J Korean Neuropsychiatr Assoc.  2016 Nov;55(4):299-309. 10.4306/jknpa.2016.55.4.299.

The Stigma of Mental Illness in Korea

• Park JI
• Jeon M

• KMID: 2361219
• DOI: http://doi.org/10.4306/jknpa.2016.55.4.299

Abstract

The stigma of mental illness is a problem that should be addressed urgently as such stigma has a negative effect on the lives of individuals with mental disorders, which may result in social and economic losses. Moreover, mental health stigma acts as a barrier to mental health service utilization. Thus, the need to reduce the mental health stigma has been highlighted. In Korea, stigma associated with individuals with mental disorders has been studied; however, few of those studies investigated mental health literacy, which might influence an individual's attitudes toward and beliefs about people with mental disorders. Furthermore, there are fewer evidence-based anti-stigma campaigns and programs in Korea than in other countries. On that basis, a review of previous studies focusing on mental disorder stigma was undertaken, and the effects of such stigma on individuals with mental disorders and on society were assessed. In addition, research into mental health literacy, rarely undertaken in South Korea, was discussed. Finally, anti-stigma campaigns that are reportedly effective in reducing mental illness stigma were reviewed. With regard to future research on mental health stigma in South Korea, it is suggested that researchers study mental health literacy to assess accurately the public's misperceptions about mental disorders. In addition, a variety of evidence-based anti-stigma campaigns should be implemented to increase public knowledge of mental disorders. Lastly, cooperation between public and private sectors should be encouraged to develop strategies for reducing the stigma and negative beliefs associated with mental disorders.

Keyword

Mental illness; Mental health literacy; Stigma

MeSH Terms

Korea*
Literacy
Mental Disorders
Mental Health
Mental Health Services
Private Sector

Reference

1. Department of Medicine Seoul National University. The epidemiological survey of mental disorders in Korea. Sejong: Ministry of Health and Welfare;2011.

2. Corrigan P. How stigma interferes with mental health care. Am Psychol. 2004; 59:614–625.

3. Kim SG. Murder at Gangnam station: fear of prejudice and stigma towards mental disorders due to sensational news. Rapportian. 2016. 05. 23.

4. Yu SJ. A comparative study of attitude of teachers and general public toward mental health. J Nurs Acad Soc. 1976; 6:1–11.

5. Han DU, Lee MK. Changes in social representation of mental illness: comparing between 1976 year and 1995 year. Korean J Health Psychol. 2003; 8:191–206.

6. Lee EH, Kim KJ, Lee SY. The attitudes of the inhabitants of Kwangju towards the persons with mental illness. J Korean Neuropsychiatr Assoc. 2000; 39:495–506.

7. Lee JE, Lee YM, Lim KY, Lee HY. A survey for community attitudes toward the mentally-ill in Ansan Area. J Korean Neuropsychiatr Assoc. 1999; 38:530–538.

8. Jorm AF. Mental health literacy. Public knowledge and beliefs about mental disorders. Br J Psychiatry. 2000; 177:396–401.

9. Furnham A, Hamid A. Mental health literacy in non-western countries: a review of the recent literature. Mental Health Rev J. 2014; 19:84–98.

10. Corrigan PW, Penn DL. Lessons from social psychology on discrediting psychiatric stigma. Am Psychol. 1999; 54:765–776.

11. Kim KH. A proposal for the Psychological Integration of South and North Korean People in the Unified Korea. Seoul: Korea Institute for National Unification;2003. p. 141–183.

12. Humanrights.go.kr. Explanation of terms in human rights; national human rights commission of korea. cited 2016 Jan 19. Available from: http://www.humanrights.go.kr/03_sub/body04_2.jsp. [homepage on the Internet].

13. Link BG, Cullen FT, Frank J, Wozniak JF. The social rejection of former mental patients: understanding why labels matter. Am J Sociol. 1987; 92:1461–1500.

14. Rabkin J. Public attitudes toward mental illness: a review of the literature. Schizophr Bull. 1974; (10):9–33.

15. McDaid D. Countering the stigmatisation and discrimination of people with mental health problems in Europe. Luxembourg: European commission;2008.

16. Lauber C, Rössler W. Stigma towards people with mental illness in developing countries in Asia. Int Rev Psychiatry. 2007; 19:157–178.

17. Angermeyer MC, Dietrich S. Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatr Scand. 2006; 113:163–179.

18. Scottish Association for Mental Health (SAMH). A world to belong to social networks of people with mental health problems. Scotland: Scottish Association for Mental Health;cited 2016 Jan 15. Available from: http://www.healthscotland.com/uploads/documents/5707-A%20world%20to%20belong%20to.pdf.

