Mental Health and Lifestyle Survey
Outline of the Mental Health and Lifestyle Survey
Purpose
Since the Great East Japan Earthquake and the accident at TEPCO’s Fukushima Daiichi NPS, many people in Fukushima Prefecture feel anxious and stressed by the experience and evacuation. The Mental Health and Lifestyle Survey was launched with the aim of comprehending the physical and mental health and lifestyle of the residents, so we can provide each of them with individualized medical care, health care, and welfare services.
Eligible Persons
- Those who were registered as residents in the covered area* from March 11, 2011 to April 1, 2012 (even after moving out of the area)
- Those who are registered as residents in the officially designated evacuation zone as of April 1 of each year of the CHC
- Other than those above, as necessary, based on Basic Survey results.
* Covered area: 13 municipalities designated by the national government as evacuation zones in 2011
Hirono Town, Naraha Town, Tomioka Town, Kawauchi Village, Okuma Town, Futaba Town, Namie Town, Katsurao Village, Iitate Village, Minamisoma City, Tamura City, Kawamata Town, and parts of Date City (specific spots recommended for evacuation)
Method and main items in the questionnaires for FY2024 Survey
Self-administered.
Questionnaire content varies depending on the age group, and in principle, for children up to junior high school age, the questionnaire is to be completed by parents/guardians living with them.
| Age group | Respondent | Main items |
|---|---|---|
| Ages 0-3 | Parents/guardians of the child covered by the survey | Health condition, height, weight, exercise habits, parent’s confidence in child rearing, concerns about children’s development and behavior, availability of consultation resources, Influence of COVID-19 to daily lives, free comments, etc. |
| Ages 4-6 | Parents/guardians of the child covered by the survey | Health condition, height, weight, exercise habits, SDQ, developmental and/or mental health problems, availability of consultation resources, Influence of COVID-19 to daily lives, free comments, etc. |
| Elementary school students | Parents/guardians of the child covered by the survey | Health condition, height, weight, exercise habits, SDQ, developmental and/or mental health problems, availability of consultation resources, Influence of COVID-19 to daily lives, free comments, etc. |
| Junior high school students | Parents/guardians of the child covered by the survey (partially children themselves) | Health condition, height, weight, exercise habits, SDQ, developmental and/or mental health problems, availability of consultation resources, Influence of COVID-19 to daily lives, free comments, etc. |
| Adults | Persons to whom the survey was addressed | Subjective health condition, height, weight, medical history (hypertension, diabetes, mental illness.), health check record, sleep habits, exercise habits, living conditions (current housing, employment status), smoking, alcohol consumption, K6 score, Influence of COVID-19 to daily lives, health effects of radiation, and availability of consultation resources, free comments, etc. |
Implementation Status
FY2023 Survey (As of October 31, 2024)
- Eligible Population: 190,748
Children (Ages 15 and younger): 16,601
Adults (Ages 16 and older): 174,147 - Number of responses (Response rate): 33,033 (17.3%)
Children (Ages 15 and younger): 1,661 (10.0%)
Adults (Ages 16 and older): 31,372 (18.0%)
Yearly changes of the survey results
Changes in the percentage of children with an SDQ score (emotional and behavioral assessment) of 16* points or more
- The proportion of high-risk children with emotional or behavioral problems was high across all age groups in FY2011, with particularly elevated levels among those aged 4 to 6 years (24.4%). Since then, the proportion has decreased across all age groups and has improved to nearly that reported in the previous study (9.5%).
* SDQ (Strengths and Difficulties Questionnaire) criteria with a cutoff value of 16 points based on previous studies
Changes in the percentage of those scoring 13* points or higher on K6
- In FY2011, 14.6% of individuals were considered to be in need of support due to the possible presence of mood disorders such as depression or anxiety disorders. This proportion has shown an improving trend, reaching 5.4% in FY2023. However, it remains higher than the proportion reported in a previous study of the general population not affected by the disaster (3%). Continued careful support and monitoring are therefore considered necessary.
* K6 Distress Scale criteria with a cutoff value of 13 points, based on previous studies
Changes in the frequency of exercise in adults
- The exercise frequency of “Almost every day” and “2-4 times a week” improved gradually, reaching 43.9% in the FY2023 survey. A national survey showed 44.8% for those who exercise more than 2 days a week (20 old and older), although not directly comparable with our survey because of differences in participants’ age and other attributes, indicating that the exercise habits of Fukushima residents were similar to those in Japan overall.
Changes in the percentage of problematic drinking (CAGE score of 2 points or higher)
- In FY2023, the proportion of participants at high risk for problematic drinking was 13.9% among males and 6.5% among females, with both showing a decreasing trend.
Influences on daily life due to the spread of COVID-19
- In the FY2023 survey, those who responded that COVID-19 exerted influence on their daily life "Significantly" or "To some extent" accounted for 26.5%, which decreased compared to FY2022.
* Percentages have been rounded and may not total to 100%.
Changes in the proportion of risk perception of radiation effects to the next generation
- Regarding possible radiation effects on the next generation, 19.7% responded that they think effects on the next generation are likely to occur (“Possibilities are high” and “Possibilities are very high” combined) in the FY2023 survey. These percentages have been gradually decreasing.
Provision of support to those in need
FY2023 Survey (Numbers confirmed on December 31, 2024)
Among the survey respondents, those who were assessed as needing consultation or support based on their mental health status and lifestyle habits were provided with telephone support. Through these calls, their situations were assessed, and advice for improvement, as well as recommendations to seek care at health or medical institutions, were provided.
