Social Stigma-Related Factors That Contribute to the Diagnostic Seeking and Treatment Adherence Behaviors of Mentally Ill South Koreans: A Literature Review

Background and purpose:

South Korea has notoriously reported the highest suicide rates among all OECD countries since 2007. While many studies have been conducted to understand various causative factors such as economic and sociocultural pressures, it has also been discovered that 75.3% of suicide attempters had a diagnosable mental illness, and that the inherent social stigma surrounding mental illness has a significant role in the worsening of mental illnesses. This in turn reflects on the apparent inability to effectively seek or adhere to treatment options. Koreans exhibit a high degree of reluctancy to seek and maintain support services for mental health issues despite the success rate of such services, however research has yet to adequately cross-reference studies about stigma to understand what could be done to improve these conditions. This study seeks to identify the weak points in patient reception and retention in present day public/private institutions and mental health resources in order to provide an understanding of what measures could be taken to improve mental health in South Korea.

Methods:

This study finds its grounding in a secondary literature analysis of studies that explore the specifics of social stigma as a hinderance on mental health programs and the mentally ill, especially within Korea. Various databases were searched – such as DBpia and PsycINFO - for studies published since 2010, utilizing keywords such as ‘mental health stigma’, ‘social stigma’, ‘treatment adherence’, and ‘Korea’. Considering these search terms and other criteria, 22 quantitative and qualitative studies were identified as pertinent for this study.

Results:

This review of prior literature and data has exposed the massive flaws in the current social welfare programs and mental health campaign efforts. Multiple studies show that the lack of proper education on mental health to avoid the internalization of stigma and lack of proper exposure to real-life cases of mental illness have contributed the most to social stigma’s enormous influence on the South Korean people’s ability to seek and maintain diagnostic services and treatment. Prevailing theories for these observations included labeling theory and symbolic interaction theory, providing an understanding of how stigma is integrated into self-identification and therefore influencing behaviors. The reduction of this internalization of broad social stigma through higher levels of education showed great implications on one's resiliency to external bias and inherent ability to seek and continue treatment services.

Conclusions and implications:

This study demonstrates the major concept that mental health literacy has the largest impact on social stigma and therefore the greatest impact on the self-efficacy and resilience of Koreans seeking and utilizing support/treatment services. Greater efforts must be made for literacy to reduce broad social and self-stigma to increase help-seeking behaviors. This study suggests that significant work must be done, mainly by governmental agencies, to foster campaigns that focus on mental health literacy, especially for those already seeking treatment, and the promotion of public and private resources to South Koreans in order to reduce the hindering effects of social stigma on mental health issues.