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== Societal perceptions of mental illness ==
== Societal perceptions of mental illness ==
South Koreans have been found to have comparatively higher levels of internalized [[Social stigma|stigma]], which relates to higher rates of mental illness and more severe symptoms.<ref name=":6">{{cite journal|last1=Kim|first1=Woo Jung|last2=Song|first2=Yoon Joo|last3=Ryu|first3=Hyun Sook|title=Internalized Stigma and Its Psychosocial Correlates in Korean Patients with Serious Mental Illness|journal=Psychiatry Research|date=2015|volume=225|issue=3|pages=433–39}}</ref><ref name=":11">{{Cite journal|last=Boyd|first=Jennifer E|last2=Adler|first2=Emerald P|date=January 2014|title=Internalized Stigma of Mental Illness (ISMI) Scale: A Multinational Review|url=|journal=Comprehensive Psychiatry|volume=55|issue=1|pages=|doi=10.1016/j.comppsych.2013.06.005|via=}}</ref> Seeking treatment for mental health conditions is largely frowned upon in Korean culture, with reports stating that only seven percent of those affected by mental illness seek psychiatric help.<ref name=":12" /> Those who turn to therapy often pay out-of-pocket and in cash to avoid the stigma associated with mental health services on one's insurance record.<ref name=":13" /> Stigma also hinders the ability of those recovering from mental illness to reintegrate into society.<ref name=":12">{{cite web|last1=Research and Information Services|title=RRT Research Response|url=http://www.refworld.org/pdfid/4b6fe2770.pdf|website=Refugee Research Tribunal|accessdate=7 October 2017}}</ref>
South Koreans have been found to have comparatively higher levels of internalized [[Social stigma|stigma]], which relates to higher rates of mental illness and more severe symptoms.<ref name=":6">{{cite journal|last1=Kim|first1=Woo Jung|last2=Song|first2=Yoon Joo|last3=Ryu|first3=Hyun Sook|title=Internalized Stigma and Its Psychosocial Correlates in Korean Patients with Serious Mental Illness|journal=Psychiatry Research|date=2015|volume=225|issue=3|pages=433–39}}</ref><ref name=":11">{{Cite journal|last=Boyd|first=Jennifer E|last2=Adler|first2=Emerald P|date=January 2014|title=Internalized Stigma of Mental Illness (ISMI) Scale: A Multinational Review|url=|journal=Comprehensive Psychiatry|volume=55|issue=1|pages=|doi=10.1016/j.comppsych.2013.06.005|via=}}</ref> Seeking treatment for mental health conditions is largely frowned upon in Korean culture, with reports stating that only seven percent of those affected by mental illness seek psychiatric help.<ref name=":12" /> As a culture heavily influenced by [[Korean Confucianism|Confucianism]], the honor of the family is prioritized over the individual, leading Koreans to forgo treatment to preserve their family's face.<ref name=":13" /> Those who turn to therapy often pay out-of-pocket and in cash to avoid the stigma associated with mental health services on one's insurance record.<ref name=":13" /> Stigma also hinders the ability of those recovering from mental illness to reintegrate into society.<ref name=":12">{{cite web|last1=Research and Information Services|title=RRT Research Response|url=http://www.refworld.org/pdfid/4b6fe2770.pdf|website=Refugee Research Tribunal|accessdate=7 October 2017}}</ref>


== Mental healthcare ==
== Mental healthcare ==

Revision as of 15:20, 12 November 2017

South Korea

Mental health issues are prevalent in South Korea, with the highest suicide rate and the highest rate of hospitalizations for mental illness among OECD (Organisation for Economic Co-operation and Development) countries.[1] South Korea has state-funded mental health services, the majority of which are inpatient hospital facilities, but they are largely underfunded and underutilized.[2][3] Despite the prevalence of mental illness, social stigma remains prevalent throughout the South Korean population, which discourages sufferers from seeking treatment.[4] Mental illness, while present across all demographic groups, is most common among the elderly and adolescents in South Korea.[5][6]

