World Experts Urge UN to Take Up Mental Health

The UN General Assembly should devote a special session to the matter of MNS disorders, global health experts said (AFP/File, Don Emmert

World experts urge UN to take up mental health

(AFP) – 4 days ago  

WASHINGTON — Mental illness and drug abuse can wreak havoc in global societies and economies, and the UN General Assembly should devote a special session to the matter, global health experts said on Tuesday.

Every country in the world is affected by the burden of mental, neurological and substance use (MNS) disorders, but often sufferers face discrimination and human rights abuse, said the article in PLoS Medicine.

"The time has come for recognition at the highest levels of global development, namely the UN General Assembly, of the urgent need for a global strategy to address the global burden of MNS disorders," said the article.

Lead authors were Vikram Patel from the London School of Hygiene and Tropical Medicine and Judith Bass from Johns Hopkins School of Public Health in the United States.

Investment is needed in three key areas, they argued: expanding knowledge about mental health disorders, better access to evidence-based programs of care and treatment, and protection of human rights.

A list of key needs to be addressed and steps to take could be enshrined in a "People's Charter for Mental Health" accounting for input from policy makers, families, researchers and other advocates.

The article said neuropsychiatric disorders will account for the loss of some $16.1 trillion US dollars globally over the next two decades, with "dramatic impacts on productivity and quality of life," particularly as the population ages.

About 25 million people have dementia worldwide, a number set to skyrocket to 80 million by 2040, with close to three quarters of dementia patients concentrated in low and middle income countries.

Meanwhile, suicide claims at least one million lives per year and nearly four percent of all deaths around the world are attributable to alcohol.

Mental illness can also boost risky behaviors that result in disease.

"Depressive disorders markedly increase the risk for noncommunicable diseases such as diabetes, coronary artery disease, stroke, and dementia," said the article.

"Conflict, displacement, poverty, gender-based violence, and other social determinants of ill health increase the risk for MNS disorders," it added.

"MNS disorders are, in turn, associated with worsening of social and economic circumstances, setting up a vicious cycle of poverty and illness."

A majority of world governments would have to agree that the issue is important enough that it deserves a special session at the UN General Assembly.

"The fact that MNS disorders affect people in all countries should offer considerable incentive for investments by both public and private sectors in this initiative," the authors wrote.

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Futaba-Okuma Deadzone: Unsafe to Human Life for at least 50 years

2 towns at risk of disappearing / Okuma, Futaba face uncertain future due to nearby crippled N-plant

Yasushi Kaneko / Yomiuri Shimbun Staff Writer

How will the government help the estimated 25,000 people who lived in areas where residency likely will be prohibited for an extended period due to the crisis at the Fukushima No. 1 nuclear power plant?

In particular, Okuma and Futaba towns in Fukushima Prefecture will face extreme hardship because most of their residential areas fall in those areas. The crippled nuclear plant is located in the two towns.

It will be extremely difficult for the municipal governments to restore the towns to their conditions before the disaster. The central government will need to consider providing assistance to the evacuees so they can lead self-reliant lives.

The Education, Culture, Sports, Science and Technology Ministry detected many spots in the two towns where annual levels of exposure to radiation would be 100 millisieverts or higher. This is at least five times higher than the level deemed safe for human habitation.

The ministry measured radiation levels one meter above the ground and monitored the radioactive contamination of soil.

The ministry has regularly measured radiation levels using vehicles and planes in affected prefectures--mainly Fukushima Prefecture but also including Tokyo--with cooperation from local governments.

Air radiation levels were measured at about 3,000 spots in the no-entry zone around the nuclear plant and planned evacuation areas as of Dec. 11. Of them, annual radiation levels of 50 millisieverts or higher were estimated at about 700 spots. These sites likely will be designated as zones where residency is prohibited for an extended period.

According to Japan Atomic Energy Agency calculations, it would take more than 50 years for radiation levels at the sites to naturally fall below the safe limit of 20 millisieverts.

