The great east Japan earthquake in 2011; toward sustainable mental health care system.

In face with a triple disaster of earthquake, tsunami and nuclear power plant accident, the degrees of which are historically hardly preceded, immediate mental health countermeasure was taken by the initiative of the national and local government together with academic and clinical organizations. Based on previous experience of natural disasters, more than 50 mental health care teams have been organized and dispatched to the affected areas, scheduled by the Ministry of Health, Labor and Welfare. When 6 months have passed, the acute and temporal support system should be replaced with more sustainable local networks with aims at promoting resilience, though community psychiatric service should be developed as well. Existing guidelines should be respected but actually it tended to be only partially recognized. In Fukushima prefecture, where nuclear plant accident occurred, its mental health impact is most concerned and long-term follow-up of the residents' health has been being planned.