Mental Health in Korea: Past and Present

Abstract

In pre-modern Korean society, mental illnesses were treated according to the concepts of Shamanism and Asian traditional medicine. H.N. Allen (1858–1932), the first missionary doctor, from USA, described mental illnesses including hysteria and delirium tremens. Western medicine brought a new way of perceiving physical and mental illnesses. From 1910 to 1945, the policy of the Japanese colonial government was to isolate patients in mental hospitals as they were considered to be harmful to society. This promoted stigma. The Government Hospital opened a special ward for mental patients in 1911. In contrast, the Australian medical missionary, Charles I. McLaren, believed in humane treatment in missionary hospitals including Severance Hospital. After the Korean War (1950–1953), psychiatry came under American influences. For the last several decades, the country has undergone a rapid and intense industrialization and democratization. Clinical and community services, as well as research and education in psychiatry, have been developed. In this brief period, the traditional agrarian, family-oriented, and collective social system has been transformed into a capitalistic, egalitarian, individualistic, high technological, and competitive one. An achievement-oriented lifestyle involving hard work, merciless competition, unstable employment and an uncertain future has created stress in many Koreans. Compounding this stress is the disintegration of the traditional, family support system. The consequence has been an exacerbation of Haan (suppressed anger and feelings of unfairness) related to a sense of historical suffering from colonialism and war, and the stress of rapid social change underlies various culture-specific mental problems. The burgeoning feelings of anger and depression are likely to contribute to the high rate of suicide. The challenges for the future include providing culturally relevant services and further promotion of the human rights of the mentally ill in the face of continued stigma. Another challenge is promoting the mental health of North Korean defectors, and marriage immigrants and their mixed-blood children. Finally, Korean psychiatry should prepare for reconstruction of psychiatry in North Korea after reunification.