Lack of Mental Healthcare in Korean Culture Leads to Social Ills

If I asked you to recall the likeness of a merciless, cruel murderer, an Asian face would probably be the last image to come to your mind. In the West, the histories of Stalin, Hitler, Jack the Ripper, and Charles Manson continue to astonish us, and mugshots of killers from every ethnicity corrode the film on American news cameras. It wasn’t until Cho Seung-hui gunned down 32 people and wounded 25 more in a mere two hours at Virginia Tech that heads started turning towards the Asian-American population. Cho, a South Korean immigrant, had lived the majority of his life in Virginia, and had been diagnosed with a laundry list of psychological impairments, including selective mutism and social anxiety disorder.

One of the primary questions posed by the VTech community after the shooting was, “Why didn’t we do something sooner?” Although Cho’s family did attempt to get their son help, interview after interview with the family mentions that they were faced with a rather trying barrier: the stigmatization of mental illness in Korean society. Perhaps believing that psychiatry was shameful while simultaneously not wanting to attract more negative attention to their son (he was already getting chided relentlessly by fellow classmates), the Cho family was hesitant to push for an intervention, especially since Seung-hui was doing well in school. When talking with relatives in Seoul, his parents spoke only of his sister’s achievements and dared not share his state with others – it was better left out of sight, out of mind.

After the VA Tech massacre, members of the Korean-American community buzzed with remorse and shame, deeply apologizing for Cho’s actions as if he had been a relative of them all. Unfortunately, Cho was not the last to bring such disappointment onto his “brethren.” A recent string of violent murders in Koreatowns across America reveal several men who seemed to have bottled up their resentment before exploding like Cho. Those on the east coast were horrified by the brutal killing of Aena Hong by then-boyfriend Charles Ann, a naturalized U.S. citizen, on Feb. 22. Despite irrefutable evidence, he pleaded not guilty to her murder during his hearing, his face expressionless. On the exact same day, a gunman in Norcross, GA killed four at a Korean sauna. Less than two months later, former student One Goh gunned down seven people at Oikos University, a small Christian college in Oakland, CA with a predominantly Korean-American population. What had suddenly made these usually crime-free communities so vulnerable to attacks? Were the geomagnetic fields of Korean-American men shifting in an unfavorable manner?

What all of these killers had in common was that they were upset about recent failures in their lives, and all reported distress adjusting to societies in which they felt outcasted – in this case, both Korean and American cultures, the ends of both for which they seemed to be grappling but never found middle ground. All were born in Korea and naturalized in America, and even despite what most would call warning signs, no one seemed to foresee their ultimate paths of destruction. What, then, is to be said of a culture that fails to keep sanity in check?

Crime in South Korea: Quality over Quantity

The locales of the above mentioned crimes are far from ominous: an institute of higher education, a quiet residential street, a Christian academy. Such austere scenery is not unlike the virtually crime-free landscape of South Korea. Nearly any statistic you read will show that crime rates in South Korea trail behind those of the United States and even many countries in Europe. Victimless crimes such as fraud and corporate corruption are more widespread, but don’t seem to be putting a damper on South Korea’s chart-topping economic victories. The numbers dwindle even more when concentrated on violent crime and homicide, likely because guns are outlawed in the country and most police don’t carry firearms either. I don’t think a week went by when I didn’t see cops asleep in their car for lack of anything better to do during my years in Seoul.

However, some might suggest that without easy access to firearms, murderers export their rage in more creative and nauseating ways. Grisly reports of bodies being chopped up, young girls being raped, and teenage boys somehow possessing the clarity to perform similar deeds themselves make the headlines more often than they should (and let’s not forget the infamous “Yoo Young-cheol”, who made “serial killer” a household term). In fact, the majority of violent crimes in Korea involve  female victims and are usually accompanied by rape, a crime which in and of itself is vastly underreported, as is domestic abuse, due to the fact that even in this hyper-developing nation many women still believe reporting such crimes is shameful and will mar their family name.

Popular South Korean films such as Memories of Murder, the “Vengeance” trilogy, and the others included in just one laundry list of films which have hailed Korean filmmakers as kings of cinematic horror do little to induce any kind of tranquility in the “Land of the Morning Calm.” One possible explanation for this unusually high tolerance for violence is that the nation has a more vivid memory of war; another is that all humans are voyeuristic by nature and South Koreans are simply more willing to succumb to this universal trait. I argue here that film is just one way of expressing a violent nature without committing a violent act firsthand, and that the reason so many of these films might resonate with such enormous audiences is that South Koreans have few other outlets through which to release unsavory emotions. In a place where saving face is a daily ritual, appearance is what gets you a job, and the term “mental rehabilitation” is scorned, those of a troubled mind may find themselves with a constricted set of options: keep a diary, or keep your thoughts bottled inside the barrel of a gun.

Stigma-happy, Trigger-happy?

