Natural disasters can severely impact local communities. When a disaster is limited in type or scope, the loss and distress felt by individual residents can be sympathetically visualized and shared, and this can help bring the community together. In 2011, however, Japan experienced the Great East Japan Earthquake and accompanying tsunami, and the scale of this disaster was compounded by the Fukushima nuclear power plant accident. As a result of this complex disaster, residents experienced very different problems, particularly in Fukushima Prefecture.
 In this paper, we describe the situation in Minamisoma City, which is located to the north of the Fukushima Daiichi nuclear power plant. After the accident, the city was divided into three zones. The southern part of the city, which is within 20 km of the plant, was designated as a restricted area; the middle section, located between 20 and 30 km of the plant, was initially designated as an evacuation readiness area; and the northern part of the city received no evacuation-related designation. In April 2012, ordinary residents were finally allowed to visit the restricted area, but utilities and municipal services in the area had not yet been restored, and residents were still prohibited from staying overnight even in August 2013.
 The overall situation was further complicated by the existence of conflicting opinions regarding exposure to low dose ionizing radiation and compensation for subsequent distress. Things became so complex that residents of the same city sometimes struggled to imagine their neighbors' feelings and state of mind.
 After the disaster, aging of the city accelerated dramatically. The proportion of elders (those aged 65 or older) in the population stood at 25.9% in March 2011, but this had increased to 32.9% by March 2013. Elders tend to have strong emotional ties to their hometowns, while younger generations are more likely to move away and start over.
 As some young people have left the area or stopped working, the city is suffering from a lack of workers. A number of residents are in a state of being overworked. While children and mothers face more difficulties after the disaster, they are less able to find support in the city.
 As of the end of March 2013, 406 deaths in Minamisoma were officially attributed to disaster-related distress. The psychological burdens placed on residents of this city are too heavy to be ignored. Robust efforts and interventions are urgently needed in order to improve mental hygiene in the area.
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