for the total area declined over the course of approximately 2 years, but then began to increase thereafter. Analysis by age revealed postdisaster male rates in evacuation areas decreased for those aged 50–69 years and increased for those aged ≤ 29 years and ≥ 70 years. Limitations: The number of suicides among females and the female population in the evacuation area was small. Conclusion: Our findings suggest the need to keep in mind that, when providing post-disaster mental health services, suicide rates can eventually increase even if they initially decrease.

Disaster Mental Health Services Review of Care for Older Persons After Disasters

As older persons make up an ever greater proportion of the world’s population, a range of concerns are being voiced by policy-makers, program managers, and care providers about best or optimal practices for serving this population’s needs during all stages of disasters. Given that age-related vulnerabilities are common in late life, this article describes existing systems of care in the United States for the provision of disaster mental health services. Second, it evaluates the evidence for disaster treatment interventions with this subgroup of the population. Third, it synthesizes the findings of recent studies focusing on screening, assessment, and treatment approaches. To advance our current system of care and to adequately respond to the mental health needs of older persons, it is advantageous to periodically review progress, identify current gaps and unmet needs, and describe opportunities for improvement. (Disaster Med Public Health Preparedness. 2018; 12: 366–372)

Systematic Consensus Building on Disaster Mental Health Services After the Great East Japan Earthquake by Phase

ObjectiveWe intended to build consensus on appropriate disaster mental health services among professionals working in the area affected by the Great East Japan Earthquake.MethodsWe focused on the first 3 months after the disaster, divided into 3 phases: immediate aftermath, acute phase, and midphase. We adopted the Delphi process and asked our survey participants (n=115) to rate the appropriateness of specific mental health services in each phase and comment on them. We repeated this process 3 times, giving participants feedback on the results of the previous round. Through this process, we determined the criterion for positive consensus for each item as having the agreement of more than 80% of the participants.ResultsWe found that the importance of acute psychiatric care and prescribing regular medication for psychiatric patients gained positive consensus in the immediate aftermath and acute phase. Counseling and psychoeducation after traumatic events or provision of information gained consensus in the acute phase and midphase, and screening of mental distress gained consensus in the midphase.ConclusionsHigher priority was given to continuous psychiatric services in the immediate aftermath and mental health activities in later phases. (Disaster Med Public Health Preparedness. 2015;9:359–366)