History

Western medicine was first introduced to South Korea by missionary doctors, and led to the transition of mental healthcare from shamanistic healers and traditional Korean medicine to mental hospitals sponsored by the Japanese government, which was occupying Korea, by 1910. Missionary hospitals, which tended to be more humane, also existed, but the isolation of patients by government mental hospitals contributed to the development of stigma in Korean society.[7] Recently, the basis of mental healthcare in South Korea has shifted from long-term hospital stays to community-based healthcare,[2][8] but the length of admission of those staying in mental hospitals is on an upward trend.[1][9] This calls into question the effectiveness of South Korean health infrastructure, as the average length of stay in other OECD countries was less than a quarter of that in South Korea in 2011.[1] Some experts question how well treatment methods in South Korean mental hospitals are working compared to that of other OECD countries.[1]

Societal perceptions of mental illness

South Koreans have been found to have comparatively higher levels of internalized stigma, which relates to higher rates of mental illness and more severe symptoms.[4][10] Seeking treatment for mental health conditions is largely frowned upon in Korean culture, with reports stating that only seven percent of those affected by mental illness seek psychiatric help.[11] As a culture heavily influenced by Confucianism, the honor of the family is prioritized over the individual, leading Koreans to forgo treatment to preserve their family's face.[12] Those who turn to therapy often pay out-of-pocket and in cash to avoid the stigma associated with mental health services on one's insurance record.[12] Stigma also hinders the ability of those recovering from mental illness to reintegrate into society.[11]

Mental healthcare

South Korean law prohibits workplace discrimination based on mental health conditions, but discrimination persists due to the lack of enforcement of such legislation.[3] Psychiatrists and other mental health professionals are well-trained and numerous, but mental healthcare remains isolated from primary care, still a major contributor to South Korea's strong stigma against mental healthcare.[3] Public spending on mental healthcare remains low, at 3%, most of which goes to inpatient mental hospitals despite the fact that most people receive treatment from outpatient facilities.[3] The South Korean government passed the Mental Health Act in 1995, which made involuntary hospitalizations significantly easier.[8] In 2017, the Mental Health Act was amended to protect the rights of those admitted to inpatient mental hospitals.[13]

Mental illness

Contributing factors

Khang et al. found that economic hardship during the late 1990s led to a sharp increase in mental illness and suicide in South Korea.[14] Social stigma within the South Korean population likewise discourages people from initially seeking treatment, exacerbating the severity of mental illness.[4][10]

Depression

In 2001, between 3 and 4.2 percent of the South Korean population was estimated to have major depressive disorder as outlined in the DSM-IV, a number which has been increasing.[5] Women, smokers, shift workers, those with poor health, those who exercise in the evenings, those who perceive their lives to be stressful, and those that were underweight were more likely to have major depressive disorder.[5] Depression is estimated to have an impact of over $4 billion USD in the South Korean economy, with morbidity costs taking up the greatest proportion of that value.[15] Increasing attention to the treatment and prevention of depression would have an impact on economic growth as well as public health.[15]

Other mental illness

Maeng-Je Cho et al. found that over one-third of the South Korean population has had a mental disorder at any point in their lives, and over one-fifth have experienced a disorder in the past year.[16] Compared to the United States and other East Asian countries, alcohol use disorder is more prevalent in Korea, and treatment is four times less likely to be sought out in Korea.[17] The prevalence of alcohol use disorder is increased by the expectation of businesspeople to engage in heavy drinking with their colleagues after work.[12] 17% of the South Korean population has insomnia, which is a rate comparable to that of insomnia in the United States.[18] 6.6% of Koreans have nicotine dependence disorder, 2% have a mood disorder, and 5.2% have an anxiety disorder, all less frequent among Koreans than among Americans.[17]

