In South Korea, the conversation around mental health is becoming less taboo, with more people now willing to discuss and seek treatment for mental health issues, including the use of antidepressants.

However, this trend spotlights two primary concerns: the increasing reliance on medication for managing mental health and the strain on the country’s mental health services infrastructure to accommodate the growing demand.

These issues are particularly pressing in the context of economic challenges and the aftermath of the COVID-19 pandemic, which has significantly impacted the mental well-being of the population.

According to the Health Insurance Review and Assessment Service, the number of people receiving treatment for depression in 2022 exceeded one million, a 33% increase since 2018. Spending on depression treatment also rose sharply, with a 60% increase from $252.2 million (336 billion won) to $403.8 million (538 billion won) in the same timeframe.

Further highlighting this trend, Organization for Economic Cooperation and Development data reveals that in 2022, the daily dosage of antidepressants per 1,000 people in South Korea reached 31.1, up by 32.9% since 2019. 

“The psychological repercussions of a catastrophic event often manifest months or even years afterward,” Lim Myung-ho, a professor of psychology and psychotherapy at Dankook University, told Korea Pro. “The current surge in depression cases is a testament to this delayed reaction.”

An illustration of people waiting in a hospital | Image: Korea Pro

CHANGING ATTITUDES

According to a survey by the National Mental Health Center, 83% of South Koreans now recognize that anyone can be susceptible to mental disorders and 73.5% believe these conditions are treatable.

This changing perspective is evident in personal experiences. Kim Yoon-seok, a 36-year-old banker from Seoul, managed work-related stress and insomnia with antidepressants.

“It brought peace to my family. My wife and I regret not starting these medications earlier,” Kim told Korea Pro, noting he is no longer as overwhelmed by negative feelings.

However, Kim’s efforts to encourage his mother to seek psychiatric help for her anxiety reflect ongoing challenges in changing the perceptions of older generations toward mental health treatment.

“The older generation still views mental health treatment as something for the weak-minded. But hopefully, they’ll come around,” he said. “Everyone needs help, and I view antidepressants as the most effective method.”

Similarly, Choi Jong-woo, a 45-year-old realtor, attributed his improved quality of life to his diagnosis and treatment of ADHD and depression. He initially attributed his mental condition to a lack of self-discipline.

“Things finally made sense. I realized I didn’t have to struggle all these years,” Choi said, citing increased media coverage of psychiatric treatments and conversations about their benefits in his social circles as reasons he decided to seek help.

“Taking medications is fundamentally about rebalancing your brain’s chemistry. It’s a logical step to take.”

The increase in public awareness and changing attitudes is mirrored in the healthcare sector. The number of private psychiatric clinics in Seoul has risen by 76.8% since 2017, and psychiatry is now a highly sought-after specialty among medical trainees.

Further, market analysis from Statista predicts a 10% growth in South Korea’s market for depressive disorder treatments within the next five years, reaching an estimated $355 million.

BROKEN SOCIAL FABRIC

Lee So-hee, a leading psychiatrist at South Korea’s National Medical Center, identifies worsening mental health among South Koreans, particularly the youth, as a significant factor driving increased depression treatment.

Lee points to a rise in young people, those in their 30s and younger, seeking emergency care for self-harm or suicide attempts, emphasizing the serious nature of the mental health crisis.

“This surge in emergency treatments underscores the gravity of the mental health crisis we’re facing; it’s not merely a matter of choice,” she told Korea Pro.

Psychiatrists interviewed by Korea Pro highlight several factors contributing to this situation, including intense competition, financial difficulties and uncertainties about housing, careers and marriage, all exacerbated by economic downturns and the pandemic.

Lee also raises concerns about the changing dynamics in family support systems. The traditional role of parents as a source of mental stability is diminishing, partly due to South Koreans’ shift toward professional childcare and an education system focused heavily on academic success.

“Parental care and monitoring is no longer working,” she said, indicating how these shifts contribute to mental health issues.

Additionally, Lee discusses the role of social media in worsening mental health among the youth by promoting superficial interactions and exposing users to harmful content, ranging from drug abuse to self-harm.

An illustration of a therapy session | Image: Korea Pro

OVERPRESCRIPTION

In response to growing mental health concerns, South Korea’s welfare ministry expanded the scope of prescription authority in 2022, enabling non-psychiatric physicians to prescribe selective serotonin reuptake inhibitors, which are widely used antidepressants, for periods longer than 60 days.

This decision has sparked debate among mental health professionals, who express concern over the increased authority for non-specialists to prescribe antidepressants and the reliance on these medications as a primary treatment for depression.

“Depression diagnoses are too readily made in Korea,” stated Lee Sang-yeol, a psychiatrist and professor at Wonkwang University’s medical school. 

He points out that treatments recommended by non-psychiatric doctors may not fully consider the patient’s history, personality, or recent life events, which can lead to an overreliance on medication based solely on self-assessment tools for depression.

According to Lee, antidepressants are not a cure-all, effectively alleviating symptoms in only about 40 to 50% of cases.

CONFLICTS OF INTEREST

Financial incentives for psychiatrists in South Korea present significant challenges, as national insurance payments are comparatively low. This situation discourages psychiatrists from offering extensive consultations or counseling, pushing them to reduce patient interaction times to accommodate more patients.

Patients seeking treatment outside the national insurance system encounter high costs, former counseling patients told Korea Pro. This higher cost contributes to a greater reliance on more affordable, insured antidepressant prescriptions rather than more expensive therapy sessions.

In response to these issues, the government announced in 2023 its plans to improve access to mental health care. These plans include reducing the interval for mental health screenings for young adults from 10 to two years and boosting the mental health budget by 22% to $290.3 million (386.6 billion won) for 2024.

The goal of these initiatives is to lower suicide rates by offering psychological counseling to one million people during President Yoon Suk-yeol’s term, with screenings for depression, schizophrenia and bipolar disorder targeted at individuals aged 20 to 34.

Despite these efforts, there is skepticism about the potential effectiveness of the government’s plans, particularly in light of the ongoing lack of reform in the medical insurance fee system. The concern is that without addressing the underlying financial and structural issues, the mental health care system may struggle to meet the increasing demand for treatment.

“The current mental care system is ill-equipped to support the growing public attention to mental disorder treatment,” Lee Sang-yeol told Korea Pro, highlighting the need for comprehensive reforms to ensure the mental health care system can adequately respond to the needs of the population.

Edited by John Lee