Table 3.
Developed gatekeeper training program contents for radiation health anxiety and other mental health issues.
| A. Presentation and group-work session (70 min) |
| 1. Introduction: Anxiety for radiation health effects and mental health issues among residents, while having some trouble with family and community relationships or economic issues and being forced to make a decision to return home. |
| 2. Specific coping skills for anxiety related to radiation health effects and other mental health issues |
| 2.1. Depression |
| 2.1.1. Epidemiology of depression and psychological distress among evacuees in Fukushima. |
| 2.1.2. Encouraging early intervention for depressive states. |
| 2.1.3. Five-step principles of the Mental Health First Aid program (MHFA). a) assess the risk of severity of depression and suicide risk, b) listen non-judgmentally, c) give reassurance and information, d) encourage a person to get appropriate professional help, e) encourage self-help strategies. |
| 2.2. Suicide |
| 2.2.1. Epidemiology of suicide in the evacuating area in Fukushima. |
| 2.2.2. Risk and protective factors of suicide. |
| 2.2.3. Specific communicating for residents who have suicidal thoughts. a) ask about the suicidal thoughts, b) encourage a person to get appropriate professional help, |
| 2.3. Alcoholism |
| 2.3.1. Epidemiology of alcoholism and the outline of issues regarding alcoholism. |
| 2.3.2. The difference between heavy drinking and alcoholism. |
| 2.3.3. The psychological factors of the starting to drink alcohol after the Great East Japan earthquake. |
| 2.3.4. Five-step principles of the MHFA. a) assess the risk of alcoholism, b) listen non-judgmentally (encourage to provide helps to residents when they are not drunk), c) give reassurance and information, d) encourage a person to get appropriate professional help, e) encourage self-help strategies. |
| 2.4. Anxiety |
| 2.4.1. An outline of the issues with anxiety. |
| 2.4.2. Group-work (10 min): Let us list the anxiety symptoms (in four dimensions: physical, psychological, behavioral and thought dimensions) |
| 3. Key points of coping with anxiety about radiation health effects and other mental health issues |
| 3.1. Skills for listening non-judgmentally. |
| 3.2. Understanding the trans-theoretical model (stages of change) and ambivalence state of suicidal thoughts and alcoholism among residents. |
| 3.3. Association among depression, alcoholism, and anxiety. |
| 3.4. Specific coping skills for residents who have any anxiety. |
| 3.5. Specific coping skills for anxiety about the health effects of radiation (recommendation to measure the air radiation level or radiation dose of crops). |
| 3.6. Referral or signposting to an appropriate resource or professional. |
| 3.7. Self-help and self-care. |
| B. Roleplay session (30 min) |
| 1. Explanation of the scene-setting: (A 60-year-old woman lived in the ex-evacuation area. She and her husband have returned to the ex-evacuation area. However, her son’s family did not choose to return home because of anxiety regarding the health effects of radiation. Besides, her husband has a significant issue with alcoholism; therefore, she implied having some slight suicidal thoughts to a livelihood support counselor.) |
| 2. Roleplay: (an example of communication for evacuees) and group discussion |
| Roleplay: (an improved of communication for evacuees) and group discussion |