Mental Health and Lifestyle Survey

Implementation Status
Provision of support to those in need
Summary
Outline of the Mental Health and Lifestyle Survey

Implementation Status

FY2021 Survey (As of October 31, 2022)

Eligible Population: 196,569
Children (Ages 15 and younger): 18,909
Adults (Ages 16 and older): 177,660
Number of responses (Response rate): 40,883 (20.8%)
Children (Ages 15 and younger): 2,992 (15.8%)
Adults (Ages 16 and older): 37,891 (21.3%)

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 percentage of children with a high risk of showing certain problematic behaviors (SDQ score of 16 points or higher) was highest in FY2011 among all age groups, especially the 4-6 years age group, at 24.4%. Group-specific percentages declined thereafter in all age groups, and the FY2019 survey results showed improvements, with the percentage almost the same as that in prior surveys.

*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, the percentage of those with high-risk scores for mood disorder (depression) and anxiety disorder was 14.6%, declining gradually until an increase in FY2021. However, the percentage is still high compared to a value of 3% from a previous study covering the general public not affected by the disaster.

*K6 Distress Scale criteria with a cutoff value of 13 points, based on previous studies

Exercise habits: Changes in the percentage for frequency of exercise in adults

Adults' frequency of exercise has gradually improved, with the percentage of respondents who answered “Almost every day” or “2–4 times a week” reaching 41.1% in FY2021. In a national survey, the proportion of those who answered that they exercise twice or more per week was 40.6%. Although national results cannot be directly compared with those of our survey, it can be said that the exercise frequency of Fukushima residents is similar to the national average.

Changes in the percentage of problematic drinking (CAGE score of 2 points or higher)

In the FY2021 survey, the proportion of those with high-risk (CAGE score of 2 points or higher) was 14.5% among males and 6.6% among females, showing a downward trend for both sexes.

Influences on daily life due to the spread of COVID-19

In the FY2021 survey, those who responded that COVID-19 exerted influence on their daily life "Significantly" or "To some extent" (the affected group) accounted for 41.6%, a result that was about the same as in FY2020, the year when this survey item was introduced.

Changes in risk perception of radiation health effects

Regarding possible radiation effects on the next generation, 24.3% responded that they think effects on the next generation are likely to occur (“Possibilities are high” and “Possibilities are very high” combined) in the FY2021 survey. These percentages have been gradually decreasing.

Provision of support to those in need

FY2021 Survey (Numbers confirmed on December 31, 2022)

We provide a telephone outreach support to those identified in need of support by telephone and interviewed them about current problems based on their survey responses.

Number of those identified in need of support: 9,786
Support by telephone: 3,375
Support by mail: 6,411
Number of those receiving support: 9,082
Support by telephone: 2,671
Support by mail: 6,411

Contents of consultations related to children in support by telephone

FY2012 623	FY2015 250	FY2020 95		FY2021 107
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 136 (21.8%)	Physical problems 15 (6.0%)	Daily Life & Lifestyle habits 18 (18.9%)		Anger, frustration, violence 15 (14.0%)
Physical problems 102 (16.4%)	Sleep problems 9 (3.6%)	Anger, frustration, violence 12 (12.6%)		Daily Life & Lifestyle habits 14 (13.1%)
Anger, frustration, violence 90 (14.4%)	Anger, frustration, violence 8 (3.2%)	Sleep problems 9 (9.5%)		Anxieties about the future 9 (9.5%)
Depression 83 (13.3%)	Dietary problems 4 (1.6%)	Physical problems 6 (6.3%)	Dietary problems 6 (6.3%)	Sleep problems 8 (7.5%)

FY2011 is not included because the tabulation method was different from that for other years. Therefore, listings are from FY2012.

The Mental Health Support Team made phone calls to responders (mostly to parents or guardians) and asked about current issues, based on survey form responses.
With regard to the contents of a consultation, “Anxiety caused by the disaster or radiation and its exposure” was the most frequent in FY2012, but “School life-related matters” has become the most frequent issue in subsequent years.

Content of consultations related to themselves in support by telephone

FY2012 5,991	FY2015 2,567	FY2020 1,968	FY2021 2,564
Physical problems 2,761 (46.1%)	Physical problems 1,145 (44.6%)	Physical problems 866 (44.0%)	Physical problems 1,233 (48.1%)
Sleep problems 2,349 (39.2%)	Sleep problems 798 (31.1%)	Sleep problems 583 (29.6%)	Sleep problems 680 (26.5%)
Depression 1,417 (23.7%)	Depression 342 (13.3%)	Depression 296 (15.0%)	Depression 451 (17.6%)
Family relationship 1,058 (17.7%)	Dietary habits 236 (9.2%)	Dietary habits 249 (12.7%)	Exercising 333 (13.0%)
Living conditions 1,049 (17.5%)	Anxieties about the future 235 (9.2%)	Exercising 245 (12.4%)	Dietary habits 272 (10.6%)

FY2011 is not included because the tabulation method was different from that for other years. Therefore, listings are from FY2012.

For adults, “physical problems” has been the most frequent, followed by “sleep problems” and “depression” since FY2012 to FY2021.

Summary

The role that the Mental Health and Lifestyle Survey has fulfilled

Significance of the Survey

The percentage of high-risk children based on parents' assessment of their emotions and behavior (SDQ score) has improved to a level approaching previous studies in FY2019 and thereafter.
As for the general mental health status (K6) of adults (ages 16 and older), the proportion of those with high-risk scores improved significantly in the first three years, decreasing to about half of that in the first year. After that, the recovery slowed down and the proportion is hovering at a higher level than that of general population in Japan.
There is a trend of gradual improvement in lifestyle habits such as exercise, smoking, and problem drinking compared to the first year of the survey.

Significance of support

We have continued to provide various types of support based on the results of the questionnaire; in particular, we have provided support by telephone to a total of more than 40,000 people through approximately 3,000 telephone calls per year.
As a result of an interview survey conducted in FY2016, we found that the level of satisfaction with support by telephone was high. A nuclear power plant accident may result in evacuation of many residents to distant places, and it is difficult to provide direct support and intervention such as outreach services, so this support by telephone is considered to have had a certain degree of usefulness.
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.

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 FY2022 Survey

Self-administered.
Questionnaire content varies depending on the age group, and in principle, for children up to junior high school age, he 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, COVID-19, 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, COVID-19, 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, COVID-19, free comments, etc.
Junior high school students	Parents/guardians of the child covered by the survey/the child	Health condition, height, weight, exercise habits, SDQ, developmental and/or mental health problems, availability of consultation resources, COVID-19, 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, COVID-19 related issues, health effects of radiation, and availability of consultation resources, free comments, etc.