Journal List > J Korean Neuropsychiatr Assoc > v.55(4) > 1017812

J Korean Neuropsychiatr Assoc. 2016 Nov;55(4):299-309. Korean.
Published online November 30, 2016.  https://doi.org/10.4306/jknpa.2016.55.4.299
Copyright © 2016 Korean Neuropsychiatric Association
The Stigma of Mental Illness in Korea
Jong-Ik Park, MD, PhD, LLM,1,2 and Mina Jeon, BSc3
1Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea.
2Chuncheon National Hospital, Chuncheon, Korea.
3Department of Mental Health Research, National Center for Mental Health, Seoul, Korea.

Address for correspondence: Jong-Ik Park, MD, PhD, LLM. Department of Psychiatry, Kangwon National University School of Medicine, 156 Baengnyeong-ro, Chuncheon 24289, Korea. Tel +82-33-258-9171, Fax +82-33-254-1376, Email: lugar@kangwon.ac.kr
Received July 26, 2016; Revised August 16, 2016; Accepted September 08, 2016.

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.

Keywords: Mental illness; Mental health literacy; Stigma

Notes

Conflicts of Interest:The authors have no financial conflicts of interest.

References
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 May 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. In: A proposal for the Psychological Integration of South and North Korean People in the Unified Korea. Seoul: Korea Institute for National Unification; 2003. pp. 141-183.
12. Humanrights.go.kr. Explanation of terms in human rights; national human rights commission of korea. [cited 2016 Jan 19].
[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. In: 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].
19. Kim SH, Lee YH, Hwang JH, Oh MA, Lee MK, Lee NH, et al. In: A study on disabled people in 2014. Sejong: Korean Institute for Health and Social Affairs; 2014.
20. Kim MK, Kim Y. In: 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. In: 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. In: 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].
35. Kim EJ. In: 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. In: 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].
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. In: Contributors to mental illness stigma [dissertation]. 16. J Soonchunyhyang Univ; 1993. pp. 1183-1188.
45. Seo MK, Kim JN, Lee MK. In: Discrimination and prejudges towards patients with mental disorders. Seoul: National Human Rights Commission of Korea; 2008.
46. Lee YH, Moon BY, Kim NY. In: 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].
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. In: 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].
59. World Health Organization. Mental Health Atlas country profile 2014: United State of America. Geneva: World Health Organization; 2014 [cited 2016 Feb 05].
60. World Health Organization. Mental Health Atlas country profile 2014: Japan. Geneva: World Health Organization; 2014 [cited 2016 Feb 05].
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 Dec 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. In: 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].
[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. In: 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. In: Educational program to improve recognition and eliminate prejudices of mental illness. Seoul: Korea Health Promotion Foundation; 2011.
95. Lee BW. In: 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.