This thesis discusses the initial mental health care response and subsequent development of postdisaster mental health policies after the 1995 Hanshin-Awaji earthquake and 2011 Great East Japan...Show moreThis thesis discusses the initial mental health care response and subsequent development of postdisaster mental health policies after the 1995 Hanshin-Awaji earthquake and 2011 Great East Japan Earthquake. It seeks to discover which actors had which roles in the progress, and how responsibility and accountability have shifted. To accomplish this goal, a causal process tracing method was used which analyzes the causal mechanisms that shaped the development of post-disaster mental health policies after the 1995 and 2011 disasters. Afterwards, a comparative analysis was used to compare the policy shaping process from both periods. By doing this, we can ascertain if lessons regarding post-disaster mental health care response have been learned, and if so, in what way these lessons have had an effect on the post-disaster mental health care regulation. After the 1995 Hanshin-Awaji earthquake, the Japanese government was heavily criticized for their delayed action, while in contrast the local government, volunteers from the civil society and NPOs immediately came to action. At that time, there was not as much knowledge regarding post-traumatic stress disorder in Japan, and precautions were scarce. After the initial response and the first studies showing many victims battling mental health problems, the government developed post-disaster mental health policies. The 2011 Great East Japan Earthquake triple disaster was unprecedented in scope, and mental health care measures employed since the 1995 disaster were not sufficient. Local governments from across the country, volunteers and NPOs offered their immediate help, while the central government was struggling in Tokyo with inadequate leadership, political power games and inflexible regulations. In the wake of the destruction regulations were again implemented based on the lessons learned, but a real recognition of mental health care still seems far away. A large focus remains on reconstruction of houses, infrastructure and financial revitalization, while the mental health of the victims seems forgotten. The national government should take up more responsibilities to protect not only the physical, but also the mental health of its citizens, and finish large projects such as permanent housing and community building in the affected areas that will provide the victims with a relief of stress and uncertainty.Show less