During the Great East Japan Earthquake, many different states of disaster were witnessed across a wide portion of the affected areas. Furthermore, there were different issues related to the provision of aid and its acceptance, depending on the phase of the disaster at the time. For the disaster-affected areas that require long-term support, aid with a longitudinal and long-term perspective that starts immediately after and/or during the acute stages of a disaster is well-received. In addition, the level of mental health support activities/services available in a community differs depending on the region. Thus, increasing such levels with only a short-term perspective may not be helpful or may even become burdensome in the long-term. It is therefore necessary to recognize the differences in needs and ability to receive support aids in the affected areas, so that the recipients of such aid can construct an aid acceptance system suited to their needs and under their control.
 An example of an aid recipient having prepared autonomously for a disaster before a natural disaster struck is Sendai City, in which the municipality prepared guidelines on mental health and welfare activities during disasters, created a mental mindset and system for the disaster relief aid recipients, and published guidelines on its website for external aid providers. After the Great East Japan Earthquake, a conference on mental health for medical and welfare workers was established in Miyagi Prefecture to facilitate the exchange of information. It was found during this time that having established a face-to-face relationship among the relevant parties in the community on a daily basis proved to be helpful in enabling the provision and receipt of aid following the disaster.
 Cooperation with local supporters will become key to establishing a stable aid provision structure for the mid- to long-term, and not just for the acute phase taking place immediately after a disaster. The tasks that face Miyagi Prefecture, in which eight years have passed since the Great East Japan Earthquake, is to smoothly transition from receiving "special" aid specific to natural disasters to "normal" support for regular periods. The Miyagi Prefecture is on the cusp of entering a new phase in which it will examine the state of aid to be provided in the future after first understanding the position of the local people, who had been receiving support as disaster relief and aid recipients. Supporters and aid recipients are in an interchangeable position and, as such, the ability to provide aid and to receive aid could be considered a closely intertwined relationship-akin to being two sides of the same coin.
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