INDEX (Volume 7 Num 1)

CULTURE AND MENTAL HEALTH ISSUES IN CONTEMPORARY SOUTH KOREA Guest Editor: Sung-Kil Min

This special issue - Editorial V. De Luca 1

An overview of major cultural and mental health concerns in South Korea: Adjustments of immigrants, imported wives and their mixed children, and political defectors - Editorial S. Min 1 - 8

This special issue will focus on cultural and mental-health issues in contemporary South Korea, with particular concern for new, historical challenges arising from a rapid increase in foreign workers, transcultural immigration, and imported wives, mainly from Southeast Asia, brought in to deal with the shortage of women for Korean men, mainly in rural, agricultural areas, and the social adjustment of political defectors from North Korea. These issues were addressed at the International Conference on Multicultural Society and Mental Health organized by the Seoul Metropolitan Eunpyeong Hospital and held in Seoul, Korea, in September 2010. For the past several decades, Korean industrialization and democratization have progressed rapidly. Now, Korean society is becoming more open, liberal, and diverse in terms of the cultural backgrounds of the people than ever before, and Korea is changing into a multi-cultural society (Yoon, 2008; Kim, 2007). Already, many cultures have been introduced from all over the world. Since the 1980s, numerous foreign laborers and foreign brides have arrived in Korea. In addition, North Koreans have been continuously defecting to South Korea. The numbers of tourists, business visitors, and foreign students have been increasing every year, as well (The Ministry of Justice, 2010). Foreigners’ adaptation to the different cultures of Korea and some of those foreigners’ consequent mental-health problems have become important social concerns in Korean society. These days, living alongside foreigners is unavoidable. Koreans must find a way to integrate these foreigners’ cultures with ours, leading to a better society. Whether Koreans can overcome their traditional nationalism, ethnocentrism, and selfish, family-oriented collectivism that was emphasized in the past is a historic challenge for Koreans. In particular, North Korean defectors’ adaptation to South Korean culture is a test case for the success of a future South and North Korean reunification (Min, 2008). This overview of the issues pertaining to the present status of foreigners in Korea examines research on major adaptation problems, foreigners’ mental-health problems, contemporary Korean culture, and proposed next steps.

Cultural and mental-health issues and their relevance to Korea: Adjustment of politically separated families, transcultural immigrants, foreign workers, intermarried couples and mixed-ethnic children - Original Paper W. Tseng 9 - 17

The impact of culture on mental health. Associated with the increase of knowledge and experience, cultural psychiatrists have become aware that culture significantly influences the mental health of people in many ways (Tseng, 2003). Namely: - Culture induces stress and other problems Based on culture-related beliefs or expectations, culture may induce certain kinds of psychological stress, such as the pressure to perform well academically, produce male children to carry on the family name, be filial toward parents, and deal with transcultural immigration or intercultural marriages. - Culture shapes the reaction to stress and manifestation of psychopathology Beyond biological and psychological factors, culture contributes to the manifestation of psychopathology. Extreme cases are “culture-related specific syndromes.” Based on the yin and yang concept, frigophobia (excessive fear of catching cold) may be observed among Chinese, the daht syndrome (fear of excessive leakage of semen) among Indians, and huabyung (fire sickness due to unexpressed, excessive feelings of hate; Min & Suh, 2010) among some Koreans. - Culture influences clinical assessments The definitions of normal and abnormal are affected by culture in many ways, including: professional definitions, measurements, performed functions, and social-cultural definitions. Thus, clinical assessments are often influenced by the clinician’s professional background, personality factors, and cultural views, all of which need careful evaluation. - Culture prefers a relevant treatment approach Based on cultural customs and habits, patients will undertake different help-seeking behaviors and turn to various forms of healing practices, including folk therapy (Hsu, 1976), unique therapy (Young et al, 2005; Zhu, 2008), or mainstream therapy (Tseng, 1999).

