Interviews
Interviews
If you want to access the summary version of the interviews, click here.
<Demography>
90% Male, 10% Female
Age: 39 to 58
Employment Type
-Professor 55%
-Private practicitoner 40%
-Hospital-employed physician 5%
<contributors>
Jaeuk Hwang- Professor at Soonchunhyang University College of Medicine
Hwayoung Lee- Professor at Soonchunhyang University College of Medicine
Min-Jae Kim- Professor at Soonchunhyang University College of Medicine
Byung-Chul Lee- Professor at Hallym University
Jeong-Seok Seo-Professor at Chungang University
Yu-Jin Lee- Professor at Seoul National University
Changsoo Han- Professor at Korea University
Chang-Woo Han- Professor of Hanyang University
Hong-Seok Oh- Professor at Konyang University
Sang-Gyu Lee- Professor at Hallym University
Jeong-Ho Seok- Professor at Yonsei University
Soon-Jae Kwon- Private physician
Joo-won Ha- Former professor, current private physician
Hu-Rim Song- Former professor, current private physician
Sung-Woo Cho- Private physician
Yong-Jun Yang- Private physician
Sang-Min Lee- Private physician
Yeong-Seok Na- Private physician
Min-Kyu Song- Private physician
Kwang-Ho Jang- Hospital-employed physician
Below is a compilation of responses, presented anonymously to protect individual privacy. The questions explore general inquiries about psychiatry and addiction, including the social dynamics, perceptions, and policy considerations surrounding mental health and substance use in the context of Korea.
#1 Currently, in Korea, the perception and social prejudice toward patients with mental illness are negative. How can this be improved?
-I think the perception of mentally ill patients has to change in shows, movies, articles, etc.
-Mental health literacy needs to be improved through media.
-It takes time to eliminate stigma, but awareness of the segmentation within mental illness is necessary. For example, the severity of depression varies from very mild cases to cases where the patient is suicidal.
-We need awareness-raising education and a treatment environment where people can receive treatment without discrimination.
-Honestly, I think the most effective thing is to naturally portray psychiatric treatment in media promotional activities and media (shows, movies, etc.).
-Promotional education will also be needed to improve social awareness at a national level. Nevertheless, it is believed that psychiatrists' social activities will be more important. For example, it is a plan to actively intervene in national traumas such as the Sewol Ferry tragedy and the Itaewon tragedy and to make those in need aware of the need for psychiatric treatment. In a more everyday sense, I think the role of a star psychiatrist like (오은영) Oh Eun-young is also important. It is necessary to expand these activities to nearby psychiatric clinics and neighborhood psychiatric doctors and to increase accessibility.
-1. Restrict media reports and media content that reinforce negative perceptions of mental illness
2. Promote government-wide awareness improvement and prejudice resolution projects including the medical community, people with mental illness, families, civic groups, media, religious communities, and public institutions
-It is important to improve practical systems, such as improving discrimination in insurance subscriptions. It will also be important for doctors to promote mental health through the media.
-Discovering cases of mental illness in celebrities can help normalize these issues and foster empathy. High-profile cases can serve as powerful examples, showing that mental health issues are common and affect people across all walks of life.
-Ultimately, we must change to a social atmosphere that recognizes the importance of mental health as much as physical health.
-Compared to 10 years ago, I feel that the prejudice against psychiatric treatment has improved significantly in Korea. As mental illness can happen to anyone at any time, it seems necessary for various organizations, such as the Korean Psychiatric Association, to actively promote it to prevent it from becoming a social stigma.
-I believe that the problem will be solved by increasing access to mental health care and treatment so that the public's mental problems can be easily dealt with.
-Standardization of descriptions in psychiatry, brain science proof of symptoms, and promotion of the concept of the mind as an organ.
-It is gradually improving, and it will be helpful if legal discrimination in areas such as insurance or employment is eliminated.
-We need realistic policies that allow people to receive treatment early and realize that mental illness is not dangerous or rare.
-Continuous campaigns and improvement in policies such as insurance discrimination.
-Promotional and educational activities are needed in various fields such as broadcasting, media, and education. Mental health problems, including addiction, are problems that are close to our lives and can be experienced by anyone in their lives. So we must change the culture so that we can become an advanced country in mental health and anyone can talk about their difficulties and receive help. The most important thing here is promotional activities to improve awareness among social leader groups. Good examples include the family of President John F Kennedy of the United States and Kate Middleton, a member of the British royal family (Princess) actively taking on the role of national mental health ambassador.