Number of support candidates and recipients for issues regarding children
Number of support candidates and recipients for issues regarding adults
* For those who met Criteria I, our “Mental Health Support Team” of clinical psychologists, public health nurses, clinical nurses, etc., made phone calls and provided counseling. The team asked about support recipients' health conditions, assessed current problems, and advised further examination at health/medical facilities when necessary.
* For those who met Criteria II, we sent reply-paid postcards to confirm their intention regarding telephone counseling. Telephone counseling was provided to those who expressed an intention to receive support or were judged to need support based on the content of their replies.
Contents of consultations related to children in support by telephone
Persons (%)
| FY2012 | FY2015 | FY2020 | FY2021 | FY2022 | FY2023 |
|---|---|---|---|---|---|
| Anxiety from disaster/radiation 147 (23.6%) |
School life-related issues 54 (21.6%) |
School life-related issues 25 (26.3%) |
School life-related issues 38 (35.5%) |
School life-related issues 35 (29.7%) |
School life-related issues 22 (32.4%) |
| School life-related issues 136 (21.8%) |
Physical health 15 (6.0%) |
Daily Life & Lifestyle habits 18 (18.9%) |
Anger, frustration, violence 15 (14.0%) |
Physical health 15 (12.7%) |
Daily Life & Lifestyle habits 9 (13.2%) |
| Physical health 102 (16.4%) |
Sleep problems 9 (3.6%) |
Anger, frustration, violence 12 (12.6%) |
Daily Life & Lifestyle habits 14 (13.1%) |
Daily Life & Lifestyle habits 13 (11.0%) |
Physical health 6 (8.8%) |
| Anger, frustration, violence 90 (14.4%) |
Anger, frustration, violence 8 (3.2%) |
Sleep problems 9 (9.5%) |
Anxieties about the future 9 (8.4%) |
Anger, frustration, violence 11 (9.3%) |
Sleep problems 6 (8.8%) |
| Depression 83 (13.3%) |
Dietary habit 4 (1.6%) |
Physical health Dietary habit 6 each (6.3%) |
Sleep problems 8 (7.5%) |
Sleep problems 8 (6.8%) |
Anxieties about the future 5 (7.4%) |
* FY2011 is not included because the tabulation method was different from that for other years. Therefore, listings are from FY2012.
* Total number of consultation cases
Content of consultations related to themselves in support by telephone
Persons (%)
| FY2012 | FY2015 | FY2020 | FY2021 | FY2022 | FY2023 |
|---|---|---|---|---|---|
| Physical health 2,761 (46.1%) |
Physical health 1,145 (44.6%) |
Physical health 866 (44.0%) |
Physical health 1,233 (48.1%) |
Physical health 1,086 (46.6%) |
Physical health 831 (42.5%) |
| Sleep problems 2,349 (39.2%) |
Sleep problems 798 (31.1%) |
Sleep problems 583 (29.6%) |
Sleep problems 680 (26.5%) |
Sleep problems 551 (23.6%) |
Sleep problems 436 (22.3%) |
| Depression 1,417 (23.7%) |
Depression 342 (13.3%) |
Depression 296 (15.0%) |
Depression 451 (17.6%) |
Depression 371 (15.9%) |
Depression 268 (13.7%) |
| Family relationship 1,058 (17.7%) |
Dietary habits 236 (9.2%) |
Dietary habits 249 (12.7%) |
Exercising 333 (13.0%) |
Exercising 293 (12.6%) |
Exercising 243 (12.4%) |
| Living conditions 1,049 (17.5%) |
Anxieties about the future 235 (9.2%) |
Exercising 245 (12.4%) |
Dietary habits 272 (10.6%) |
Dietary habits 270 (11.6%) |
Dietary habits 238 (12.2%) |
* FY2011 is not included because the tabulation method was different from that for other years. Therefore, listings are from FY2012.
* Total number of consultation cases
Summary
The role that the Mental Health and Lifestyle Survey has fulfilled
Significance of the Survey
- In FY2023, the proportion of children with high-risk scores (SDQ score of 16 or higher) who had certain emotional or behavioral problems was 9.7% among children aged 4 to 6, 10.7% among elementary school students, and 8.4% among junior high school students. Since FY2019, the proportion has improved to a level that is nearly the same as that of the previous study.
- In the FY2023 survey, the proportion of those with high-risk scores (K6 score of 13 points or higher) for mood disorder or anxiety disorder was 5.4% overall; however, the situation improved significantly, decreasing to about half the level in the first year in the three years following the disaster. Since then, the recovery has slowed, and in recent years, the values have remained higher than the national indicators.
- Regarding lifestyle habits such as exercise, smoking, and problematic drinking, a gradual improvement trend has been observed compared to the first year of the survey, but in recent years, the situation has remained almost unchanged.
Significance of support
- Based on the questionnaire survey results, we continue to provide various forms and styles of support. Specifically, for telephone support, we conducted approximately 2,000 calls in FY2023, bringing the total number of individuals who have received telephone support to over 40,000 to date.
- Regarding telephone support provided in FY2023, children most frequently sought counseling for “school-related matters,” “daily life and habits,” and “physical health”, while adults most commonly sought consultation regarding “physical health,” “sleep,” and “depression.”
- However, depending on the condition of the residents, it may be difficult to provide support only by telephone, and it may be necessary to seek the cooperation of external support organizations. In order for the support by telephone to function smoothly, it is essential to collaborate with municipalities and other related organizations on a regular basis; we have actually been building such a network.