Now that I’ve reeled you in with tales of murder and atrocity, I now bring the focus back to our four original, America-grown perps: could a broader acceptance of mental health disturbances, as well as psychiatric treatment, have prevented these four men from exploding? Consider this other commonality: neither One Goh nor Charles Ann (who, as aforementioned, plead “not guilty”) showed any remorse for their crimes. I’m no psychologist, but this seems to tell me that something isn’t quite right upstairs.

Another sign that something might be awry among how South Koreans deal with stress is the fact that the country now has the highest suicide rate among OECD countries, surpassing even Japan, and this article summarizes quite well why the rate doesn’t show signs of dropping any time soon. One American psychologist who visited a rehabilitation center – as most of the “treatment” for mental illness in South Korea is still institution-based – supplied this report:

The model of psychiatry practiced in South Korea reflects the hierarchy of Confucianism, essentially meaning that the father has the power to admit members of his family as he sees fit — one wife was admitted for two months for changing her religion; one young man was in for a year for yelling at his father. In addition to fifteen people sharing a room, the hospital carries out ECT [shock treatment] without anesthesia which leads to broken bones.

Granted, this article is about five years old, but the most recent WHO report is still only from 2006, and cites no new information (in sum, that South Korea is still working towards putting folks in institutions). Currently, those who do admit themselves to the sprinkling of mental health clinics around the nation pay in cash, and those who seek help from counseling centers in their communities in America opt out of providing their names during phone counseling. While it may seem counterintuitive, many Koreans (older ones, especially), choose to consult a shaman for help in treating their malaise, but believe that “paying someone just to talk to them” (a.k.a. counseling) is balderdash. Another typical way to cope with stressors is to literally “drown your sorrows”, or drink. Which, as we all know, can have disastrous consequences when done in excess (and alcohol is literally cheaper than water in South Korea).

Regardless of how slowly mental health treatment might be developing in the motherland, Korean-Americans are more than hesitant about utilizing the facilities available to them in their new home. This “1.5 Generation,” as Korean-born Americans are often dubbed, is torn between the availability of counseling or other treatments for their emotional distress and the admonition they might face from friends and family for resorting to it. As many of them live in Korean-American communities, the neo-Confucian approach usually wins out. This brief summary released by the National Alliance on Mental Illness posits several dead-on indicators for this resistance, as well as some policy suggestions to overcome it. One of those indicators is a Korean concept known as “Han” (not to be confused with the “Han” in “Hanguk”), which roughly translates to a collective feeling of oppression and injustice (think, Japanese colonization of Korea) in the face of overwhelming odds – which should be avenged. “Vengeance” is a common theme in Korean thriller cinema, and was a common theme in all four of the incidents mentioned at the start of this article.

Another cultural factor to consider is that, as suggested at the end of this Washington Post piece, in societies where mental maladies are not defined as such, their effects are frequently described as merely physical ailments. Aside from the “hwa-byung” (“anger sickness”) mentioned in the article, when I worked in Korea I was often diagnosed with “Mom-sal”, which my doctor told me was basically a sickness caused by overwork and stress. She treated me with some unidentified pill cocktail; never mind advising me to “slow down” or “rest,” as all illnesses are physical and should thus be physically cured. This makes the situations of severely depressed or otherwise afflicted 1.5 Generationals all the more delicate to approach, yet also much more critical as they confront their struggles in a country with fewer social outlets but greater access to weapons.

Seeking Solutions

The options for Korean-Americans with mental health issues is a double-edged sword: attempt treatment and face the disapproval of your friends and relatives (which will probably cause even more anxiety) or avoid treatment all together in the hopes that you can make it on your own. Many choose the latter, and end up making it out of their dark ages safely. Others, however, become ticking bombs, and perhaps it’s no surprise that the least likely to seek psychiatric treatment are males, for whom expressions of weakness or emotion are taboo across many cultures.

One of the best ways to connect with Korean-Americans in need of psychiatric support is through the Internet. Not only is it anonymous and low-profile, but Koreans are addicted to it. Psychiatrists and clinics that offer Korean-language services would do well to publicize themselves on places like Daum Cafes or Naver Blogs, and those that are English-only can reach out to the younger generations through Facebook, which is now dominating the Korean webosphere from one end of the earth to the other. Rather than for pitting angry netizens against one another, why not use Internet anonymity as a tool for peace and (inner) harmony? Engaging with your patient via webchat may not seem conventional, but in reality a business that is based mostly on chatting need not ascribe to a single stationary location in this era.

Of course, it’s always easier said than done, but one can only hope that such tragedies can yield something more positive and instill motivation in the hearts of some Korean-Americans, especially those who have had some success in bridging the culture gap, to become more educated about this topic and establish even better resources for others in their community who might be struggling with serious anxiety that may be overlooked by family or friends.

“We all experience pain when we suffer loss and joy when we achieve what we seek. On this fundamental level, religion, ethnicity, culture, and language make no difference.” – Dalai Lama XIV

Other sources:

• Stressed and depressed Koreans avoid therapy
• Mass shooting at spa shocks Korean community
• California gunman profile
• Another Korean shooter
• Five killed in shooting outside Georgia health spa
• Fatal hit and run homicide investigation
• Health history of Cho
• An isolated boy in a world of strangers