-Mental health is an issue for all of us. W.H.O recommends that each country establish policies that prioritize mental health as the most important health issue. 1) It is necessary to improve policies and build infrastructure to solve the country's mental health problems. 2) Strengthening promotion and education to improve public awareness of mental health issues across the entire life cycle (from children to the elderly) 3) Establishing various policies to eliminate discrimination against people with mental illness 4) Establishment of a central system for active and effective treatment of mental illness across the medical community, society, and region, etc.
-We need to create an environment and activities that accommodate people with mental illness.
-Improving publicity and policy regarding ongoing mental illness stigma.
#2 How do you approach patients when they have difficulty communicating or have difficulty performing tests due to disabilities/language barriers, etc.?
-I use Google Translate, or I ask the Guardian.
-Brain MRI+MRA, non-verbal clinical psychological testing (typically LICA), translation through translators or people.
- Sign language or foreign language interpreters are used within the hospital.
-If behavioral problems are severe, they may be evaluated while hospitalized, and people who live with them often understand the patient quickly, so we get help from them.
-You rely on the clinician's observations. If the issue is English, prepare some questionnaires in English.
-We check for abnormal behavior and obtain information from guardians.
-Use simple gestures. For example, when asking if you slept well, put your hands together and lie down on your face, pretending to sleep or pretending to eat with your hands.
-First, we collect information about the patient from the guardian. We then proceed with the diagnostic process by talking with the patient, observing behavior, and building a relationship with the patient.
-Observing patient behavior, obtaining information through family members and other acquaintances, selecting tests that can be performed according to the patient's level, and actively using a translator translation app
-Information acquisition is done through the patient's guardian, and evaluation is done by observing the patient.
-Bring an interpreter.
-We use text or pictures, interview parents, and sometimes use objective tests (Brain MRI, EEG, etc.)
-The most important thing in psychiatric examination is psychological testing, which is mainly conducted through verbal communication. Therefore, if there is a language barrier due to language impairment, hearing impairment, visual impairment, or difficulty speaking Korean, it will be difficult for most hospitals to perform a good psychological test. Depending on the hospital, they may have questionnaires and personnel available to perform tests in consideration of these special cases. When psychological testing is difficult, a doctor's examination and conversation (with the patient or, if difficult, with a guardian) may be more important in the diagnosis, and brain imaging and electroencephalography, which do not require verbal tools, can be used as diagnostic tools.
-During treatment, you may be accompanied by an interpreter or use a translator. But it's not smooth. For psychological tests, foreigners will be referred to a place where foreigners can receive treatment. In the case of visual or hearing impairment, the test is not performed because it is difficult to perform.
-It can be approached through communication using translation, drawings, art, music, etc., but there has not been enough research in this area and I personally lack experience in this as well.
-You must prepare for all possible communication. You can also do it in writing. If that does not work, obtain additional information from guardians and family members. Tests can also be conducted through pictures and videos.
-A staff member will work with the patient one-on-one to resolve the communication issue or we receive help from a guardian.
-Observe behavior and facial expressions and interview with the guardian.
-Communicate through writing.
#3 What do the family of the person with addiction/surrounding people mainly experience, and what can the family/surrounding people do to best help the person with addiction?
-Addiction can be gambling, gaming, etc. The scope is very broad, such as shopping, but if you look at the question below, it seems you are referring to drugs, alcohol, etc. A common characteristic of people with addiction is that they are overly preoccupied with the substance or activity they are addicted to and spend time and money on it, which can cause a lot of damage to their family members. Also, because they often do not respond to their family members' recommendations for treatment, there is a possibility that their family members will have a very frustrating experience. It would be helpful to provide emotional support to addicted patients and gradually encourage them to participate in treatment.
-I often see cases where the patient’s family is in as much pain as the patient themself or is in even more severe pain. This is because the problem of addiction is not limited to the individual but also causes stress and pain to their family and those around them. By activating self-help programs to help families and people around them, it is important for self-help group leaders (patients or patients' families) who have experience in recovering from addiction, along with treatment staff, to help the families and people around addicted patients who are currently suffering. This is known to be very effective.
-They feel helpless. It is necessary for them to learn about the overall treatment and improvement process through education.
-The most problematic issues are violence and property issues. When restrictions are placed to stop the addiction, severe aggression is often shown, resulting in the addiction being permitted (enabling or codependence in psychiatric terms). Additionally, in Korea, it is still culturally taboo to disclose domestic violence or legal issues to the outside world, which often results in the destruction of entire families. The most important thing is to break down the traditional, consanguineous concept in Korean culture that family problems must be resolved within the family and to make isolation and treatment mandatory in the treatment of addiction by legislating it.
