Large-scale natural disasters have a significant effect on residents’ mental health. The Miyagi Disaster Mental Health Care Center (DMHCC) was established as a long-term mental health care center in response to the 2011 Great East Japan Earthquake and Tsunami (GEJE). Although six DMHCCs have been established in Japan, their exact role and functioning are still unclear. This study aimed to explore which population used the center in each recovery phase. Logistic regression was performed to identify the residents’ characteristics according to the consultation pathways using the data collected by the Miyagi DMHCC. These data included personal information of the residents who were supported by the center from 2013 to 2018. The working-age unemployed men sought help by themselves, and the isolated older females were supported by home visits through the health survey. Long-term mental health care centers should observe community recovery and provide appropriate support. The implications of this result and future research directions are discussed.

Background A long-term mental health support system for the community is sometimes needed following massive natural disasters. Although the Disaster Mental Health Care Center (DMHCC) was established as a long-term mental health care center in Japan, its exact role and functioning are unclear. The Great East Japan Earthquake and Tsunami (GEJE) of 2011 affected thousands of residents. The Miyagi DMHCC was established in Miyagi prefecture in response to the GEJE and supported residents and communities as a long-term mental health care center. Methods The main purpose of this study was to clarify which population is psychologically at high risk and which methods are useful for residents’ mental health in each phase. The study used data collected by the Miyagi DMHCC that included personal information of residents who were supported by the center from 2013 to 2018. Chi-square tests of independence were conducted on the annual number of individuals supported by the center, sex, and the number of support methods used by the center according to years. A one-way analysis of variance was conducted on the annual mean age, followed by a post-hoc comparison of the functioning of the center. Results The number of residents who needed mental health support dramatically increased in Miyagi prefecture after the 2011 disaster. The Miyagi DMHCC supported 6,850 individuals who sought mental health services, which accounted for 22.9% of all cases reported to the health services between 2012 and 2017. Based on the results, in the first few years, the elderly residents who lived alone were declared as high-risk individuals by the health survey and supported through home visits. Several years later, as younger people started to seek mental health support by themselves, they underwent counseling at the Miyagi DMHCC. Conclusion Residents who need mental health support might change depending on recovery phases. Long-term mental health care centers should observe community recovery and provide appropriate support. We discuss the implications of this result and future research directions.