Environment Minister Goshi Hosono has said it will be "difficult to lower air radiation levels with conventional decontamination methods" in areas where annual levels are 50 millisieverts or higher. Residing in these areas will be forbidden for an extended period.

The government has only said "it will likely take at least five years" until residents can shift back to these areas. The government has not specified after how many years residents can return--or even if they actually will be able to live there again.

A survey by Fukushima University found that about 60 percent of residents of the two towns wish to return. Many of the evacuees said they cannot make any concrete plans for the future until it becomes clear whether they will be able to return to the towns.

The government needs to properly explain the current conditions in the towns--and the likely fate of the municipalities--to the evacuees.

Government assistance to evacuees mainly comprises measures that assume they will return home, such as construction of temporary housing units in which they can live for two years in principle.

From now, it will be necessary to consider helping evacuees resettle elsewhere by offering assistance in such fields as employment and education, and helping them fit in and form local communities.

The government should present such measures as soon as possible.

Meanwhile, Futaba Mayor Katsutaka Idogawa has suggested his town might need to move elsewhere.

"I'll have to ask for a temporary site to which our town will be relocated," he said to reporters.

Okuma and Futaba might have to consider merging with neighboring municipalities to which some residents will move, if the locals consent to such a tieup.

(Jan. 9, 2012)

 

http://www.yomiuri.co.jp/dy/national/T120108003576.htm

Suicide

Thursday, Jan. 12, 2012

Suicides top 30,000 for 14th straight year

2011 figure lowest since annual tally hit mark in 1998

By MIZUHO AOKI

Staff writer

2011 appears to be the 14th straight year for the annual suicide count to exceed 30,000, according to tentative statistics recently released by the National Police Agency.

 

The latest 2011 figure — 30,513 — however, was the lowest number since the annual suicide count topped the 30,000 mark in 1998, declining from 31,690 in 2010. Males accounted for 20,867 of the 2011 suicides, or 68 percent, the data show.

By prefecture, Tokyo had the most suicides, at 3,100, followed by Osaka with 1,899 and Kanagawa with 1,824.

An NPA official said a further statistical breakdown, including ages, occupations and other details of the victims, will be released sometime later this year.

"Although the total number declined, it is still a very serious situation to have over 30,000 people a year committing suicide," Yasuyuki Shimizu, director of the Tokyo-based nonprofit suicide prevention group Lifelink, told The Japan Times Wednesday.

The statistics show declines in annual suicide counts in Miyagi, Iwate and Fukushima prefectures, which were devastated in the March 11 disasters. But Shimizu said optimism about the results may be short-lived, because suicides tend to increase in devastated areas after a year or so, as was the case in the wake of the Great Hanshin Earthquake of 1995.

As reality sets in, people are forced to confront their losses, and some may suffer greatly to the extent that they commit suicide, Shimizu said.

According to a different survey by the Cabinet Office, as of November 49 people in the three prefectures committed suicide for reasons related to the March 11 disaster. Considering past studies, continuous support is crucial, Shimizu stressed.

The data also show that unlike the past three years in which the highest monthly suicide count was marked in March — which is the end of the business year for many corporations — last year saw the level peak in May.

Shimizu, who analyzed the unusual spike in May, said the jump may be related to the media's sensationalized reporting on the May 12 suicide of TV celebrity Miyu Uehara. Daily suicide tallies increased sharply for 10 days starting May 13, Shimizu said.

"Those who committed suicide in this period were mostly women in their 20s and 30s. . . . The media's excessive reporting may have triggered" this phenomenon, Shimizu said.

To prevent suicides, Shimizu said consultations to help people meet multiple needs, including debts and employment, are necessary.

"From our survey, we know that, on average, there are four reasons why people commit suicide," he said. "So by providing consultations to meet such multiple needs, I believe (we can) help people who feel cornered choose a path to live."