-Guardians suffer from criticism, shame, embarrassment, and burden toward their patients. We need to emphasize that addiction is a disease and that it can be treated, and let them know that it is no different from any other disease.
-It's easy to become anxious about the behavior of a person with addiction and fall into a state of codependency where your happiness depends on the person with addiction. Approach them in a way that would be helpful for their treatment, but it is not good to be too tied to the patient's life. It is sufficient to maintain an independent life and serve as a helper to assist with treatment. It is important to make the decision to boldly let go of things that are out of your reach.
-They experience many emotions, including despair, anger, depression, and anxiety. Since the addict's family members also suffer from psychiatric difficulties, they often receive treatment together.
-Emotional support is needed, and I think it is important to guide addicts into a treatment environment.
-They feel helpless and misunderstand that addiction is a problem of will, so you need to explain that addiction is a biological disease and empathize with them.
-Addiction is a disease that is contagious. The term contagious means that family members experience emotional difficulties such as depression and anxiety due to the addicted person, and conflicts arise in family relationships. If the family of an addicted patient is better educated and understands the behaviors that occur due to the disease, a support system will be established with the family as the guardian, and the patient will be able to receive the best help possible.
-As the family attempts to address the addiction problem themselves or tries to solve the person with addiction’s problem on their behalf, a state of codependency occurs in which the family becomes sick as well. To help a person with addiction, the family's recovery is first necessary to free the family from co-dependence and maintain a healthy life on their own. Afterward, it is necessary to maintain 'cold love' so that the addict can recognize their problem and guide the person with addiction so that they have no choice but to choose the process of receiving treatment on their own.
-First, people with addiction tend to lie to their families in order to spend money and time on the subject of their addiction. Second, family members experience betrayal and depression due to the patient's lies. People with addiction ask their families for money to pay the debt incurred while purchasing or engaging in addictive substances, which can worsen the family's financial difficulties. The family must first view the patient's problem as a disease and treat it supportively. But it's about making the patient responsible for their actions. In other words, you should not compensate for economic losses, etc.
-Distinguish between the family's responsibility and the patient's responsibility.
-The family may become frustrated and break up with the patient because they think the patient is breaking their to abstain from drinking. The first step is to realize that addiction is a disease of the brain.
-It is easy for family members to morally blame the patient and to consider addiction as a matter of personal will rather than a disease.
-The most important thing is not to solve the addict’s problems on behalf of them. (Do not pay for their debt)
-Families of people with addiction sometimes fall into a psychological trait called co-dependency. This is a behavior that causes a person to act like an addict themselves while suffering and suffering from their family's addiction problem. People often complain of feeling helpless, depressed, and guilty. Patients and their families are victims of addiction. They are not being punished for doing something wrong. Make them aware that they need treatment and encourage them to participate in treatment. This means that doctors and healthy people around them need to reach out and help.
-Family members and people around them often experience despair. However, we must not forget that there is hope, even in despair.
-Difficulties due to behavioral changes while addicted. Family members should recommend the patient to continue their treatment.
-The addict's family is a trauma patient. Support tailored to trauma patients is needed.
#4 Are there any characteristics of people who are more easily exposed to addiction?
-People with impulsive and stimulation-seeking tendencies are vulnerable. Socioeconomically isolated or underprivileged groups often turn to substances to forget their suffering. Genetic predisposition is also important (family history), and the area of residence and surrounding environment also seems to have a significant influence. The spread of drugs through SNS is also a crucial factor.
-If they have severe anxiety/depression and don’t have a support system, they are more susceptible.
-Addiction is caused by a combination of three factors: personal characteristics, the surrounding environment, and characteristics of the addictive substances. Personal characteristics include those with a family history of addiction, those who had a lot of psychological difficulties in childhood, or those with psychological vulnerabilities who have no choice but to depend on addictive substances.
-A study using Cloninger's temperament and character inventory revealed that people with addiction have higher novelty seeking than other people.
-They show a decline in frontal lobe function, often hereditary (epigenetics). Additionally, a lot of people with addiction have experienced physical, verbal, or sexual abuse in the past.
-People with ADHD tendencies, high novelty seeking. People may also become addicted to avoid depression or anxiety.
-Dependent and passive personality / If you lack a support system such as family and friends / If you are exposed to addiction-related stimuli around you.
