Since the Great Hanshin Awaji Earthquake in 1995, media reports on importance of mental health services for survivors and service providers, and hundreds of mental health teams were coordinated and dispatched to the disaster areas right after the Great East Japan Earthquake and Tsunami last year. However, how much of such services were truly welcomed and utilized by the survivors? Some argue that the concept of mental health itself is western born hence it does not really fit with Japanese culture. This paper, however, points out aftereffects of disaster are universal but how they are expressed might be influenced by culture, social structures, and individual differences. And survivors in general need support to recover but it does not have to be ‘mental health’ per se, and it is up to providers' ability in how to present it so that mental health service is accepted and utilized. Examples from author's experiences are included to make points.