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Paper Heart
CW: suicide, mental illness The lifetime prevalence of mental health disorders in South Korea is one out of every three people, slightly higher than the world average of one in four. In light of the high profile celebrity suicides in 2019, I decided that I wanted to know more about the state of mental health care in South Korea. In doing my research, I learned much more about the mental health care system in South Korea and the types of care that are available to South Korean citizens. However, there was a dearth of information regarding the care available for the non-Korean speaking, expat community in South Korea. So how do therapists in South Korea work with the multifaceted and deeply cultural mental health issues that foreigners experience here? This was the question that guided my search as someone who has dealt with anxiety since college and has peers who have experienced various forms of mental illness. I sought out Dr. Ebesutani to hear more about his experience working with the English-speaking foreigner population in South Korea. Dr. Chad Ebesutani is a US and South Korea Licensed Psychologist and Director of the Seoul Counseling Center. The Seoul Counseling Center—with locations in both Sinsa-dong (Gangnam) and Pyeongtaek (near the Camp Humphreys US Army Base)—is a space for English-speaking expats, international students, Korean Americans, and army personnel and families to receive counseling from certified South Korean and American therapists. Dr. Ebesutani is also an Associate Professor of psychology at Duksung Women’s University, where he runs a Child Psychology Research Lab focusing on evidence-based treatments and the assessment of mental health skills usage among both clinical and non-clinical populations. I started off our time together by asking Dr. Ebesutani about the most common mental health issues/disorders that he encounters among his foreigner clients. He stated that depression and anxiety are the most common disorders. With South Korea having the highest suicide rate of all OECD (Organization for Economic Co-operation and Development) countries, this observation was not surprising even among the foreigner population. He noted that social anxiety and panic disorder were also common problems he encountered at his center. I recalled a time when I used to suffer panic attacks in college as a result of my uncertain academic future. I would wake up in the middle of the night, heart thumping so hard that I could feel it in my ears. Social anxiety is also a condition I deal with on a day-to-day basis here even as a Korean American—so this observation was, again, not surprising to me. I wondered how foreigners, who often have left a significant part of their support systems back in their home country, work through such problems. But there were two additional issues that Dr. Ebesutani raised that I had not expected: societal integration challenges and alcohol abuse. According to the Journal of Korean Medical Science, South Korea is home to the highest prevalence of alcohol abuse/alcohol dependence among OECD countries, with approximately 7% of the population suffering from this disorder. These two problems often strongly impacting the expat life in South Korea is noteworthy, as often in South Korean workplace culture, alcohol is the gateway to inclusion in the greater workplace ecosystem through what is known as ‘hwe-sik’ (회식), the South Korean after-work company dinner. Dr. Ebesutani and the psychologists at his clinic work with many Korean American clients. Korean Americans in Korea belong to a unique niche of people who straddle the line between belonging and alienation. And it is not surprising that Korean Americans also deal with issues of societal integration. Dr. Ebesutani noted that lack of comfort with the Korean language was often the issue that prevented this population from feeling like they are truly “Korean.” Ultimately, this issue boils down to the issue of identity and feelings of isolation from one’s community. As a Korean American, I empathized deeply with what Dr. Ebesutani’s Korean American clients were feeling. I came to Korea hoping that by being here and integrating into the social fabric of my home country, I could feel more “Korean.” And after a year and a half of being here and working on my Korean as well as my mannerisms, I have integrated somewhat. But as a Korean American, that is not enough. Korean people asking me where I’m from, innocent comments from teachers about how well I eat the food, and the phrase “You’re so American” all contribute to the separation of Koreans and Americans. This idea of isolation from community as a Korean American in South Korea may seem paradoxical at first. However, unlike “proper” non-Korean foreigners, Korean Americans are often met with criticisms along the lines of “You’re Korean, so why can’t you…?”. As long as you look Korean or reveal that you are part Korean, there is a certain expectation that Korean people have of you even if you have never engaged with the culture for various reasons; meanwhile, our non-Korean foreigner counterparts are given praise by local Koreans for their smallest dip into Korean culture. Our hyphenated identities often create conflicts within ourselves regarding our sense of belonging and identity as Korean people. The mental health issues that people face in South Korea, just like anywhere else in the world, are embedded in culture and require a nuanced understanding in order to address. The South Korean government has been slowly but surely developing its response to mental illness in the past 20 years. The Mental Health Act of 1995 in South Korea and its subsequent revision in the 2016 Act on the Improvement of Mental Health and the Support for Welfare Services for Mental Patients (AMSW), are two of the most prominent government initiatives to promote the welfare of people suffering from mental illness. However, Dr. Ebesutani informed me that these Acts were created primarily to care for individuals with serious mental illnesses (SMI), such as those with schizophrenia, severe bipolar disorder and severe major depression who experience substantial impairment to their daily functioning.
Syllable
I asked my mother the Korean word for nectarine and she told me 천도복숭아, heavenly peach. And I recognized the angel there, though she wouldn’t have believed I knew her. I had heard her on the phone one room over, unripe and glorious like a child playacting stone fruit, head held between summer-bare knees acting out being eaten remaining whole. By Sarah Berg