-If you are emotionally unstable and feel lonely easily, tend to seek new things, or lack emotional support from your family.
-If you have a high tendency to pursue new things, are impulsive, have high excitability, etc.
-Personality-wise, it is related to a high tendency to seek stimulation and may have underlying emotional problems such as depression, lethargy, and loss of interest. It is also related to coping style, so people are vulnerable to stress and do not know how to relieve it, so they tend to fall into addiction.
-Emotionally vulnerable, with a high propensity to take risks, and in an environment where addictive behavior is easily accessible.
-If a person has a family member suffering from an addiction-related problem, if they have intense curiosity, a strong competitive spirit, have high impulsiveness, or have a low-risk aversion. These characteristics make them vulnerable to addiction.
-People who are impulsive or have a high tendency to seek pleasure are more likely to develop addiction. If a parent has an addiction problem, there is a high chance that their child will develop an addiction. In addition, many factors - psychological, social, and environmental - affect the progression of addiction.
-People who seek stimulation and want to avoid the problems in life tend to be more prone to addiction.
-Not really.
-Novelty seeking.
-High tendency to pursue new things or vulnerable to addiction due to depression and anxiety.
-Characteristically, high levels of anxiety and depression, low self-esteem, and being alone without friends can be risk factors.
-People with a high tendency to seek stimulation due to their temperament have a high tendency to become addicted.
-If you are not emotionally stable and have other mental health problems such as depression, anxiety, or insomnia, you may be more prone to addiction.
#5 In addition to drugs such as cannabis, do you believe that substances such as alcohol/nicotine/caffeine be called gateway drugs? *Gateway drugs: a habit-forming drug that, while not itself addictive, may lead to the use of other addictive drugs.
For example, "Many believe that alcohol and cigarettes are gateway drugs that increase the risk of subsequent involvement with illegal drugs."
-Research suggests that early exposure to marijuana and illicit drugs may be linked to illicit drug and cocaine use in adolescence and in addition to drugs, alcohol, and nicotine cause changes in brain function and they are used before usage of more harmful substances. However, there is controversy about this. Regardless of the controversy, it is clear that early exposure of adolescents to substance abuse leads to the deterioration of brain function, so adolescents should stay away from them.
-In my opinion, alcohol/nicotine/caffeine cannot be called gateway drugs. However, for those who are vulnerable to becoming addicted to these substances (e.g., those with a family history, those who have previously been diagnosed with addiction and have recovered, etc.), complete abstinence from alcohol and nicotine is necessary.
-Although a consensus has not yet been reached, it is thought that mixing caffeinated beverages with alcohol at clubs may increase the risk of exposure to other drugs.
-Marijuana is often said to be a gateway drug to drug addiction, but even so, substances such as alcohol, nicotine, and caffeine cannot be considered gateway drugs to drugs. However, these three substances are substances that can themselves cause addiction problems (dependence, abuse, withdrawal, etc.).
-If you easily have positive experiences such as pleasure, euphoria, or pain relief by using a specific substance, it can be considered a gateway drug because it can increase the likelihood of seeking out substances with stronger effects such as drugs in the future.
-Since the first gateway to addiction is alcohol, cigarettes, and coffee, which are commonly encountered in our society, the gateway theory states that people who become addicted to these commonly encountered substances are likely to progress to harder drugs later on.
-Although not medically defined, substances such as caffeine are considered to have low harmful effects as gateway drugs.
-No, illegality is necessary to be considered as a gateway drug.
-I don't think so. Marijuana may also have become a gateway drug because it is prohibited by law (limited accessibility) and not banned by the law because it is a gateway drug. The interpretation of cause and effect can be sharp. I don't think caffeine has those properties at all.
-I don't think caffeine can be called a gateway drug.
-Since caffeine is often enjoyed normally, I don’t think it can be called a gateway drug.
-Caffeine does not cause drug-like pleasure, so I don't think it's that bad, but I think children and teenagers who are still growing may be more vulnerable to it.
-No.
-Yes.
-I think so.
-It is a gateway drug in a very broad sense.
-Alcohol may be considered a gateway drug.
-Alcohol, nicotine. Caffeine is not called a gateway drug.
-Alcohol and nicotine are clearly gateway drugs. Caffeine is ambiguous.
-This may be the case for alcohol and nicotine, but clinical research is still lacking for caffeine.
#6 Will treatment allow patients to return to their pre-addiction life completely? (Is there a “complete recovery” for addiction?)