Demographics of mental illness

Mental illness in the elderly

Between 17.8 and 27.9 percent of those aged 65 or older in South Korea are likely to suffer from depression, significantly higher than the rate in other countries.[19] Factors associated with late life depression in Korea include illiteracy, living alone, poverty, low education, smoking, head trauma, and intellectual disability.[19] The high rate of depression among Korean elders may be a result of the rapidly aging population and the dissolution of the tradition of children caring for their aging parents.[19] Government social services for the elderly, such as the Law of Elderly Welfare, are inadequate to provide for the growing population's needs, contributing to mental illness within the demographic.[6]

Among a sample of elderly Koreans living in the United States, 34% were found to have depression, less than a fifth of which had ever seen a mental health professional. The majority of older Koreans living in the United States exhibited a negative perception of mental health services.[20]

Mental illness in adolescents

More than 10% of Seoul adolescents have been found at high risk for internet addiction disorder.[21] Internet addiction is positively correlated with family factors including child abuse and a harsh parenting style.[21] Depression and obsessive-compulsive disorder are both correlated with internet addiction among adolescents.[22]

Hyun-Sook Park et al. have found a gender difference in predictors of suicide ideation among Korean youth; with the main predictors for females being bullying, sexual orientation, depression, low self-esteem, and hostility; and the primary predictors for males being history of suicide attempt, parental alcohol abuse, smoking, hostility, and low self-esteem.[23]

Besides the elderly, adolescents have the highest suicide rate in South Korea[5] and adolescents had the highest proportional increase in suicide rate between 1986 and 2005.[6]

Suicide

Main article: Suicide in South Korea

In 2013, the suicide rate in South Korea was 29.1 per 100,000, a decrease from 33.3 per 100,000 in 2011. This rate is more than twice the OECD average.[1] Between 2000 and 2011, South Korea's suicide rate more than doubled, contrary to the international reduction trend.[1] This rise is suicides is potentially linked to the economic wellbeing of South Koreans, as suicides have historically been higher during times of economic strife.[6] The increase in suicides has been most significant among women, adolescents, and the elderly.[5][6]