19. Kim SH, Lee YH, Hwang JH, Oh MA, Lee MK, Lee NH, et al. A study on disabled people in 2014. Sejong: Korean Institute for Health and Social Affairs;2014.

20. Kim MK, Kim Y. Survey on the life of people with mental disability at home and their family. Seoul: National Human Rights Commission of Korea;2008.

21. Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, et al. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA. 2004; 291:2581–2590.

22. Sharac J, McCrone P, Clement S, Thornicroft G. The economic impact of mental health stigma and discrimination: a systematic review. Epidemiol Psichiatr Soc. 2010; 19:223–232.

23. Borinstein AB. Public attitudes toward persons with mental illness. Health Aff (Millwood). 1992; 11:186–196.

24. Gong SJ. The perceptions and attitudes of lay person towards the mentally ill. J Korean Acad Psychiatr Ment Health Nurs. 1997; 6:265–277.

25. Sung JM. A study on the perceived stigma and coping orientations of discharged psychiatric patients [dissertation]. Seoul: Soongsil University;1996.

26. Ministry of Health and Welfare. Report of health and welfare. Sejong: Ministry of Health and Welfare;2004.

27. Farina A, Feliner RD. Employment interviewer reactions to former mental patients. J Abnorm Psychol. 1973; 82:268–272.

28. Link BG, Cullen FT, Struening E, Shrout PE, Dohrenwend BP. A modified labeling theory approach to mental disorders: an empirical assessment. Am Sociol Rev. 1989; 54:400–423.

29. Rosenfield S. Labelling mental illness: the effects of received services and perceived stigma on life satisfaction. Am Sociol Rev. 1997; 62:660–672.

30. Link B. Mental patient status, work, and income: an examination of the effects of a psychiatric label. Am Sociol Rev. 1982; 47:202–215.

31. Han HS. Study on the solutions to the NIMBY syndrome in selecting the site of non-preferred facilities: in the case of the 154kv Sung Sanbranch power transition line project [dissertation]. Jeju: Juju National University;1999.

32. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997; 349:1498–1504.

33. World Health Organization. The global burden of disease: 2004 update. Geneva: World Health Organization;2008.

34. World Economic Forum. The global economic burden of non-communicable diseases. Geneva: World Economic Forum;2011. cited 2016 Jan 10. Available from: http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf.

35. Kim EJ. Study on the economic cost of mental disorders [dissertation]. Seoul: Seoul National University;2006.

36. Jung YH. Cost of illness and health-friendly fiscal policy. Health Welf Policy Forum. 2010; 156:50–61.

37. Knapp M. Hidden costs of mental illness. Br J Psychiatry. 2003; 183:477–478.

38. Angermeyer MC, Matschinger H. The stigma of mental illness in Germany: a trend analysis. Int J Soc Psychiatry. 2005; 51:276–284.

39. Kim Y, Lee JS, Lee SY, Park GH, Moon SG, Jang WM, et al. The national mental health commission report in 2007. Seoul: Ministry for Health, Welfare and Family Affairs;2007.

40. Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA. Public conceptions of mental illness: labels, causes, dangerousness, and social distance. Am J Public Health. 1999; 89:1328–1333.

41. Kim SW, Yoon JS, Lee MS, Lee HY. The analysis of newspaper-articles on psychosis. J Korean Neuropsychiatr Assoc. 2000; 39:838–848.

42. A life without stigma: A SANE Report. South Melbourne: SANE Australia;2013. cited 2016 Mar 6. Available from: https://www.sane.org/images/PDFs/ALifeWithoutStigma_A_SANE_Report.pdf.

43. Lee CS, Lee DY, Hwang YS. Report of crime conducted by the mentally ill in Korean newspapers. J Korean Neuropsychiatr Assoc. 1996; 35:1132–1144.

44. Seo MK, Kwon YJ, Jeong HY. Contributors to mental illness stigma [dissertation]. J Soonchunyhyang Univ;1993. 16:1183–1188.

45. Seo MK, Kim JN, Lee MK. Discrimination and prejudges towards patients with mental disorders. Seoul: National Human Rights Commission of Korea;2008.

46. Lee YH, Moon BY, Kim NY. Study on social stigma related to mental health. Seoul: Korea Institute for Health and Social Affairs;2008.

