As the three-year anniversary of the Great Tohoku Earthquake and Fukushima nuclear incident approaches, a new study on the psychological damage afflicted upon one coastal community reveals a host of mental health concerns.

The town of Hirono on the coast of Fukushima prefecture was hit hard by the March 11, 2011 earthquake and tsunami. The Fukushima Dai-ichi nuclear campus, inundated by the tsunami which triggered a series of reactor meltdowns, is only about 30 kilometers from Hirono. Large sections of Hirono was forced to evacuate because of their proximity to the nuclear reactor, and may more residents chose to leave on their own.

Although just two of Hirono's 5,418 residents lost their lives in the disaster, the new research by Brighham Young University psychology professor Niwako Yamawaki and scholars from Saga University in Japan points to evidence that Hirono residents are struggling to keep their sanity.

The researchers examined the mental health of 241 Hirono residents, finding that more than half of those evaluated experience "clinically concerning" symptoms of post-traumatic stress disorder.

Additionally, two-thirds of those sampled reported depression.

"This was the world's fourth-biggest recorded earthquake, and also the tsunami and nuclear plant and losing their homes - boom boom boom boom within such a short time," Yamawaki said. "The prevalence one year after is still much higher than other studies of disasters that we found even though some time had passed."

The Hirono residents involved in the study all lived in temporary housing provided by the Japanese government when Hirono was evacuated.

As Yamawaki and her collaborators surveyed the Hirono residents, the average age of whom was 58, they detected a sense that many of the people missed the community feeling of their now-evacuated hometown.

"Japanese are very collectivistic people and their identity is so intertwined with neighbors," Yamawaki said. "Breaking up the community has so much impact on them."

Yamawaki and her collaborators, including Hiroko Kukihara at Saga University, published their research in the journal Psychiatry and Clinical Neurosciences.