Summary and trend analysis in responses
Keywords
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Keywords 〰️
Below is a summary and analysis of the trends in responses to each question. For full, detailed responses, please refer to the complete interview transcripts.
#1 Currently, in Korea, the perception and social prejudice toward patients with mental illness are negative. How can this be improved?
Role of Media in
Shaping Perceptions
Media Representation
Television shows, movies, and news articles—influence public attitudes. Many suggest that portraying mental health issues naturally and empathetically in media can reduce stigma and normalize psychiatric treatment and mental illness.
Supportive Environments
Creating environments where individuals with mental health challenges feel accepted and can access treatment without fear of discrimination is essential. Fostering empathy and openness across society can make Korea a more “advanced” country in terms of mental health.
Positive Celebrity Influence
Highlighting mental health struggles among well-known public figures and celebrities is seen as a way to humanize these issues and make them relatable. High-profile figures, such as “star psychiatrists” like Oh Eun-young or national mental health ambassadors, can set examples and foster empathy.
Public Education and
Awareness Campaigns
Mental Health Literacy
Improving understanding of mental health through nationwide educational initiatives is needed. For example, a clear understanding of the spectrum of mental health disorders is crucial (e.g., understanding that depression varies in severity and range).
Promotional and
Coordinated efforts between government, civic groups, the media, and healthcare providers to improve mental health awareness and challenge prejudice is needed. Examples from other countries, like the mental health advocacy roles of Kate Middleton or the Kennedy family, can be potential models for Korea.
National Efforts
Legal and
Policy Reforms
Addressing Structural
Discrimination
It is important for policy reforms to eliminate discrimination, especially in areas like insurance and employment. Legal changes to reduce structural stigma is necessary to ensure that mental health issues are treated on par with physical health conditions.
Creating Accessbile
Treatment Systems
Policies should make mental health services more accessible, allowing early intervention. The accessibility can help people see mental illness as a common health issue rather than something rare or dangerous.
Community and
Social transformation
Social Acceptance
and Cultural Change
There is a need for a cultural shift that values mental health equally with physical health. Campaigns to raise awareness among social leaders and institutions are viewed as crucial for achieving this change.
#2 How do you approach patients when they have difficulty communicating or have difficulty performing tests due to disabilities/language barriers, etc.?
Use of Translation tools
and Interpreters
Digital Tools
Many practitioners use translation apps like Google Translate for basic communication. Additionally, written communication, such as text-based tools or simple phrases, helps facilitate understanding.
Referral to Specialized Center
Some hospitals refer patients to facilities equipped to handle communication barriers, particularly for foreigners or those with sensory impairments, as specialized testing environments can provide more tailored support.
They might also offer dedicated staff assistance by assigning a staff member to work directly with the patient, allowing for focused, individualized support and minimizing communication difficulties. This can involve simplified language or repeated explanations to match the patient’s comfort level.
In-Person Interpreters
Hospitals often provide interpreters for sign language or foreign languages. These interpreters help bridge communication gaps and make treatment more effective.
Guardian
Involvement
Information Gathering
Guardians or family members provide valuable insights into the patient’s behaviors, symptoms, and needs, particularly when direct communication is limited. This includes initial data collection and supporting non-verbal assessments.
Supportive Role
Guardians can assist by interpreting the patient’s non-verbal cues or relaying relevant medical history, as they often have close understanding of the patient's needs and preferences.
Behavioral Observations and
Non-Verbal Communication
Observation
Using gestures (e.g., mimicking sleep or eating) allows for communication without words, making it easier to convey basic questions and understand responses.
They might also use drawings, art, music, or other creative means to facilitate interaction, and written communication.
Gestures and
Demonstrations
Clinicians rely heavily on observing patient behavior, facial expressions, and responses to non-verbal cues. This includes evaluating abnormal behaviors, mood, and reactions during the session.
Alternative Testing and
Diagnostic Tools
Non-Verbal Psychological Tests
When language barriers or disabilities prevent standard psychological testing, clinicians may use non-verbal or simplified assessments, such as the LICA test, or diagnostic imaging (e.g., MRI, EEG) that does not require verbal interaction.
#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?
Emotional impact on
Family members
Feelings of Betrayal
and Financial Strain
Families often face a sense of betrayal and financial hardship due to the deceptive behaviors of the person with addiction, including lying or borrowing money for addictive activities.
Therapy and Counseling
for Family Members
Seeking professional help allows families to manage their own mental health, empowering them to create a stable environment that supports long-term recovery.
Connecting with self-help groups provides families with a support system, coping strategies, and guidance from others who have navigated similar experiences.
Secondary Trauma
The stress of dealing with addiction can lead to secondary trauma, where family members develop their own mental health struggles, adding to the emotional toll.
Codependency and
Enabling problems
The Cycle of Codependency
Families frequently become codependent, tying their emotional state to the behavior of the person with addiction, often resulting in unhealthy dynamics.
