Friday, May 24, 2013

South Korea's Suicide Epidemic

"South Korea is a country unlike any other, having gone through extremely rapid economic, social and political changes at a speed never before seen in history. Education, technology and economy in particular have flourished, making South Korea among the wealthiest, most educated and technologically advanced countries in the world. However, cultural and social attitudes and beliefs have not been able to match the speed of modernization, giving birth to a multitude of social problems that have risen as a result. Among these, suicide in particular has increased at alarming rates in recent years, particularly among the younger population, resulting in South Korea now having one of the highest rates in the world. In order to understand this problem, one must begin by developing a strong understanding of the economic, historical, social, and, most importantly, cultural influences behind South Korea's suicide epidemic.

50-year gap contrast picture, showing
the hyperdevelopment in Korea
Upon arriving in Seoul, Joanne Cho, MPH and Fulbright Junior Researcher, began collaborating with professors from various universities throughout Korea in departments ranging from public health and cultural anthropology to clinical social psychology. With their guidance, she started interviewing study participants as well as professions currently conducting research on suicide in South Korea. Through these interviews and her own individual studies into Korea's history, society and culture, Joanne began establishing a groundwork understand of the issues surrounding suicide. She has been focusing in particular on ho cultural and historical influences have shaped modern Korean society, and how these in turn affect social and familial relationships as well as attitudes regarding mental health. In addition, she has been studying the hypercompetitive educational and employment systems which have become a major sources of stress and pressure in Korea today. Joanne hopes to come up with a two level solution to the suicide issue: one that can be implemented at the policy level, and a micro level solution that can be employed by individuals."

South Korea's Suicide Epidemic

Probably the quote that Joanne collected early on from one of her professor informant's was this shocker: "자살이야말로 가장 한국적으로 죽움을 맞이하는 방법이 아닐까..." "Suicide is quite possibly one of the most Korean ways to die..." The statement stunned her and it became a large catalyst in promoting her research as the statement casually suggested solutions to life's problems could be met with a social statement of choice death.








Why are so many Koreans choosing to end their own lives?


Main Research Focus

  • Women, generally from a younger cohort
  • Historical and socio-cultural context
  • Media influence
  • Current status of mental healthcare and suicide prevention research
  • Recommendations for future research


Why focus on women?

Most of the research on suicide has been on the elderly, the youth, and men, but one aspect of suicide that is sadly overlooked is women committing suicide. Researchers tend to overlook this group because the numbers of women terminating their lives is much lower, but, when comparing the number of women committing suicide with other OECD countries, the number is much, much higher and even growing at a faster rate than men committing suicide. What factors are driving this social epidemic?





It's interesting to note that the highest number of people committing suicide, comparing married and single, is from the single cohort. Joanne has a lot of concern on the relatively unresearched suicide rates of young (especially) unmarried women.

Historical Background 

Korea experienced an extremely rapid rate of economic development and modernization (see picture at top), and this rapid development has been a breeding ground for the fierce competitive environment present today. Additionally, the rate of cultural maturity has not reached the speed of the urbanization. Complicated by these aspects are generational differences creating friction between the traditional, conservative values and the emerging Western, capitalistic trends. Neo-Confucianism has been a big determinant in the past controlling the hierarchical society favoring men and controlling women, putting emphasis on the family, among other social determining values. Korean "Confucian" values expect social harmony by each individual knowing his/her place in society, e.g. everyone has a title based often on patriarchism and age. In (Neo) Confucianism, human relations made up the foundation of the social order. Confucianism is the basis for hierarchy-driven society that Korea has become - "vertical" social structure.

Korea is among the most ethnically homogeneous nations in the world that has the 단일민죽국가, the "single-race society". There is a huge sense of cultural "we" rather than "me" which appears in language, e.g. Korean don't say "my mother" but "our mother". This sense of "we" taps into a "herd mentality", resulting in extreme pressure to follow almost identical paths to success. Thus, hypercompetitiveness results, even among "friends".







A major observance Joanne made about suicide in the media, and it is very frequent in movies, dramas, etc, is that suicide isn't typically depicted as something horrible but rather as something quite sensible, e.g. a bad guy atones for his sins by jumping off a bridge, and everyone forgives him. The media often heroizes people who have committed suicide, and the media's tone regarding the victim before and after suicide change drastically. This gives the impression that suicide is an acceptable way of dealing with difficulties, and gives reason and justification for those contemplating suicide to make the same choices.




Within the past few years, celebrities and even a president of Korea committed suicide and in the wake of these suicides, a rash of suicides were triggered across Korea.


Research, Intervention and Prevention

  • The concept of therapy and clinical psychology not well developed or accepted
  • Still not seen on par with other clinical illnesses and diseases
  • Lack of family support during treatment
  • Misconceptions regarding suicide and suicidal behavior
Too much reaction, not enough action: Suicide has been discussed since rates have gone up in early 2000, but little has been done.