Study on immigrant workers in South Korea: Their mental health, social support, and quality of life - Brief Report S. Jung, Y. Oh, Y. Bae 18 - 20

Starting from the 1980s when its industrial structure started to change, Korea saw the size of its workforce decrease and started hiring immigrant workers. Most of the foreign workers were Chinese – including Korean-Chinese and those living near the border between China and Korea – and others from Southeast Asian countries such as Vietnam, Cambodia, the Philippines, Indonesia, Bangladesh, and Nepal. Their numbers have increased ever since and now reach almost 600,000. These immigrants work in factories and construction sites across the country. Most foreign workers in Korea work for small businesses and thus play an important role in solving Korea’s problem of having a small workforce. However, Korea is now faced with a different problem caused by the lack of legal and institutional protections for foreign workers living in Korea. This led to the exploitation of immigrant workers, violation of their human rights, discrimination, and prejudice. In both 2008 and 2009, delayed payment of wages was the biggest reason immigrant workers sought counseling at the Korea Support Center for Foreign Workers (2010). Also, the number of industrial accidents, an indicator of poor working conditions, drastically increased from 15,896 in 2008 to 29,193 in 2009. In particular, the number of fraud and assault cases nearly doubled, from 852 cases in 2008 to 1,482 in 2009. This illustrates how the number of fraud and assault cases has been increasing as the working environment of foreign workers changed. A review of the literature revealed that, in general, workers who leave their home country to work in a foreign one with a different culture suffer from mental problems such as severe depression and anxiety (Griffin & Soskolne, 2003; Hovey & Magana, 2002). Because of the cultural differences and the lack of social support, they experience high levels of stress, face language barriers, and have traumas or suffer from stress disorders due to the physical and psychological abuse they get in their workplace (Vega et al, 1987). Post-traumatic stress disorder (PTSD) usually occurs after a person experiences a traumatic moment that most people do not experience in their lifetime, but recent cases show that physical or verbal abuse that causes strong fear, powerlessness, and panic can cause PTSD even though the trauma may not seem so severe on the outside (Kinzie & Goetz, 1996). Recovery from mental health problems caused by extreme stress or trauma depends on how well-organized the social support system is (Weeraporn, 2004). Previous research by Korean scholars on foreign workers in Korea found that social support had a particularly positive effect on reducing depression and anxiety and on psychological stability and adaptability (Lee, 2004). Furthermore, Lee (1997) reported that the poorer the work environment and the more inadequate social support, the higher stress levels foreign workers experience. A study by Lee and colleagues (2004) reported that one group of illegal immigrants (ethnic Koreans from China) showed relatively serious symptoms of somatization disorder, anxiety, and phobic anxiety, all of which are associated with stressful experiences such as delayed payment of wages, physical abuse, and industrial accidents, and saw their quality of life go down.

Immigrated, interculturally-married women in South Korea: Mental health status, health care utilization, and suggested policy directions - Original Paper Y. Ahn 21 - 24

Korea is becoming a multi-cultural society. The Ministry of Justice and the Ministry of Gender Equality and the Family play central roles in creating policies to support marriage-based immigrants. Various services, including Korean language and culture, have been provided through Multi-Cultural Family Support Centres based on the ‘Multi-cultural Families Support Act’. However, health care policies for immigrants are relatively scarce. The ever-increasing multi-cultural population in Korea poses a significant challenge to nurses offering individualized care to their clients. The author reviews articles and reports related to marriage-based immigrant women’s health status, behaviors, and health care service utilization in Korea, and proposes policy directions as follows: integration of the health care system with language, culture, and health literacy; development of national standards on culturally and linguistically appropriate services; development of an assessment insprograms; and vitalizing functions of the Public Health Centers.

