[Challenges faced by psychiatric services in Miyagi Prefecture after the Great East Japan Earthquake]

Following the Great East Japan Earthquake and Tsunami, the number of patients with onset, relapse, and exacerbation of mental disorders was expected to increase in Miyagi Prefecture, one of the worst affected areas. The functioning of almost all psychiatric hospitals sharply declined or even ceased. This situation worsened with traffic congestion and crippled public transportation, hindering many patients with psychiatric disorders from accessing mental health services. Among them, patients with schizophrenia and related disorders were affected the most; some could not reach the hospitals and clinics they had regularly visited and had to become new patients of another hospital or clinic. Moreover, an increasing number of patients with schizophrenia needed to be hospitalized because of acute exacerbations of their disorder, due to the experience of the disaster and the consequent drastic changes in their living environment Unfortunately, the support system for psychiatric institutions after disasters is not yet well structured; the system needs to be rebuilt and strengthened in anticipation of future disasters.