mental health

Unwanted Pregnancies need to be discussed

Posted on September 3, 2012. Filed under: Abuse Neglect Death, mental health | Tags: , , , , |

By PHILIP BRASOR (Japan Times)

Two weeks ago a 17-year-old girl collapsed in a shopping mall in Hiroshima and was rushed to the hospital. At the same time a dead fetus was found on the floor in the corner of the mall’s food court. The girl eventually admitted that she had just given birth to the child.
On Aug. 6 a baby’s corpse with the umbilical cord still attached was discovered in a plastic bag at a refuse collection station in Mie Prefecture. A 24-year-old woman who lived nearby was later arrested. She had given birth to the baby about a week earlier.On Aug. 9, a cleaning person found the body of an infant wrapped in a towel in a train station rest room in Hamamatsu. An autopsy revealed that the baby was born shortly before it died and that the cause of death was an injury to a blood vessel.

In July, a 27-year-old woman in Osaka was arrested for possession of illegal drugs and when police searched her apartment they came across the remains of a baby in her closet. She said she had drowned the child five years earlier in a bathtub right after giving birth, which she never reported.

These four news stories appeared within the space of a month — and were not the only ones involving the killing of newborn babies — adding a dramatic dimension to a larger story that has been covered extensively by the mainstream media.

In late July the health and welfare ministry released figures showing that the number of child abuse cases in 2011 rose for the 21st straight year, which isn’t necessarily surprising since it has only been in the last two decades that local governments have addressed the problem and encouraged people to report suspected abuse. but the part of the report that attracted the most scrutiny is the section on “death from abuse.”

In 2010, 98 children died as a result of abuse, 10 more than in 2009. When the number of children who perished in “group suicides” is subtracted, the number is 51, 80 percent of which represent children less than 3 years old. Twenty-three were less than 1 year old. If you expand the time frame and include all the children known to have died “through abuse” since 2003, the year the ministry started compiling figures, you find that between that year and 2011, 193 were less than 1 year old and 39 percent of those (76) died “on the day they were born.” Ninety percent of these infants were killed by their mothers.

It doesn’t take much deductive reasoning to conclude that these babies were not wanted in the first place. One can imagine the 17-year-old girl in Hiroshima slowly realizing that she is pregnant and suffering in silence as she tries to hide her condition from friends and family, and then going into labor in a shopping mall; or the 24-year-old Mie woman, who reportedly returned to her home town from Tokyo, presumably to have her unplanned child in secret, and when that happened she panicked and put the baby in a garbage bag.

News reports avoid the word “unwanted.” They use nozomanai, which means “unhoped for.” It may sound like a trivial distinction, but the idea that one’s pregnancy was “unhoped for” leaves open the possibility that it will result in something better. “Unwanted” doesn’t sound open-ended at all, and the gist of the related news reports and editorials is what the authorities are doing to address the problem. The solution is always to help these women accept what has happened to them and “rescue” those children born into situations where they become victims of abuse.

A recent Asahi Shimbun article reported on a counseling service set up by a maternal health center in Izumi at the request of the Osaka prefectural government. The center brought in an outside organization, Ninshin (pregnancy) SOS, which specifically answers queries from women about unplanned pregnancies. The stories followed the same patterns: the high school girl who can’t confide in anyone, the woman who finds herself pregnant, and then dumped, by her married lover.

The person in charge of Ninshin SOS, Takuyo Sato, told the Asahi that the prefecture set up the service because “there are too many babies dying from abuse.” Almost all the calls they receive are from women “who don’t want to be pregnant, and haven’t seen a doctor yet.” If the caller is a minor, she is urged to talk to her parents. If it is a woman who says she can’t afford a baby, they refer her to services that can help her for free or at minimum cost. If the caller sounds depressed, they urge her to seek a friend’s assistance, or go to her local welfare office and consult a case worker.

Sato believes that the work she is doing will be effective in “preventing abuse” of children who are the products of unplanned pregnancies. “We can reduce the risk that these women will go through labor without medical attention,” she says. “We can also reduce child abuse as a result of the feelings of mothers who didn’t want to give birth to them.”

And then she adds, “It might help if they work out the problem at an early stage.” The reporter doesn’t ask for clarification, but we can assume this means at an early stage in the pregnancy. Sato doesn’t say if she advises callers about abortions or even if any of the callers ask about the procedure, though SOS’s website offers information about terminating pregnancies. Abortion is never discussed in relation to this particular problem in the media. As it stands, hundreds of thousands of Japanese women undergo abortions in clinics and hospitals every year, even though technically abortion is illegal and not covered by any form of national insurance.

The fact that abortion is available and never discussed in the media when the topic is infanticide is like talking about suicide without mentioning intervention. Adoption should also be discussed in the same conversation, and it isn’t. As long as scared pregnant women are made to feel that their only recourse is having and raising a child they don’t want, it will be difficult to talk to them.

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Volunteer firefighters need care / Experts will treat PTSD, survivor’s guilt

Posted on June 21, 2011. Filed under: mental health | Tags: , , , , |

The Yomiuri Shimbun

The government will dispatch mental health experts to the three prefectures worst hit by the March 11 earthquake and tsunami to provide counseling for voluntary firefighters who may have been traumatized when they responded to the disaster.

In the face of imminent tsunami, many volunteers did such dangerous work as trying to manually close floodgates and leading people to safety.

