With a high level of stigma, low public awareness and poor provisions of treatment, mental health is a tricky area for Koreans and foreign residents alike, but visa and language barriers, as well as cultural issues, can make it a particularly difficult area for expats.

Lack of balance between work and other activities, alcoholism and the negative stigma attached to psychiatric medication are making mental health issues worse, according to counselor Yvon Malenfant. 

Overseas studies also confirm that social isolation is one of the most significant contributors to low mental health, which can be an ongoing issue for migrants, who often live alone and away from their families.

And Malenfant, who holds a religious master of divinity degree, explains that while expats themselves don’t have a problem seeking treatment, the culture of “saving face” is an ongoing problem in Korean workplaces that makes it difficult for individuals to reach out.

He attributes a part of the ongoing issue to the culture of South Korea, where he says showing weakness is worse than revealing the truth.

“In a high-context culture you don’t reveal weakness, and in a low-context culture words are on the page, you say what you mean, mean what you say.”

Noreen Jaden, a registered psychologist and CEO of Adaptable Human Solutions, a group of internationally licensed therapists based in Seoul, believes that expatriation can intensify everyday encounters, and hopes that with support expats can help work through these issues.

“It is our desire to support people as they experience these and to destigmatize both the issues that arise and the seeking of assistance,” Jaden says.

“We hope that our services encourage expats and others to engage more fully in their lives and work.”

Alcoholism has also been attributed to the nation’s high suicide rate, and Malenfant said that psychiatrists don’t always give enough warning about the dangers of alcohol when prescribing drugs.

“It’s the onus of the psychiatrist to tell the client not to drink whilst taking medication and they are failing, most of them,” he said. “If one does drink and take certain types of medication, there can be some severe side effects.”

Although some psychiatrists are failing in their role, Malenfant admits Korea’s drinking culture adds to the problem.

“In Korean culture you have ‘hoesik,’ you go out eating and drinking, and they are highly encouraged to participate in drinking, it can make things very scary,” Malenfant said.

Dr. Tae Kyung Lee, founder of Seoul National Hospital’s International Psychiatric Center hopes that awareness of his center will encourage families to reach out. Lee opened the IPC in 2007, a decision that came from his own experience living overseas.

“Living in Boston, I was anxious about how I could cope with possible medical problems of me and my family members because of the language handicap, cultural differences and unfamiliar medical system,” he said. “After returning to Korea, I empathized with foreigners living in Korea who have the same difficulties I experienced in the U.S.”

However, Lee has been frustrated by low public awareness, which he says has led the IPC to only receive one or two patients a week.

The IPC offers services for conditions ranging from anxiety and adjustment disorders to addictive disorders and schizophrenia.

For some foreigners, such as those with an E-2 teaching visa, restrictions on taking psychiatric medication make it difficult to reach out for assistance.
Malenfant explains that for those working in private academies and universities, seeking access to psychiatrists and counselors can be frowned upon and in previous cases has left individuals unemployed.

“When people fill out a form, they are asked if they are taking any psychiatric medication, if they have ever suffered from anxiety, depression, and a lot of those people are immediately dismissed,” says Malenfant.

Some choose not to reveal mental health information and continue to use medication, but medical checks including blood tests are required by the Korean government, which potentially causes issues of visa fraud.

Malenfant says that where seeking treatment is not possible, “mindfulness” activities and other home practices can help, and are becoming increasingly popular in Korean society.

Yoga, as well as self-help novels are some sources of help, he says. Malenfant agrees the introduction of smartphone apps encouraging “mindfulness,” mental health awareness days and unified community would also help.

Working in Itaewon, he hopes for a multilingual community, with one community center representing both Koreans and foreigners.

“I think it would be really good if people can rub shoulders. There is so much love and growth in a community.”

While it appears as though mental health is not being thoroughly addressed, Malenfant is optimistic. He says that although the cultural change is slow, it is still occurring. Work with public speaking and job interview skills suggests to him a new demand in Korean society for a balance between intellectual and emotional intelligence.

“There is a revolution in Korea, whether we work to live or live to work.”

International community centers, such as the Gwangju International Center, offer contact information for those needing further assistance.

Park Min, a representative from the GIC, says that language barriers make it difficult for the center to find psychologists proficient in English.

Park said expats living in Gwangju can contact the Christian Mental Hospital and Chosun University Hospital International Medical Assistance Center should they need to speak to someone.

While AHS does not offer crisis or medical services, the company can refer clients to community resources, clinics and hospitals, should they be needed.

“We believe that part of excellent care is being upfront about what we do and don’t do,” says Jaden.

A variety of English-speaking and Korean-American psychiatrists and psychologists are available through Malenfant’s website. AHS and home visit therapists are reachable through their website or social media.

Malenfant believes continued awareness of mental health services, alongside a stronger sense of community, is a means of ensuring positive progression toward awareness and treatment.

“It is something very important to us (counselors and therapists) to try and make Seoul a more livable place.”

By Zoe Samios (zoesamios@heraldcorp.com)