Visualizing the Process of Disaster Mental Health Services in the Joso Flood by Network Analyses of Emails

Tohoku J Exp Med. 2020 Oct;252(2):121-131. doi: 10.1620/tjem.252.121.


Joso City, Ibaraki Prefecture, Japan was severely affected by flooding of the River Kinugawa in September 2015. Local psychiatric organizations immediately began providing disaster mental health services (DMHS). In post-disaster settings, DMHS involving organizational interventions by multiple regional institutions are required to support disaster victims. However, little is known about the process of coordinating multiple institutions or determining whether appropriate support has been provided. To elucidate the characteristics of communications that enable effective disaster medical team formation, we conducted network analyses of sender-recipient pairs of emails during the period of DMHS activity. The network analysis is a research method that represents various objects as a network of nodes and edges and explores their structural characteristics. We obtained 2,450 time-series emails from five core members of DMHS, including 32,865 pairs of senders and recipients. The network generated by the emails was scale-free, and its structure changed according to the phases of disaster recovery. In the ultra-acute phase, which lasted about 1 week, spreading information and recruiting people to provide disaster support was given the highest priority. In the acute phase, which lasted about 1 month, support and swift decision-making were essential for directing large numbers of staff. In the mid- to long-term phase, support for staff to share information and experience in small groups was observed. Network analyses have revealed that disaster medical teams must change their communication styles during the mission to adapt to different health needs corresponding to each post-disaster phase.

Keywords: assortativity; disaster mental health services (DMHS); email network; flood; network analysis.

MeSH terms

  • Disaster Planning / organization & administration*
  • Disasters
  • Earthquakes*
  • Electronic Mail*
  • Emergency Medical Services / organization & administration
  • Floods
  • Health Services Needs and Demand / organization & administration
  • Humans
  • Japan
  • Mental Health
  • Mental Health Services / organization & administration*
  • Patient Care Team