-There is no complete recovery from addiction. Because addiction is part of the brain system. Addiction is a part of the human brain system because the Seeking system and Lust system coexist in the midbrain over the Nucleus accumbens and Ventral tegmental area.
In fact, not only with alcoholism but throughout our lives, we are forced to pick between two options whether to engage in activities that have little immediate effect and might betray our effort but increase the value of social life and provide semi-permanent satisfaction (study, exercise, etc.) or activities that give you 100% satisfaction but must continue (drinking, gambling, binge eating, etc.).
Many parts of life are a series of two choices, and people who choose the former circuit have less activity in the latter circuit (people with jobs, beliefs, and families are prevented from becoming addicted, as seen in the pattern of opioid addiction after the Gulf War) ) People who choose the latter circuit have less activity in the former circuit. Addiction is divided into various forms and is one of the choices that we are forced to make throughout our lives.
-The concept of “cure” is no longer used these days. Can a cold be completely cured? You get a cold every year, right? It's not a cure, it's a recovery. It may happen again, but if you are free from the problem and are fully functioning in your role, it can be considered as recovery.
-Yes, it's a small number, but I think there are definitely some cases of complete recovery.
-If the addiction is in the early stages, you can aim for a complete cure, but in many cases, the addiction has already progressed significantly by the time treatment is received, and in this case, the likelihood of a complete recovery is low.
-No human being can go back to their previous life. Returning to your previous life should not be the goal of treatment. The goal of the treatment should be living a new life.
-It seems that a complete recovery is not easy in addiction. I think you should think of it as something you have to manage for your entire life.
-It's difficult to say it can be completely recovered, but rather in a state that you are manage/maintaining.
-I think it would be more accurate to say maintenance rather than complete recovery. Treatment is necessary to maintain a lifelong abstinence from the object of addiction. In many cases, life before addiction was not very happy, so it would be better to say that treatment of addiction will lead to a new life.
-It's very rare, but I believe it's possible.
-I believe that you need to approach addiction as a chronic disease rather than with the concept of a complete recovery. Addiction needs constant management. Returning to your previous life is a very difficult goal, but I believe it is possible.
-It is quite difficult, but possible, as only one in 10 people with alcohol use disorder are completely recovered.
-Although complete recovery is possible, I believe that even once complete recovery is reached, continuous efforts and help from those around you to prevent relapse are necessary.
-Because addiction has the characteristics of a chronic disease, consistent management and prevention of relapse are more important than the concept of complete recovery. If an addict becomes free from addiction and no longer depends on the addictive substance, they will have no difficulty in maintaining daily life and may be able to mature personally and live a better spiritual life than the life before addiction.
-In rare cases, a person may return to their daily life previous to addiction. However, since addiction is a tendency, it is a disease that must be managed for life rather than being completely cured.
-Rather than a complete cure, you can live a life of recovery by continuing to abstain from alcohol or drugs.
-Depends on the drug type and definition of complete recovery (cure).
-It’s not impossible.
-It's difficult but possible.
-It is possible, but it requires consistent self-management.
-Just like other psychiatric disorders, it is possible to completely return to the previous state, but there is a possibility that it will get worse again at any time. Therefore, even if recovered, caution is always required.
#7 What are your thoughts on legalizing medical marijuana in Korea?
-I think it is possible in limited areas.
-I believe that it is necessary to legalize medical marijuana with strict management standards in place. (e.g., treatment of patients with incurable pediatric epilepsy).
-They can be allowed under strict regulation, but I believe more research is needed on the potential socio-cultural impacts of medical cannabis.
-I think it should be legalized under strict control. There is certainly pain that can only be alleviated through this.
-You must follow the correct prescription guidelines in situations where it is absolutely necessary. Education about cannabis addiction must be provided in parallel.
-I oppose.
-I think it is premature as there are no institutional regulations in place in Korea.
-It would be helpful to review and decide on use in medical facilities carefully.
-I believe it can be used under strict guidelines if absolutely necessary. However, if it is prescribed indiscriminately, like opioid (narcotic) painkillers, there will be many problems.
-I am against it. Oxycodone and fentanyl also have medical uses but are seriously abused. Even if it is used, it should only be allowed for a very limited number of patients diagnosed with cancer or suffering from extreme pain.
-Conditional approval.
-I agree as long as there is strict management.
-Under the premise that thorough management is possible to prevent misuse of medical marijuana for commercial purposes, I support the legalization of limited medical use only for patients who absolutely need it.
