FUKUSHIMA Lives on the Line

122Odaka Akasaka HospitalNo consultationsSunflower House 3 (Occupational Support B)• Sunflower House, Sunflower House 2 (Occupational Support B)• Reopened late March: Flat• 7 Group Homes (Sunflower House)• Sunflower House, Sunflower House 2 (Occupational Support B)• Reopened late March: Flat• 7 Group Homes (Sunflower House)April: partial reopening of Asagao (Occupational Support B)June: partial reopening of Hot-Yu (Occupational Support B)September: move to occupational support B : Pony HouseThree closed group homes (HibarigaokaHospital and Odaka Akasaka Hospital)Three group homes and care facilitiesthat reopened in April (Asagao)Investigating move to another area: Coffee Time (Occupation B)Evacuation ZoneClosed: Aoba Community Workshop (Occupational Support B)Moved to Iwaki and reopened: Yui-no-SatoConsultation and Support Workplace, Group HomeFutaba Kosei HospitalNo consultationsFutaba HospitalNo consultationsTakano HospitalOutpatient care reopenedon May 9Hibarigaoka HospitalJune 22- Outpatient care reopenedfor only two days a weekAugust 1, 2011Image 3: Status of Psychiatric Welfare Facilities (e.g., Workshops and Group Homes) and Hospitals with Beds for Psychiatric Patients in the Soso area of Northern Hamadori after the Disaster �(source: Kazuma Yonekura, Soso Health and Welfare Office)This radiation contamination has forced the relocation of 113,000 people (as of July 2011), and the transfer of 10,000 of the 240,000 Fukushima elementary, middle, and high school students to schools outside the prefecture (as of May, source: Ministry of Education, Culture, Sports, Science and Technology). The incident has adversely affected Fukushima’s main industries of agriculture, fishing, and tourism, and stirred up anxiety in parents with small children. The radiation contamination has uprooted the lives of countless people.Also, the nuclear accident has significantly changed psychiatric care, healthcare, as well as our welfare system. There are five hospitals with psychiatric treatment facilities within 30 kilometers of the Fukushima Daiichi plant (Image 2). From March 12 to 17, four hospitals to the north of the plant—Futaba Kosei Hospital, Futaba Hospital, Odaka Akasaka Hospital, and Hibarigaoka Hospital—were ordered to transfer their inpatients and forced to close down; Takano Hospital to the south of the plant also had to transfer their psychiatric patients to another hospital. These sudden patient transfers were conducted under absolute chaos, and some patients even passed away from the stress and the cold weather outside. At one stage, a total of over 840 psychiatric hospital beds were rendered unusable. There are many workshops and group homes within 30 kilometers of the plant that were also forced to close (Image 3). Some patients and users of psychiatric, healthcare, and welfare facilities were evacuated to other areas of Fukushima or outside the prefecture and, thus, many facilities voluntarily closed down. Moreover, those who stayed back no longer had access to their regular facilities.2. What We Needed to PrepareFrankly, I never imagined encountering a radiation exposure incident myself or that a nuclear accident would cause such social chaos and enormous setbacks to our psychiatric medical system. I had grown accustomed to the “myth of safety”. But the catastrophe actually occurred, and we were all made to realize the possible recurrence of such events in the future. Thus, we who experienced these events must broadly share our experiences with those inside and outside Japan, emphasize that such events could occur again, and identify measures to address them.There are 55 nuclear power plants in Japan that are either operational, under periodic inspection, or offline (as of July 2011, Image 4). These spread across 13 prefectures, from Hokkaido to Kyushu. The possibility that a disaster such as a massive earthquake might strike these areas and cause radiation exposure on par with the Fukushima incident cannot be denied. Thus, psychiatric care providers in Japan must realize and think about how to respond to these events and address them not as a hypothetical situation, but as a real possibility.Managers and employees of psychiatric care facilities certainly never dreamed that their entire hospitals would be ordered to evacuate. And just where on earth would they evacuate their patients to? What should they do if they were unexpectedly ordered to complete this evacuation within a day or two? On March Lessons from Fukushima: What We Can Learn about Psychiatric Care from the Radiation Exposure Incident