[Mental health activities for evacuees of the volcanic eruption of Mt. Unzen-Fugen--crisis intervention of a psychiatrist].

In a regional mental health activity for residents who have been evacuated for over three years on account of the volcanic eruption of Mt. Unzen-Fugen, a crisis intervention of the author took place in 76 people (21 males and 55 females) between June 1992 and November 1994. Most of them were over 41 in both sexes and half of female subjects was over 61. Using ICD-10, 57.9% of total were tentatively diagnosed as having depressive disorders (F32, F34.1, F41.2 and F43.2). Of the 76 cases, 49 people improved with counseling, 22 people received a prescription of psychotropics from general practitioners and 5 people required outpatient care or hospitalization at psychiatric or geriatric institutions. The outcome as of November 1994 was 60 remitted cases including 6 relapse cases, 6 worsened cases and 10 unchanged cases. The case history and the reality of crisis intervention was introduced on some cases and the evacuated people's peculiar psychology, that mental scars and grief after experiencing the disaster are unspoken and kept locked in their hearts, was discussed. On the basis of the above results and discussion, I considered the meaning of visiting the evacuees' shelters and emphasized the importance of the following basic strategies of crisis intervention to evacuated people: 1. to give them counseling so that they can accept their devastating experiences as part of their life, 2. to give support to the whole family, 3. to work in close cooperation with general doctors in cases requiring drug therapy. Furthermore, it was insisted that it is necessary to establish a disaster mental health system to give support to evacuees who need psychiatric help on a long time scale not just immediately after the disaster. Finally, I pointed out the undeveloped level of disaster mental health activities in Japan and referred to future problems.