47. Kim GI, Seo HH, Park YC, Lee ST, Kim YY. Follow-up study: public knowledge and attitudes toward mental illness in Korea. Ment Health Res. 1989; 8:118–132.

48. Yang OK. Social stigma on people with mental disorder. Korean J Soc Welf. 1998; 35:231–261.

49. Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG. “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatry. 2010; 167:1321–1330.

50. Kim CN, Seo MK. A study on prejudice and discrimination against the mentally ill. Korean J Health Psychol. 2004; 9:589–607.

51. Kilian R, Becker T. Macro-economic indicators and labour force participation of people with schizophrenia. J Ment Health. 2007; 16:211–222.

52. See Me. ‘See me’ so far: a review of the first 4 years of the Scottish anti-stigma campaign. Edinburgh: ‘See me’;2006. cited 2016 Feb 05. Available from: http://www.docs.csg.ed.ac.uk/EqualityDiversity/see_me_so_far.pdf.

53. Lee CR, Kim Y, Yoo CI, Lee JH, Lee H. Mental disorders and fitness for work in Korea. Korean J Occup Environ Med. 2003; 15:224–236.

54. SANE Australia. A life without stigma: A SANE report. South Melbourne: SANE Australia;2013.

55. Lauber C, Nordt C, Braunschweig C, R◦ssler W. Do mental health professionals stigmatize their patients? Acta Psychiatr Scand Suppl. 2006; (429):51–59.

56. Psarra V, Sestrini M, Santa Z, Petsas D, Gerontas A, Garnetas C, et al. Greek police officers' attitudes towards the mentally ill. Int J Law Psychiatry. 2008; 31:77–85.

57. Bhang SY. A comparison study on the attitudes of mental health professionals towards mental disorders [dissertation]. Seoul: Seoul National University;2005.

58. World Health Organization. Mental Health Atlas country profile 2014: Republic of Korea. Geneva: World Health Organization;2014. cited 2016 Feb 05. Available from: http://www.who.int/mental_health/evidence/atlas/profiles-2014/kor.pdf?ua=1.

59. World Health Organization. Mental Health Atlas country profile 2014: United State of America. Geneva: World Health Organization;2014. cited 2016 Feb 05. Available from: http://www.who.int/mental_health/evidence/atlas/profiles-2014/kor.pdf?ua=1.

60. World Health Organization. Mental Health Atlas country profile 2014: Japan. Geneva: World Health Organization;2014. cited 2016 Feb 05. Available from: http://www.who.int/mental_health/evidence/atlas/profiles-2014/jpn.pdf?ua=1.

61. Han SH. Current medical care legislation may destroy human dignity right and health right;one in four basic livelihood security beneficiaries receives treatment for mental disorders. Energy Economy. 2015; 12. 29.

62. Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aust. 1997; 166:182–186.

63. Jorm AF, Nakane Y, Christensen H, Yoshioka K, Griffiths KM, Wata Y. Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan. BMC Med. 2005; 3:12.

64. Gong AT, Furnham A. Mental health literacy: public knowledge and beliefs about mental disorders in mainland China. Psych J. 2014; 3:144–158.

65. Loo PW, Wong S, Furnham A. Mental health literacy: a cross-cultural study from Britain, Hong Kong and Malaysia. Asia Pac Psychiatry. 2012; 4:113–125.

66. Lee SH, Suh JH. Mental health literacy of the Korean public: a comparison between depression and schizophrenia. Korean J Soc Welfare Stud. 2010; 41:127–158.

67. Jorm AF, Christensen H, Griffiths KM. Public beliefs about causes and risk factors for mental disorders: changes in Australia over 8 years. Soc Psychiatry Psychiatr Epidemiol. 2005; 40:764–767.

68. Razali SM, Khan UA, Hasanah CI. Belief in supernatural causes of mental illness among Malay patients: impact on treatment. Acta Psychiatr Scand. 1996; 94:229–233.

69. Georg Hsu LK, Wan YM, Chang H, Summergrad P, Tsang BY, Chen H. Stigma of depression is more severe in Chinese Americans than Caucasian Americans. Psychiatry. 2008; 71:210–218.

70. Seo M, Rhee M. Mental health literacy and vulnerable group analysis of Korea. Korean J Soc Welf. 2013; 65:313–334.

71. Priest RG, Vize C, Roberts A, Roberts M, Tylee A. Lay people's attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch. BMJ. 1996; 313:858–859.

