# Difficulties and Coping Strategies of Psychiatric Visiting Nurses After the Noto Peninsula Earthquake: A Qualitative Descriptive Study

## TL;DR

This study explores the challenges and coping strategies of psychiatric nurses after a major earthquake in Japan, highlighting the need for community-focused disaster mental health policies.

## Contribution

The study recommends rethinking disaster policies to prioritize community care networks and a strengths-based mental health approach.

## Key findings

- Psychiatric nurses faced system-level care paralysis due to infrastructure collapse.
- Nurses used pre-existing relationships to maintain care and acted as liaisons to external teams.
- Patients showed unexpected resilience during the disaster.

## Abstract

Background/Objectives: The 2024 Noto Peninsula earthquake in Japan severely affected community care for persons with psychiatric disabilities. This study analyzed the difficulties and adaptive coping strategies of psychiatric visiting nurses (PVN) to inform disaster mental health practice. Methods: A qualitative, descriptive design was used. Semi-structured interviews were conducted with six PVN, and the data were analyzed thematically. Results: Key findings indicated two main challenges: a system-level paralysis of care owing to infrastructure collapse and the ethical dilemmas experienced by the role of PVN as “dual victims.” In response, nurses leveraged pre-existing therapeutic relationships to ensure care continuity and acted as essential liaisons to external teams. The study also documented substantial and unexpected patient resilience. Conclusions: Based on the findings, this study’s primary contribution is a recommendation to reframe disaster policy by shifting focus from merely deploying external aid to empowering existing, trusted community care networks and adopting a strengths-based model for mental health support.