Conservative values undermine importance of active prevention and intervention: Notion that active discussion of sensitive topics would only worsen the problem.

Issues with implementation of programs: Minimal monitoring by govt (not sufficiently mandated), not to mention the questionable validity due to the insufficient testing of effectiveness.


Suicide research in Korea

Inadequate support from govt and funding organizations: Studies expected to give quick results in the shortest amount of time (typically 3 years maximum), and the quantity of research is stressed over the quality

Competition between researchers makes collaboration and data sharing very difficult, slowing down the research process.

Limited inter-organizational collaboration.

Future Direction in Research

Research that measures individual effects of social and cultural constructs: Interdisciplinary collaboration is crucial; studies that look into more specific reasons behind impulse in necessary.
Reliable research on effect of intervention programs: Programs should be tailored to match cultural and social environment in Korea (also age-cohort specific); there is an urgent need for proper diagnostic criteria in measuring depression and depressive symptoms.
Comparative study on effects of acculturation on suicide (between Korean-Americans and Koreans): Korean-Americans have been considered a high-risk group for suicide, but how does this compare with Koreans in Korea?
Comparative study between suicide trends in Korea and Japan: Both countries share similar cultural and social traits, yet differences in suicide trends are worth studying. E.g. Japan is funding research for their high rate of suicide and the numbers have been dropping. The Korean govt, on the other hand, with its rising rates of suicide only allots 0.5% funding to research/prevent suicide than that of Japan that has a dropping suicide rate.


The Need for Future Direction in Policy

Greater govt involvement in intervention efforts: Rather than just focusing on facilities and funding, personnel and policy need to be firmly implemented.
Stricter media control that is enforced: Similar to how smoking and sexual content are filtered, positive reinforcement and overt acts of suicide should be limited.
More focus on rural areas with greatest disparities: Till now, most of the resources have been centered around Seoul and major cities where rates are lower than out-lying regions.

Saturday, May 11, 2013

Play: Medea

The White Box Theater has once again put together a stellar performance. This time on the Greek classic, Medea by Euripides. For this performance as with many in this theater, the theater was repartitioned to meet the acting needs; however, this time the audience had front-row seats and were seated around an arena of sorts, the Greek centerpoint of all communal activity but here the centerpoint of the drama unfolding. Medea, played by Stephanie Ann Foster, played the schizophrenic role of witch, seductress and the still in love but spurned wife, and to her shame, her conflicting emotions seared by rage at being the cuckold, she kills in a cunning passion her husband's new wife, her own beauteous children, and leaves the aches and pains of her deeds for her husband to discover ... and forever carry the burden that at heart, he was the monster who allowed the monster of a first wife to foist this evil on him.

Medea remonstrates with the women of Greece and gets their approval for some form of revenge on her man who took her from a foreign land and now tosses her aside for another women. Women, symbolized by the chorus, see she has a point.

Jason and Medea still wrapped in a web of love ... and hate. Their chemistry is still there but underlining that is the new wife who has appeared. For Medea, she has been displaced. For Jason, he has recovered an element of youth by engaging to marry a young and youthful girl, with innocence as her attracting charm.

Poisoned "gifts" have been given by Medea for the new wife. Her children (assisted by the chorus) are delivering them with strict instructions NOT TO TOUCH them. The chorus has turned on Medea but is powerless to change her or her intended destruction.

Medea, crafty and spiteful, spitting revengeful words at Jason for his traitorous act of dumping her when she made him the great king who he now is. Revenge is all she has left.

Jason's new bride, young and innocent, has been entangled in the web of Medea's witchery and dies a horrible death. Tragedy upon tragedy, and so the play ends with emotions of nothing but tragedy and bitter living.

Wednesday, May 1, 2013

Waters Available in the Store

About a year ago I took this picture of water in refrigeration at Emart. (There are even more brands available now!) Korea has really developed a fixation on bottled water, and yes, they should have some concern on what they drink since flouride, chlorine and who knows what is added to the water supply piped into homes and apartments. Although throughout the city and in homes there are many kinds of water filters, and portable filters are available for the small and economizing household, there really is a hyper sense of "drink bottled water for your health" here. Most of the brands are Korean, e.g. DMZ suggesting the "pure and unpolluted waters" where few people live between North and South Korea, SamDaSoo which is supposedly Korea's best brand, and Jeju which is supposedly from the "pristine southern island" of Jeju but which, according to my students, is now processed in Seoul. Some of the more exotic waters on this shelf alone are the Evian and Fiji. The water from the deep and "unpolluted waters" of Hawaii might also be here too. Marketing water is very lucrative, and it certainly looks like a lot of companies are cashing on people's sense of health, which the media seems to control and then benefit by.