The Faultline of Kokoro no Kea: Mental Distress and Post-Disaster Psychosocial Care After the Great East Japan Earthquake

In Japan, a country prone to a range of natural disasters, such as earthquakes, tsunamis, typhoons, and volcanic eruptions, “kokoro no kea” (care for the heart/mind) has become a familiar concept and practice to address psychological impacts of disasters, such as grief and trauma.

According to the Cabinet Office Government of Japan (2012), kokoro no kea aims to support disaster victims by reducing mental health symptoms such as PTSD and depression so that individuals feel part of a reconstruction community. On March 11, 2011, the Great East Japan Earthquake devastated the Pacific coast of north-eastern Japan. The earthquake and tsunami largely affecting Iwate and Miyagi prefectures, together with the nuclear meltdown of the Fukushima Daiichi Nuclear Reactor, resulted in nearly 20,000 deaths and 2,600 missing persons. Right after the disaster, Disaster Psychiatric Assistant Teams (DPATs) were dispatched for immediate psychiatric support and coordination. Similar to the deployment of kokoro no kea after the 1995 Great Hanshin-Awaji Earthquake and the 2004 Niigata Chuetsu Earthquake, a year after the 2011 Great East Japan Earthquake, three “Kokoro-no Kea Centers” (disaster mental health centers) were established in the Iwate, Miyagi, and Fukushima prefectures .