Support for disaster survivors with PTSD

This study examines the challenges and approaches in providing mental health support to survivors with PTSD following the Great East Japan Earthquake, tsunami, and nuclear accident of 2011, based on clinical experience in Minamisoma City, Fukushima Prefecture. The paper first outlines the principles of disaster psychiatry and Psychological First Aid (PFA), emphasizing the importance of ensuring safety and security. Through case studies of elderly evacuees and disaster response workers, it illustrates how the disruption of community ties and prolonged evacuation significantly impacted mental health outcomes. Analysis of clinical records from a psychiatric clinic established in 2016 revealed high treatment discontinuation rates (58.5%) among PTSD patients and insufficient intervention for substance use disorders. The study also presents cases where Prolonged Exposure (PE) therapy was successfully implemented, demonstrating its effectiveness in treating complex trauma resulting from both disaster experiences and pre-existing conditions. The findings suggest that while standard psychiatric care should be consistently available in disaster-affected areas, specialized trauma-focused interventions should be introduced only after basic stability has been established. This staged approach aligns with current disaster mental health intervention frameworks.