Fukushima anniversary mental health
A lone house sits on the scarred landscape, inside the exclusion zone, close to the devastated Fukushima Daiichi Nuclear Power Plant on Feb. 26, 2016 in Namie, Fukushima Japan.  Christopher Furlong—Getty Images

This May Be the Biggest Health Threat From Fukushima—And It's Still Ongoing

Mar 11, 2016

The 2011 earthquake that struck in Japan killed more than 15,000 people as buildings crumbled and tsunami surged. The meltdown at a local nuclear power plant led to lasting adverse health effects and the relocation of half a million area residents.

Now, five years after the incident, the lasting effects of the earthquake continue to threaten tens of thousands of residents of affected communities as survivors battle a mental health crisis of untold proportions.

"This is an ongoing disaster in a literal sense—not just rhetorically," says Irwin Redlener, a professor at Columbia University who studies natural disasters. "The challenges they’re experiencing now are really overwhelming."

A car drives down the empty streets of Fukushima City during a snow storm on March 1, 2016. The city is located about 70km from the Fukushima Daiichi nuclear power plant.
VIEW GALLERY | 18 PHOTOS
A car drives down the empty streets of Fukushima City during a snow storm on March 1, 2016. The city is located about 70km from the Fukushima Daiichi nuclear power plant.Dominic Nahr
A car drives down the empty streets of Fukushima City during a snow storm on March 1, 2016. The city is located about 70km from the Fukushima Daiichi nuclear power plant.
Japanese dictionaries for first-graders remain inside a classroom at the abandoned Kumano Elementary School in Okuma, Japan, March 4, 2016. The school lies within the 5km exclusion zone around the Fukushima Daiichi nuclear power plant.
A tree hovers over a lake that was contaminated by the disaster at the Fukushima Daiichi nuclear power plant, Minamisoma, Japan, March 8, 2016.
Decontamination bags are seen in the woods of Itate, Fukushima, Japan, March 7, 2016.
Temporary housing units are seen at night, March 4, 2016.
Damaged graves in Namie can be seen on the fifth anniversary of the tsunami that struck on March 11, 2011, after a massive earthquake along the northeastern coast of Japan.
Police search inside the exclusion zone for residents who are still considered missing from the tsunami, Namie, Japan, March 11, 2016. More than 2,500 people remain missing, according to government statistics.
Sachie Matsumoto, 43, and her mother look up at a Buddha statue called “Daihisan no Sekibutsu,” or “Stone Buddha statue of mountain of great sadness,” carved more than 1,000 years ago and situated inside the 20km exclusion zone, Osaka, Japan, March 6, 2016. Sachie would come here as a child.
An empty street scene in Minamisoma, Fukushima, March 8, 2016.
Students in the first rows prepare to graduate from Minamisoma's Ishigami Junior High School on the fifth anniversary of the massive earthquake and tsunami that struck the northeastern coast of Japan, damaging the Fukushima Daiichi nuclear power plant 25km away.
Pictures can be seen of Sachie Matsumoto, a hostess and a mother of two boys, and her best friend since elementary school. She said he committed suicide last December by jumping in front of a train, Minamisoma, Fukushima, March 3, 2016.
Sachie Matsumoto talks on the phone inside her temporary house in Minamisoma, Fukushima, March 3, 2016. Her son, a decontamination worker, tried to commit suicide. Her family will soon move to a new home built with savings and compensation money.
Terumi Murakami, a 43-year-old mother of three children and an evacuee from Okuma, 5km from the Fukushima Daiichi nuclear power plant, shows all the daily pills she takes, Iwaki, Japan, March 4, 2016. Murakami said severe depression and isolation pushed her to attempt suicide in this bedroom on April 5, 2015, after taking two month's worth of prescription drugs for depression. She survived after her children found her and called an ambulance. It was also the first day of school for her youngest daughter.
Yuki Mine, a 34-year-old part-time hairdresser and bartender, and other Minamisoma residents enjoy legal gambling in one of the many slot machine arcades, March 6, 2016. Several arcades have opened up in this region due to the high number of decontamination and other workers that have flocked to the town, as well as many residents who have received large amounts of compensation.
Many residents in Minamisoma prefer to eat food from outside of Fukushima, which does not align with what the government wants. Minamisoma, Fukushima, March 8, 2016.
A hose from a fire engine is seen after an incident at a bar in Minamisoma, Fukushima, March 8, 2016.
A birds nest can be seen inside a locker at a Ukedo elementary school, which was damaged by the tsunami, inside the restricted 20km exclusion zone, Namie, March 10, 2016.
Terumi Murakami, a 43-year-old mother of three children and an evacuee from Okuma, about 5km from Fukushima Daiichi nuclear power plant, walks through her children's highly contaminated and abandoned Kumano Elementary School grounds in Okuma, Japan, March 4, 2016. The school lies within the 5km exclusion zone around the crippled nuclear power plant.
A car drives down the empty streets of Fukushima City during a snow storm on March 1, 2016. The city is located about 70km from the Fukushima Daiichi nuclear power plant.
Dominic Nahr
1 of 18

The lingering chaos of the disaster represents perhaps the biggest contributor to ongoing mental health issues. Research published this week in the Journal of Epidemiology and Community Health this week shows that two thirds of residents who lived in the evacuation zone have moved more than three times since the disaster, suggesting they have been unable to resettle in a stable location. Nearly 40% of families had been separated by relocation.

A lack of trust in government authorities charged with protecting community health has also contributed to mental health problems. The country has continued to source huge portions of its power from nuclear plants and has not backed off plans to increase their use. Many residents live in fear that another disaster may be just around the corner. This overarching environment of suspicion and mistrust of the government carries over to other personal relationships. Some also experience stigma from those who think they may suffer from radiation. Others worry that their food may be affected by radiation.

Instability and distrust both contribute to a number of conditions faced by disaster survivors—from post-traumatic stress disorder (PTSD) to depression. The new research attributes a spike in the regional suicide rate to the ongoing consequences of the disaster. The suicide rate in affected regions in Japan ranged from 110 to 138 deaths per 100,000 people in 2014, compared with just below 20 deaths per 100,000 people nationwide.

The disaster's continuing mental health effects can be particularly devastating for children who have been displaced. Many have jumped between schools and have been separated from family members.

And the problem only worsens with each move or school swap.

"Their ability to be resilient is eroded over time," says Redlener. "Children are very susceptible to the family dynamic, in addition to whatever trauma they may have experienced themselves."

All products and services featured are based solely on editorial selection. TIME may receive compensation for some links to products and services on this website.