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.

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