Those of us who are fortunate enough to live in the developed world have access to a high standard of mental health care. Yes, it’s not always perfect, and in some systems our financial situation may preclude access to the full range of available treatments. But just imagine if you will, living in the Democratic People’s Republic of Korea, better known to us all simply as ‘North Korea’.
Suffering from a mental illness in North Korea is nothing short of horrendous. The Open Radio for North Korea recently broadcast a thought-provoking article, written by Heyoung Jung, on social perceptions and mental health treatments. What is immediately obvious is the negative societal perception of psychiatric illness. A transcript from the programme highlights the stark situation:
‘Perception of mental disorder is extremely negative in North Korea. Mentally ill person is called “Number 49” or “Number 49 subject” and put into custody at “Number 49 Prevention Post” (Reference1). The term ‘Number 49’ originated from North Korea’s ‘Cabinet Decision No. 49 on People with Mental Disorders,’ which came into effect in 1965. Ordinary residents whisper to each other saying, “That person is Number 49,” if one has been to a mental hospital. It is not easy for someone to get a new job with a record of mental hospital treatment, since most of the employers shun employing ‘Number 49 subjects.’’
Furthermore, those with mental health conditions are discriminated against when it comes to employment. In terms of treatment, all in-patient facilities, which are basic and underfunded, are located in remote rural areas. Although there are psychiatric clinics in the larger provincial hospitals, these only treat people as out-patients.
And as if the above is not bad enough, the forms of treatment used are truly shocking. According to the sources interviewed by the Open Radio for North Korea, two methods are used as treatment: insulin coma treatment and sedative injections. There is apparently no application of counselling or psychological intervention/therapy.
Very few medical students want to practice psychiatry in North Korea; it is the least prestigious of all the specialities. As a result, there is a tendency for the least academically gifted students to work in mental health.
The medical situation is a mirror of the wider societal prejudice and discrimination that appears to be endemic in North Korea; mental health and wellbeing is simply not seen as important.
So one can only but imagine what it must be like to live with bipolar disorder in a cold and unsympathetic society. Let us hope that the situation will improve drastically; God knows it needs to.
You can read the transcript of the article here.