In 2006, Japan DMORT was established by physicians, nurses, forensic pathologists, social workers, and a journalist (inspired by a major train crash in the previous year) to provide mental support to disaster victims’ families who had not received care. However, disaster victims’ identification and care of the families were monopolized by police in Japan. Also, our ‘study group’ status confused people who were affected by disasters.

To describe the development and future challenges of our association.

We developed our policy to focus on mental support through various activities such as the 11 closed seminars with disaster victims’ families, 21 training courses for disaster responders, and several workshops in medical or nursing conferences. In the Christchurch Earthquake, NZ (2011), with young Japanese casualties in a collapsed building, our core member reported the needs of families’ mental support, which showed the validity of our policy.

In the Great East Japan Earthquake (2011), we distributed mental health care manuals for disaster responders. In the landslides in Izu Oshima Island (2013), 3 members supported victims’ families through the town office. In the Kumamoto Earthquake (2016), two members made grief work on families of 17 victims at the prefectural police academy. These activities convinced the police of the need for medical/mental support and ourselves of the necessity for legal status. In 2017, we reorganized our association into an incorporated society. We also became official members of crime/disaster victims support liaison councils of two prefectures among 47 in Japan. In 2018, official agreements were made with the Hyogo prefectural police. But in the Heavy Rains and Flooding of July and in the Hokkaido Eastern Iburi Earthquake of September, the local police did not agree to accept us.

Official collaboration with police is essential nationwide in Japan. Further relief activities are expected.

To effectively respond to this relatively new, complex mandate it is essential to find effective models of coordination to ensure that medical and health services can meet the standards now expected in a disaster situation. This theme explored various models, noting both the strengths that can be built on and the weaknesses that still need to be overcome.

Details of the methods used are provided in the preceding paper. The chairs moderated all presentations and produced a summary that was presented to an assembly of all of the delegates. Since the findings from the Theme 1 and Theme 4 groups were similar, the chairs of both groups presided over one workshop that resulted in the generation of a set of Action Plans that then were reported to the collective group of all delegates.

The main points developed during the presentations and discussion included: (1) preplanning (predisaster goals), (2) information collection (assessment), (3) communication (materials and methods); and (4) response centres and personnel. There exists a need for institutionalization of processes for learning from experiences obtained from disasters.

Action plans presented include: (1) creation of an information and data clearinghouse on disaster management, (2) identification of incentives and disincentives for readiness and develop strategies and interventions, and (3) action on lessons learned from evidence-based research and practical experience.

There is an urgent need to proactively establish coordination and management procedures in advance of any crisis. A number of important insights for improvement in coordination and management during disasters emerged.