References

  1. ^ a b c d e f "Korea's increase in suicides and psychiatric bed numbers is worrying, says OECD" (PDF). OECD. Retrieved 7 October 2017.
  2. ^ a b Roh, Sungwon (2016). "Mental health services and R&D in South Korea". International Journal of Mental Health Systems. 10 (45). doi:10.1186/s13033-016-0077-3.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  3. ^ a b c d World Health Organization (2011). "WHO-AIMS Report on Mental Health in Republic of Korea" (PDF). WHO Collaborating Center for Psychosocial Rehabilitation and Community Mental Health in Korea. Retrieved 7 October 2017. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  4. ^ a b c Kim, Woo Jung; Song, Yoon Joo; Ryu, Hyun Sook (2015). "Internalized Stigma and Its Psychosocial Correlates in Korean Patients with Serious Mental Illness". Psychiatry Research. 225 (3): 433–39.
  5. ^ a b c d e Ohayon, Maurice M.; Hong, Seung-Chul (2006). "Prevalence of Major Depressive Disorder in the General Population of South Korea". Journal of Psychiatric Research. 40 (1): 30–36. doi:10.1016/j.jpsychires.2005.02.003.
  6. ^ a b c d e Kwon, Jin-Won; Chun, Heeran; Cho, Sung-il (27 February 2009). "A closer look at the increase in suicide rates in South Korea from 1986-2005". BMC Public Health. 9 (72). doi:10.1186/1471-2458-9-72.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  7. ^ Min, Sung-kil; Yeo, In-sok (2017). "Mental Health in Korea: Past and Present". Mental Health in Asia and the Pacific: 79–92. doi:10.1007/978-1-4899-7999-5_5.
  8. ^ a b Kahng, Sang Kyoung; Kim, Hyemee (2010). "A Developmental Overview of the Mental Health System in South Korea". Social Work in Public Health. 25 (2): 158–175. doi:10.1080/19371910903070408.
  9. ^ Kim, Agnus M (2017). "Why do psychiatric patients in Korea stay longer in hospital?". International Journal of Mental Health Systems. 11 (2). doi:10.1186/s13033-016-0110-6.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  10. ^ a b Boyd, Jennifer E; Adler, Emerald P (January 2014). "Internalized Stigma of Mental Illness (ISMI) Scale: A Multinational Review". Comprehensive Psychiatry. 55 (1). doi:10.1016/j.comppsych.2013.06.005.
  11. ^ a b Research and Information Services. "RRT Research Response" (PDF). Refugee Research Tribunal. Retrieved 7 October 2017.
  12. ^ a b c McDonald, Mark (6 July 2011). "Stressed and Depressed, Koreans Avoid Therapy". The New York Times. {{cite news}}: Cite has empty unknown parameter: |dead-url= (help)
  13. ^ Shin, Dongho (6 March 2017). "The World Health Organization (WHO) expressed support for the revision of the Korean Mental Health Act". Department of Mental Health Policy. Retrieved 20 October 2017. {{cite news}}: Cite has empty unknown parameter: |dead-url= (help)
  14. ^ Khang, Young-Ho; Lynch, John W.; Kaplan, George A (2005-12-01). "Impact of economic crisis on cause-specific mortality in South Korea". International Journal of Epidemiology. 34 (6): 1291–1301. doi:10.1093/ije/dyi224. ISSN 0300-5771.
  15. ^ a b Chang, S.M.; Hong, J.P.; Cho, M.J. (May 2012). "Economic burden of depression in South Korea". Soc Psychiatry Psychiatr Epidemiol. 47 (683). doi:10.1007/s00127-011-0382-8.
  16. ^ Cho, Maeng Je; Kim, Jang Kyu; Jeon, Hong Jin (March 2007). "Lifetime and 12-Month Prevalence of DSM-IV Psychiatric Disorders among Korean adults". Journal of Nervous and Mental Disease. 195 (3). doi:10.1097/01.nmd.0000243826.40732.45.
  17. ^ a b Chou, S. Patricia; Lee, H.K.; Cho, M.J. (April 2012). "Alcohol Use Disorders, Nicotine Dependence, and Co Occurring Mood and Anxiety Disorders in the United States and South Korea—A Cross-National Comparison". Alcoholism: Clinical and Experimental Research. 36: 654–662. doi:10.1111/j.1530-0277.2011.01639.x.
  18. ^ Ohayon, Maurice; Hong, Seung Chul (2002). "Prevalence of Insomnia and Associated Factors in South Korea". Journal of Psychosomatic Research. 53 (1): 593–600. doi:10.1016/S0022-3999(02)00449-X.
  19. ^ a b c Park, Joon Hyuk; Kim, Ki Woong (2002). "A Nationwide Survey on the Prevalence and Risk Factors of Late Life Depression in South Korea". Journal of Affective Disorders. 138. doi:10.1016/j.jad.2011.12.038.
  20. ^ Jang, Yuri; Kim, Giyeon (April 2007). "Attitudes of Older Korean Americans Toward Mental Health Services". Journal of the American Geriatrics Society. 55 (4). doi:10.1111/j.1532-5415.2007.01125.x.
  21. ^ a b Park, Soo Kyung; Kim, Jae Yop (February 2008). "Prevalence of Internet Addiction and Correlations with Family Factors among South Korean Adolescents". Adolescence. 43 (172). Choon Bum Cho.
  22. ^ Ha, J.H.; Kim, S.Y. (August 2007). "Depression and Internet Addiction in Adolescents". Psychopathology. 40.
  23. ^ Park, Hyun Sook; Schepp, Karen G. (2006). "Predictors of Suicidal Ideation Among High School Students by Gender in South Korea". Journal of School Health. 76 (5) – via Gale.
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