|
|
| | Changing needs and new perspectives for psychiatry and mental health services in Korea | | 2006-5-26 6:37:20 Former President Korean Neuro-Psychiatric Association (KNPA) Yong Sik Kim, M.D.,Ph.D, Jong-Ik Park, M,D, Ph.D |  Former President Korean Neuro-Psychiatric Association (KNPA)1) Yong Sik Kim, M.D.,Ph.D1.2)
Department of Psychiatry, College of Medicine, Seoul National University2)
Assistant Professor, Department of Psychiatry, College of Medicine, Jong-Ik Park, M,D, Ph.D3)
Kangwon National University3)
Seoul Korea
The history of Korean psychiatry has actually begun with the foundation of the Cho-sun Neuropsychiatric Association (former Korean Neuropsychiatric Association) in 1945.A vast number of Koreans then perceived psychiatric illnesses as demonic possessions and indigenous healers using traditional methods, such as incantation to drive away bad soul from patient, took the place of psychiatrists. Only a few mental hospitals were established and the public conceptions about mental health service fell much behind those of the western societies.
Since the initiation of Korean national economic development plan in 1960s,the number of mental institutions grew gradually but a large portion of mental institutions grew gradually but a large portion of patients suffering from psychosis and alcohol dependence still remained in asylum Dynamic psychiatry came to prevail in most academic fields, commencing the era of modern psychiatry. Rapid industrialization in the 80’s brought about family disintegration and breakdown of social support system, resulting in displacement of mentally ill persons outside of the family.
From the mid –80’s,the government enacted the policy to increase psychiatric beds to absorb psychiatric patients and homeless people. The prejudice and discrimination against the mentally ill were still predominant and such atmosphere resulted in unwanted prolonged hospitalization and difficulty in returning to the community.
Mental health act was finally passed in 1995to ensure human rights and increase community mental health services
Through such laws, the public and the government officials came to recognize the importance of mental health Since the year 2000, people with chronic mental disorders finally became entitled to receive social welfare services, such as economic support, employment and housing Disability benefits for people with mental impairment could reduce the burden of ill-stricken family and prevent impoverished life in the community
According to epidemiological survey by CIDI in 2001,prevalence of major psychiatric disorders is as follows: mood disorder 4.7%, and somatoform disorder 0.64%. Although the analysis of service utilization has not yet been completed, the proportion of untreated mental illness was found to be still quite high despite sufficient human resources in Seoul Future research in 2006 should consider how the issues, such as rapid industrialization and social change, economic and social inequalities, and natural disasters, may influence mental health.
Future challenges to decrease mental health burden can be summarized as :1)Development of community mental health service programs, 2) Redistribution of financial resources and renovation of reimbursement system, and 3) Effective arrangement of human resources, With limited resources, the best strategy for reducing the burden of mental health service is to suppress unnecessary demand. While about 20%of Medical Care program budget is presently being spent on mental disorder patients, none is allocated for community based mental health program. In other words ,the financial burden of long-term hospitalization must be shifted toward the community .Specifically , though insufficient in number, there are nevertheless several scores of community mental health center that provide relatively good services in Korea. While it is not expected that diverse service programs can be developed by the individual center by itself, the alliance and linkage among centers and interconnects with hospitals and other related facilities may play a role in creating better alternative service programs. Given the scarcity of financial and human resources, effective management is the most important component of the health system’s inputs. The lack of healthcare budget and shortages in trained personnel may be overcome by effective distribution of mental healthcare In accordance with redistribution of mental healthcare budget, reimbursement system also ought to be reimbursement system also ought to be restructured .To sum up, the challenges to the changing needs of mental health service in Korea can be overcome by effective management of financial and human resourced and by the role of psychiatrist as a leader and supervisor to coordinate in a broader perspective. | | [CLOSE] |
|
|
Ministry of Health, (2003) No.013
ICP:No.040657