Setting Boundaries
To avoid enabling behaviors, families are encouraged to set clear boundaries, maintain their independence, and support the person with addiction in taking responsibility for their own actions (e.g. not paying off the debts for a gambling disorder patient).
Education and
Empathy Building
Understanding Addiction
as a Disorder
Educating family members on the biological and psychological nature of addiction helps reduce stigma by clarifying that addiction is not a problem of will or a moral failing. This understanding fosters a more empathetic approach, enabling families to support their loved one’s recovery with compassion rather than judgment.
Recovery Process
Awareness of the
Learning about the stages of recovery and treatment helps families manage their expectations and provides clarity on how best to support their loved ones.
Self-Help and
Professional help for familes
Self-Help Groups
#4 Are there any characteristics of people who are more easily exposed to addiction?
Personality Traits
Impulsivity and
Novelty-Seeking
Individuals who seek stimulation, excitement, or new experiences and are prone to boredom may have a higher risk of addiction.
Risk-Taking Behavior
High-risk tolerance and a strong inclination toward thrill-seeking or competitive activities can predispose individuals to addiction.
Those who lack healthy coping mechanisms for managing stress are more vulnerable to using addictive behaviors as an escape.
Emotional Instability
High levels of anxiety, depression, or emotional vulnerability make individuals more likely to turn to addictive behaviors as a way to cope.
Genetic and
Familial Influences
Family History of Addiction
A genetic predisposition is significant, with addiction being more common among those with family members who also struggled with it.
Setting Boundaries
To avoid enabling behaviors, families are encouraged to set clear boundaries, maintain their independence, and resist taking responsibility for the addict’s actions.
Environmental and
Social Factors
Lack of
Support System
Individuals without strong social support from family or friends are more likely to use addictive behaviors to cope with isolation or loneliness.
Addictive Stimuli
Exposure to
Environments where addictive behaviors or substances are accessible (e.g., social media, high-risk communities) increase addiction risk.
Coping style and
Mental Health
Poor Stress Management
#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."
Skepticism about Gateway Theory
for Caffeine and Other Legal Substances
Limited Evidence
for Caffeine
Some have skepticism about caffeine as a gateway drug as caffeine lacks the euphoric effects associated with substances typically classified as gateway drugs. There is insufficient clinical research supporting the idea that substances like caffeine directly lead to harder drug use. While alcohol and nicotine may have characteristics of gateway drugs, the evidence for caffeine as a gateway drug is weak.
Legal substances like caffeine and alcohol do not necessarily lead to drug abuse. The lack of legal restrictions plays a significant role in determining whether a substance functions as a gateway. For example, marijuana may be seen as a gateway drug partially because of its restricted legal status.
Legality and Accessibility
Support for Alcohol and
Nicotine as Gateway Drugs
Early Exposure
and Brain Changes
Early exposure to alcohol and nicotine can lead to changes in brain function that may increase the likelihood of trying more harmful substances. These substances, like cannabis, may act as gateways by introducing the experience of altered mental states, which can lead to interest in stronger drugs.
Common Starting
Substances
Since alcohol and cigarettes are easily accessible and commonly used in society, they often serve as the initial step in addiction pathways, potentially increasing the risk of progression to harder drugs.
Individual Vulnerability
as a Key Factor
Susceptibility to addiction varies among individuals. Those with a family history of addiction, past addictive behavior, or psychological vulnerabilities may be more prone to seeking out stronger substances after using alcohol or nicotine, even if these substances are not inherently gateway drugs.
Pleasure-Seeking and
Reinforcements
Predispositions
Genetic and Psychological
Experiencing pleasure or relief from legal substances can increase the desire to seek out stronger, illicit drugs in the future, particularly for those who are predisposed to addiction.
#6 Will treatment allow patients to return to their pre-addiction life completely? (Is there a “complete recovery” for addiction?)
Concept of Recovery
over Cure
Chronic Nature of
Addiction
Addiction behaves like a chronic disease, requiring ongoing management rather than a one-time cure. Recovery involves achieving a state where the individual can manage their addiction, but the risk of relapse always remains.
Focus on the “New”
Rather than seeking to return to a pre-addiction life, the goal of treatment is often seen as achieving and maintaining a new, stable, abstinent life, where continuous support and self-management are key.
Recovery can achieve personal maturity and spiritual growth, which may help them build a more resilient and purpose-driven life post-addiction.
Addiction as a
Lifelong Condition
Recovery as a State of
Functionality
“Cure” is no longer the ideal terminology; instead, recovery is reaching a functional state where the individual is free from dependency and can manage daily responsibilities. This approach mirrors how other chronic health conditions, like asthma or diabetes, are managed rather than cured.
Continuous Effort and Support
Even when recovery is reached, continuous efforts, along with support from family and professionals, are crucial to prevent relapse and sustain recovery.
Other Factors of
Recovery
and Addiction Severity
Influence of Early Intervention
Individuals with mild or early-stage addiction have a better chance of full recovery, while those with advanced addiction face more difficulty in returning to a pre-addiction state.