A community-based social cohesion program for immigrant women married to Koreans - Original Paper Y. Ahn, H. Chung, H. Yoon, K. Choi 25 - 28

We conducted a demonstration project to help immigrant women married to Korean men adapt to the Korean community. Participants were 19 couples who agreed to participate in a community-based social cohesion program – the recreational program participation by the group was to enhance the social cohesion with family members and local residents. The program was developed with local community participation, using a partnership strategy, and included a village dance that could involve local residents. We held the program for 6 months, and a Community Health Practitioner provided case-management services. The main outcome variables were family stress and family strengths, which were assessed using the Family Systems Stressor-Strength Inventory (FS3I). The data were analyzed using descriptive statistics, and the Wilcoxon signed-rank test. The results revealed significant mean differences between pre- and post-intervention family stress for both immigrant women and their husbands. However, we found significant mean differences between pre- and post-intervention family strengths for the husbands only. The community-based social cohesion program affected family stress and family cohesion even with the limitation of limited methodological rigor (due to participant-specific conditions and community characteristics). Replication of this study with better methodological rigor and measurements of cultural competence are needed in the future.

Understanding the society and people of North Korea based on North Korean defectors’ testimonies - Brief Report W. Jeon 29 - 31

North Korean defectors: Their cultural adjustment to college life in South Korea - Original Paper T. Jung 32 - 34

The number of North Korean defectors entering South Korea in search of political freedom and economic opportunities has been increasing sharply since the 1990s. They have also become increasingly diverse in regard to their generation, gender, and social class (Yoon, 2000). In particular, youths in their 20s and 30s accounted for 61 percent of the total defector population (Ministry of Unification, 2009). Also, 72.3 percent of the young defectors admitted into South Korea in 2007 were in company with their family members (Cho, 2008). A majority of the young defectors turn for their education to South Korea’s formal schools, where academic background is highly valued. For example, the Citizens Alliance for North Korean Human Rights estimated that 450-600 North Korean new arrivals enrolled in college in 2009. However, their new academic careers require them to meet a variety of social expectations relevant to school life in South Korea, such as meeting their academic responsibilities and forming peer relationships. In the adaptive process of young defectors to South Korean school life lurk many difficulties. First, young defectors while in North Korea experienced school education which did not function properly due to economic hardship (Cho, 2008). Second, they underwent a prolonged vacuum in education mainly because they had to stay in a third country for an extended period of time before they came into the educational system of South Korea (Cho, 2008). Third, differences between North and South Korea in political ideology and view of Korean history make it difficult for young defectors to follow in classes relevant to humanities and social sciences (Kim, 2004). Further, they have to struggle to understand hundreds of foreign words used in class and to be familiar with essay assignments and exams, which were not common in school life in North Korea (Park, 2009). All of these factors cause college students from North Korea to fall behind South Korean students in academic performance. Despite the growing number of college students from North Korea and the range of problems they face in their school lives, studies of their adjustment to school in South Korea are quite few. The existing studies have focused on the issues these students face and factors that influence their lives in South Korean society and, thus, have failed to uncover the process of these students’ cultural adaptation. Further, such studies have tended to examine how the immigrant students become accustomed to cultural and educational systems in South Korea, with no consideration of the North Korean culture they experienced previously. Given this status quo, my colleagues and I conducted two studies (Hu et al, submitted; Park & Jung, submitted) based mainly on in-depth interviews with undergraduates from North Korea, to delve into their experiences with adjusting to school and other adaptive aspects.

Mental health policies and projects of Seoul metropolitan government in relation to multi-cultural society of South Korea - Brief Report H. Mo 35 - 36

As Seoul, the capital of the South Korea, moves toward becoming an international, multi-cultural city, its government expects the number of foreign immigrants and temporary visitors will increase in the future. By the end of 2009, about 250,000 foreigners were living in Seoul City. Among those foreigners, it includes 146,358 foreign laborers (57%), 29,455 foreign brides (12%), 28,637 foreign students (11%), and 9,952 business company employees (4%). In order to face and dealing with the people of multicultural background, it is necessary for the Seoul Metropolitan Government to concern the mental health policies to guide all the projects and to promote various nature of services to improve the life of the foreigners living in the city of Seoul.

• The experiences of Multi-Cultural Mental Health Clinic at the Seoul Metropolitan Eunpyeong Hospital - Brief Report N. Kim 37 - 39


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