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Care Providers

Disaster’s Scope Impeded Psychiatrists’

Best-Laid Plans

Aaron Levin

Japanese psychiatrists recount the multilayered story of challenges facing mental health care providers following last spring’s devastating earthquake and tsunami.

The Great Eastern Japan Earthquake on March 11, 2011, along with the ensuing tsunami and the subsequent explosions at three nuclear power reactors at Fukushima, left much physical and human damage in their wake, reported Japanese psychiatrists at the annual meeting of the International Society for Traumatic Stress Studies in Baltimore last November.

More than 15,000 people died, nearly 6,000 were injured, and 3,700 remain missing.

Jun Shigemura, M.D.

 

The disaster workers who responded to the scene, and who continued working in the area for many months afterward, were among the hardest-hit groups, said Jun Shigemura, M.D., Ph.D., of the National Defense Medical College in Tokorozawa, Japan.

“Disaster workers were not only exposed to traumatic events but had heavy workloads and bore high expectations from the rest of Japanese society,” said Shigemura, listing a number of affected groups: police, military forces, firefighters, coast-guard personnel, nuclear-plant employees, civilian government officials, construction workers, and-medical and dental professionals.

Many recovered bodies were held pending identification in temporary morgues. Shigemura described meetings with mortuary workers responsible for 500 unidentified bodies in a single warehouse. He sought to destigmatize the workers’ acute responses to the tragedy and to handling the resulting bodies, and he helped supervisors understand the stresses borne by these workers.

Nuclear-plant workers were under particular stress, he said. They worked six days on and three days off and often slept in the plants wearing their protective clothing. Many had already come close to death, having survived the tsunami, the explosion, and the release of radiation. Some had lost coworkers, family members, and homes and were additionally burdened by public criticism and guilt for being among the perpetrators of the nuclear part of the disaster.

Radiation Complicated Response

National health authorities will need to allocate additional resources to counteract this increased stress and higher prevalence of mental health disorders among the disaster responders, said Shigemura.

The radiological dimension of the disaster added to the complexity of the response, said Yoshiharu Kim, M.D., Ph.D., of the National Center for Neurology and Psychiatry in Tokyo.

“Anxiety about radiation can develop independently of actual pollution,” he said. “So the scientific idea of ‘safety’ is different from the psychological sense of ‘security.’ ”

As a result, it is important for health authorities to integrate psychosocial support with provision of information about radiation well beyond the known geographic limits of increased radioactivity, he pointed out.

Lessons Learned From Prior Disaster

As bad as the disaster was, the mental health response might have been worse had it not been for the lessons learned from a previous massive earthquake that struck the city of Kobe in January 1995, said Hiroshi Kato, M.D., Ph.D., of the Hyogo Institute for Traumatic Stress in Kobe.

Workers in protective suits and masks wait to enter the emergency operation center at the crippled Fukushima Dai-ichi nuclear power station in Okuma, Japan, last November.

Credit: AP Photo/David Guttenfelder, Pool

“Before the Kobe quake, the suffering of survivors was overlooked because people were habituated to disasters and bore them with silence, avoidance, and patience,” said Kato. “ ‘Gaman’—endurance—is a very important attitude in Japan.”

The nation was better prepared to offer mental health support for survivors after the March earthquake, but was handicapped by the sheer scope of the damage, said Kato. “Many survivors lost family members, and people couldn’t put their lives back together because the loss of infrastructure destroyed their livelihoods as well.”

The mental health response system developed after Kobe depended on public-health nurses providing outreach, since they were already close to local people and thus were able to reduce the stigma some people felt about seeing higher-level mental health professionals.

After the 2011 disaster, however, regional health centers were evacuated or severely damaged, said Kato. In addition, many health workers were among the disaster’s victims. Thus, increasing the mental health workforce on such short notice was difficult. Long-term funding was allocated for more mental health workers, but there were not enough professionals available for the short term.