#7 What are your thoughts on legalizing medical marijuana in Korea?
Conditional Support
for Limited Medical Use
Strict Regulation
and Control
Some support the idea of legalizing medical marijuana but only under rigorous guidelines to prevent misuse. Strict prescription guidelines, limited patient eligibility, and careful monitoring to avoid scenarios like those seen with opioid abuse is necessary.
Specific Medical Cases
Some think that medical marijuana could be approved for severe, incurable conditions, such as pediatric epilepsy or cancer-related pain, where conventional treatments are ineffective. Medical marijuana can be an option for extreme cases where its benefits are well-documented.
Need for Further Research
and Institutionial Framework
Evidence-Based Support
Some argue more research is needed to understand the therapeutic effects and risks of medical cannabis before legalization. Legalization should be postponed until Korea establishes a robust institutional framework and research evidence that supports its safe use.
Healthcare System
Preparedness
Some claim that Korea currently lacks the necessary regulatory and healthcare infrastructure to manage medical marijuana safely. Therefore, it’s premature to legalize it without clear regulations and safeguards in place.
Concerns About Potential
for Misuse and Addiction
Risk of Misuse
Some compare medical marijuana to prescription drugs like opioids, which are often misused despite their medical purpose. They fear that increased accessibility could lead to misuse or that marijuana might become a gateway to other substances.
Increased
Societal Acceptance
Some entirely oppose legalization due to marijuana’s reputation as a gateway drug, and they are concerned that medical legalization could increase general access and societal acceptance, potentially leading to recreational use and misuse.
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?
Work-Life Balance and
Personal Well-Being
Maintaining Balance
and Healthy Life Style
Therapeutic Neutrality
Maintaining a neutral, professional distance helps healthcare providers stay objective and avoid emotional entanglement with patients. This includes reinforcing the belief that their work is meaningful and valuable.
It is important to have a healthy work-life balance, which includes taking regular breaks, using vacations, and establishing boundaries between work and personal life to recharge.
Regular exercise, sufficient sleep, and stress-relief activities are essential. Engaging in hobbies and maintaining personal interests outside of work could help avoid burnout by allowing mental and emotional recovery to occur.
Emotional Support Systems
Family and Friends
Family and Friends
Social support from family and friends is vital for stress relief. Spending time with loved ones provides a grounding effect, helping to manage work-related stress.
Colleagues and Mentors
Communication with colleagues or mentors (such as other psychiatrists or psychologists) offers a safe space to discuss challenging situations, share experiences, and gain insights. Having a support network within the workplace is seen as essential for mutual encouragement. Check-ins help reinforce healthy mental practices and provide strategies to manage difficult emotions.
Programs
Maintaining a neutral, professional distance helps healthcare providers stay objective and avoid emotional entanglement with patients. This includes reinforcing the belief that their work is meaningful and valuable.
Optional: What ethical dilemmas/moral struggles did you face as a psychiatrist, and how did you deal with them?
Balancing Patient Autonomy
with Societal Safety and Support
Long-Term Hospitalization
vs.
Patient Rights
Deinstutionalization
Deinstitutionalization is idealistic for certain patients need long-term support environments. An expanded, quality network of mental health facilities that can serve as supportive communities for those who cannot fully reintegrate into society.
Conflicts Between Professional
Duty and Insitutional Constraints
Financial and Resource
Limitations
Treating low-income patients under social welfare programs, such as Medical Protection, presents challenges when hospitals prioritize financial viability over patient care. This creates an ethical dilemma between the duty to treat patients in need and the financial pressures on healthcare facilities.
Psychiatrists face dilemmas when dealing with chronically ill patients who struggle to adapt to society but also deserve autonomy. Prolonged hospitalization in psychiatric facilities may protect patients’ health temporarily, but it raises ethical concerns regarding their human rights and freedom. There is a need for community facilities and support systems that allow chronically ill patients to integrate safely back into society.
Providing Unbiased Care
in Difficult Situations
Family and Friends
Treatment of Unethical
or Violent Patients
Psychiatrists often treat individuals with criminal backgrounds or those who have caused harm to others. While it may feel ethically challenging to provide care to such patients, it is important to maintain professional ethics and offering unbiased treatment by focusing on the patient’s needs, regardless of past actions..
Supporting Patient
Choices without Judgement
Psychiatrists often encounter patients who repeatedly make harmful choices. It is challenging to support these individuals while maintaining a non-judgmental stance, recognizing that their role is to offer guidance, not to dictate choices.
Programs
Maintaining a neutral, professional distance helps healthcare providers stay objective and avoid emotional entanglement with patients. This includes reinforcing the belief that their work is meaningful and valuable.
Navigating Conflicting Interests
in Patient Treatment
Patient Desires vs.
Professional Judgement
Psychiatrists often face difficult decisions when a patient’s wishes conflict with the psychiatrist’s assessment. Deciding how much to intervene, especially when a patient’s goals may not align with therapeutic realities, is a complex ethical balance.