Survivors of the March 11 earthquake and tsunami need long-term mental health care to protect them from debilitating conditions that could lead to suicide, Japan's government said Friday.
In its annual policy paper on suicide prevention, the Cabinet Office decided to include a separate section on the psychological needs of disaster victims. The report said survivors may be undergoing shock, stress and depression from the overwhelming losses. They may also feel guilty for escaping death.
More than 23,000 are dead or missing, and entire towns along Japan's northeast coast were washed away.
Observers around the world have lauded survivors' calm demeanor in the face of tragedy and destruction, but the report warns against assumptions that the Japanese could largely withstand problems like post traumatic stress disorder.
"In fact, we cannot determine this until we are able to obtain detailed information," the report said.
Japan already has one of the highest suicide rates in the industrialized world, with nearly 25 suicides per 100,000 people. That compares to about 11 per 100,000 in the United States.
The figure trails only Russia, parts of Eastern Europe and South Korea. Suicides in Japan rose dramatically during a financial crisis in 1998, and more than 30,000 people have killed themselves every year since.
Three months after the disaster, the Japanese Red Cross cites mental health as a "major concern," especially among the 91,000 still living in evacuation shelters. It said Friday it is expanding the number of caregivers and psychosocial support teams working in evacuation centers and nursing homes.
The government paper urges aid workers and local mental health providers to reach out to survivors by offering mental health education and simple consultations. People with problems should be screened and properly treated by a specialist, it said.
"Post-disaster mental care should be tackled for months and years," the report said. "There is an urgent need for the overall region to strengthen its engagement with this issue."
Friday's paper also revealed broader suicide statistics in Japan.
Men accounted for about 70 percent of the country's 31,690 suicides last year. More than 60 percent of people who took their own lives did not have jobs, underscoring the strong correlation in Japan between economic conditions and suicide.