Previously, mental health counseling had been provided only to professional firefighters, but the Fire and Disaster Management Agency of the Internal Affairs and Communications Ministry has decided to offer counseling to volunteers, too.

The experts will counsel the members of the local volunteer firefighting associations in Iwate, Miyagi and Fukushima prefectures for such problems as post-traumatic stress disorder (PTSD).

In the three prefectures, a total of 249 voluntary firefighters died or went missing in the disaster.

Volunteer firefighters usually are ordinary citizens who help extinguish fires and provide logistical support to their local fire departments. They also participate in local disaster management activities.

They are regarded as part-time special local public servants.

In the event of a large-scale disaster, volunteer firefighters work to limit disaster damage by, for example, evacuating residents and closing floodgates.

According to the agency, as of April 2010, municipal governments across the nation had 2,275 teams of local volunteer firefighters with a total membership of about 883,000.

The agency will dispatch psychiatrists and clinical psychotherapists belonging to its mental health support team for emergencies, which was established in 2003.

The team has dispatched experts 30 times for serious accidents and disasters, including the train derailment on JR West’s Fukuchiyama Line in 2005.

In the three disaster-hit prefectures, there are about 80,000 local volunteer firefighters in total. In Iwate Prefecture, 116 volunteer firefighters died or went missing, the highest number among the three prefectures.

In Iwate and Miyagi prefectures, a total of 27 professional firefighters died or went missing. Thirty police officers belonging to the prefectural police forces were killed or went missing.

In Rikuzen-Takata, Iwate Prefecture, 50 volunteer firefighters died while trying to evacuate residents after a tsunami warning was issued.

In the prefecture’s Iwaizumicho, four volunteer firefighters narrowly survived when they stayed on a flood barrier until just before the tsunami struck, trying to manually close a floodgate that would not close mechanically.

Since the disaster, local volunteer fighters have shown symptoms of what is known as critical incident stress.

And some are reportedly suffering from survivor’s guilt after other volunteers died in the disaster. Others are said to feel they can no longer work as volunteer firefighters due to strong fears of tsunami.

The agency feared that unless the volunteers receive counseling, they may develop PTSD.

The experts will inquire about such things as sleeping problems, and introduce the volunteers to medical institutions specializing in their problems if necessary.

An official of the agency’s Disaster Management Division said: “This disaster is unprecedented in terms of the large number of local volunteer firefighters affected.

“It [counseling] is necessary because they were exposed to so much danger.”

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Japan must not overlook mental health of children in disaster zone

Posted on March 31, 2011. Filed under: mental health | Tags: , , , |

There are many elementary school children making the rounds of disaster evacuation shelters to look for their missing parents. Others are searching the rubble of collapsed buildings for mementos such as photos as well as their belongings. Some children were seen to smile during their school graduation ceremonies. People across the country are trying to cheer up these children in quake- and tsunami-hit areas.

More than 10,000 people have been confirmed dead and some 16,000 others remain missing following the March 11 Great East Japan Earthquake. Facing this unbelievable reality, anybody would want to encourage child survivors to help them conquer hardships already experienced and those sure to come.

However, children are already doing their best. Even though they do not understand what has happened to them as much as adults and cannot express their feelings, they can also suffer from disaster trauma and become overwhelmed with grief after losing their family members, their homes or both.

Rather than simply urging children to overcome the disaster, what is needed is to look for subtle changes in their emotions and provide appropriate psychological support.

Children who have experienced such a massive disaster tend to complain of insomnia and loss of appetite, act infantile, be frightened by loud sounds, easily lose their temper, have nightmares and refuse activities they enjoyed before the traumatic event.

If children begin to show these symptoms, adequate care should be provided to them, such as telling them, “You’re all right,” and avoiding letting them sleep alone, in order to reassure them.

Some children repeatedly talk about what they saw and experienced in the disaster, but adults around them should understand this as a sign that they are trying hard to accept the shocking reality and patiently listen to what they have to say.

Pep talks like, “Never say die” and “There are some other people who are in more difficult situations. Overcome this hardship,” must be avoided. Adults may say these things to children to encourage them, but they can be counterproductive, driving a child into a psychological corner.

Some children are afflicted with survivor’s guilt when the rest of their families lost their lives in the disaster. They should rather be convinced that they do not have to hide their tears or their feelings.

The Japanese Association of Clinical Psychology and the National Center of Neurology and Psychiatry (NCNP) have guidelines on their respective websites on dealing with children who have experienced a massive disaster.

Mental health experts are working in quake-hit areas, but they cannot look after all the children who need their care. Academic societies specializing in children’s mental health are providing telephone and e-mail counseling, and such services should be fully utilized.

Children can initially endure the harsh living conditions at shelters because they maintain a sense of tension after the disaster. If their evacuation is prolonged, however, they may suffer from sudden depression or feel physically ill. Minor symptoms that children show immediately after a disaster can be dealt with if adequate care is provided. However, post-traumatic stress disorder should be suspected if children continue to show such symptoms for more than a month. In that case, expert treatment is required.

Even children who did not experience the quake could show symptoms such as insomnia if they repeatedly see shocking images of the disaster on TV. There are reportedly some cases where children who were not hit by the disaster complain they feel anxious and suddenly begin to cry in class. Close attention should be paid to subtle changes in children’s words and deeds so as not to overlook any sign that they are developing psychological problems.

Efforts to provide mental care for children in quake- and tsunami-devastated areas have come to a crucial stage. The nation as a whole is urged to protect both the mental and physical health of children.

Click here for the original Japanese story

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