-Cannabis is effective in some incurable diseases. Most doctors support the medical use of cannabis limited to these diseases. However, we are concerned that this process may increase the accessibility of marijuana use and increase the possibility of misuse.
-I oppose it since marijuana is a gateway drug.
-If you can have it very limited and under complete control, it seems possible.
-I would like to follow the social consensus.
-I oppose.
-I support it as long as it is managed well.
-It is possible to legalize medical marijuana if it is medically necessary rather than for recreational purposes, but in light of the case of other drugs such as sleeping pills or tranquilizers, it seems that thorough management is needed to prevent abuse.
#Optional: Due to the nature of your job, there is a high possibility of experiencing burnout/secondary trauma. Is there a way to prevent or manage this?
-Strictly maintaining neutrality and therapeutic distance from the patient while teaching care and respect for the patient's life, and above all, the belief that my actions are valuable.
-1. Irregular meetings with an expert mentor (psychiatrist or psychologist) 2. Frequent conversations between family members 3. Incorporation of humor into daily life.
-You need a hobby.
-Manage it through communication with colleagues/family, time with your supervisor or mentor, and your own burnout prevention activities (e.g. hobbies, vacations, etc.).
-Work-life balance is essential, as well as relationships with family and friends, hobbies, etc.
-Exercise 4 times a week, chat with colleagues (even through KakaoTalk if you can't meet in person), and drink less (never use alcohol to relieve stress).
-I think it is a good idea to always discuss and discuss stressful situations with family, friends, and co-workers to prevent burnout. Also, I think it is important to have a good life, family, hobbies, etc. outside of work.
-I think it is important to maintain good hobbies and interpersonal relationships. Emotional support from colleagues is also important. These methods can help maintain an objective perspective, and programs such as Mindfulness-Based Stress Reduction (MBSR) are also beneficial.
-Do a hobby or exercise that brings you joy.
-Frequent socializing with colleagues, venting emotions, exercising, etc.
-Spending time with family, friends and colleagues is best.
-Consult with a nearby psychiatrist.
-You must have your own healthy lifestyle habits. You must try to maintain a balanced life. You must make many friends that make you happy.
-A good night's sleep.
-You must have your own healing point.
-Self-management of yourself and practical recovery support for the medical staff are necessary.
#Optional: What ethical dilemmas/moral struggles did you face as a psychiatrist, and how did you deal with them?
-As a psychiatrist, I have many concerns when it comes to keeping chronically mentally ill patients in hospitals for long periods of time. Patients must live in society according to their own will and form relationships with others, but in reality, we see cases where chronically ill patients come back out into society, and their symptoms worsen, or they are unable to adapt, and their health deteriorates.
They are not a prisoner, so being confined in a psychiatric hospital for several years is not the right solution when considering human rights. However, in our society, there are almost no community facilities or management services for these people.
I try to put a lot of interest and effort into strengthening the role of the community and creating a service system for the return to society and recovery of these people and chronic addiction patients.
-People with chronic mental illness who can never return to society have no choice but to isolate themselves from society. Deinstitutionalization is just a theoretical, idealistic thing that people who have never properly treated patients talk about. We need to create their own society. In other words, the expansion and qualitative improvement of mental illness facilities.
-It's the same with other doctors, but the patient may not always be the one who is ethical. For example, psychiatrists may encounter violent criminals as patients. It may not feel ethically right to help such a person, but in any case, when meeting a psychiatrist with a patient, I believe that it is basic ethics as a doctor to stand in the patient's shoes and provide medical treatment that is helpful to the patient. I think we will do what we can.
-I can give advice to patients who repeatedly make bad choices, but I usually see many people who end up making bad choices again, and I find comfort in saying that psychiatrists are people who support choices, not people who make choices for them.
-Psychiatrists are human beings, not priests, so you need to consider individual life and patient problems separately.
-It is difficult when you have to choose between a patient’s happy state in the illness and a cold state in reality about whether grandiosity that does not cause problems in life should be treated.
-When what the patient wants and what I think are in conflict, it is difficult to decide how much I should intervene.
-Medical Protection patients pay a certain amount for treatment, so if admitted to a university hospital, the hospital will be in the red, making it difficult to admit them. In times like this, the question becomes whether it is treatment or the hospital’s profits.
(*Medical protection is a social security system with a different concept from medical insurance. It is a public assistance-type social welfare system that provides basic medical benefits funded by the government to low-income people who cannot maintain their livelihood or are below a certain level.)
-I often face it. You just have to believe in your own values.