72. Angermeyer MC, Däumer R, Matschinger H. Benefits and risks of psychotropic medication in the eyes of the general public: results of a survey in the Federal Republic of Germany. Pharmacopsychiatry. 1993; 26:114–120.

73. Lauber C, Nordt C, Falcato L, Rössler W. Lay recommendations on how to treat mental disorders. Soc Psychiatry Psychiatr Epidemiol. 2001; 36:553–556.

74. Velligan DI, Weiden PJ, Sajatovic M, Scott J, Carpenter D, Ross R, et al. The expert consensus guideline series: adherence problems in patients with serious and persistent mental illness. J Clin Psychiatry. 2009; 70:Suppl 4. 1–46. quiz 47-48.

75. Angermeyer MC, Matschinger H. Have there been any changes in the public's attitudes towards psychiatric treatment? Results from representative population surveys in Germany in the years 1990 and 2001. Acta Psychiatr Scand. 2005; 111:68–73.

76. Lee SH, Suh JH. The ability to recognize symptoms of depression and beliefs about treatment among Koreans. Ment Health Soc Work. 2009; 32:41–77.

77. Ko H, Choi H. Mental health literacy among parents of adolescents and teachers in Korea. J Korean Acad Psychiatr Ment Health Nurs. 2015; 24:168–177.

78. Jang Y, Kim G, Hansen L, Chiriboga DA. Attitudes of older Korean Americans toward mental health services. J Am Geriatr Soc. 2007; 55:616–620.

79. Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rüsch N. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv. 2012; 63:963–973.

80. Kelly CM, Jorm AF, Wright A. Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. Med J Aust. 2007; 187:7 Suppl. S26–S30.

81. Kitchener BA, Jorm AF. Mental health first aid: an international programme for early intervention. Early Interv Psychiatry. 2008; 2:55–61.

82. Pinfold V, Toulmin H, Thornicroft G, Huxley P, Farmer P, Graham T. Reducing psychiatric stigma and discrimination: evaluation of educational interventions in UK secondary schools. Br J Psychiatry. 2003; 182:342–346.

83. Francis C, Pirkis J, Dunt D, Blood RW, Davis C. Improving mental health literacy: a review of the literature. Canberra: Commonweath Department of Health And Aged Care;2002.

84. Paykel ES, Hart D, Priest RG. Changes in public attitudes to depression during the Defeat Depression Campaign. Br J Psychiatry. 1998; 173:519–522.

85. Pirkis J, Hickie I, Young L, Burns J, Highet N, Davenport T. An evaluation of beyondblue, Australia's national depression initiative. Int J Ment Health Promot. 2005; 7:35–53.

86. Jorm AF, Christensen H, Griffiths KM. Changes in depression awareness and attitudes in Australia: the impact of beyondblue: the national depression initiative. Aust N Z J Psychiatry. 2006; 40:42–46.

87. Vaughan G, Hansen C. ‘Like Minds, Like Mine’: a New Zealand project to counter the stigma and discrimination associated with mental illness. Australas Psychiatry. 2004; 12:113–117.

88. Kcl.ac.uk. Institute of Psychiatry, Psychology & Neuroscience; Time to change: evidence for anti-stigma campaign. cited 2016 Feb 23. Available from: http://www.kcl.ac.uk/ioppn/about/difference/20-Time-to-Change-Evidence-for-anti-stigma-campaigns.aspx. [homepage on the Internet].

89. Schulze B, Richter-Werling M, Matschinger H, Angermeyer MC. Crazy? So what! Effects of a school project on students' attitudes towards people with schizophrenia. Acta Psychiatr Scand. 2003; 107:142–150.

90. The National Mental Health Commission. The national mental health commission report in 2004. Sejong: Ministry of Health and Welfare;2004.

91. Relevant Ministry. Mental health comprehensive strategy. Sejong: Relevant Ministry;2016.

92. Seoul Mental Health Center. Seoul mental health center report in 2015. Seoul: Seoul Mental Health Center;2015.

93. Seo JH, Lee SH, Shin DG, Kwon OY, Park Kim YH, Si YH, et al. A study to reduce discrimination and prejudges towards mental disability. Seoul: National Human Rights Commission of Korea;2012.

94. Kim KH, Kim GH, Moon YH, Yum HK, Oh YA, Yoon HS, et al. Educational program to improve recognition and eliminate prejudices of mental illness. Seoul: Korea Health Promotion Foundation;2011.

95. Lee BW. A study on current state and improvement approaches of human rights education for mental health facilities. Cheongju: Korean Human Resource Development Institute For Health and Welfare;2014.