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Objective@#This study aimed to examine how marital status, occupational status, and individual personality influence suicidal ideation and suicide attempts among Korean middle-aged adults, and explore the effects of their interaction. @*Methods@#A total of 2,464 middle-aged adults were surveyed about suicidality in the past year (1-year suicidality). Participants’ current marital and occupational status, including other demographic and clinical variables were investigated. Personality traits were assessed using the Big Five Inventory. The dependent variable was the presence of 1-year suicidality. Independent variables were current marital and occupational status. Generalized linear model (GLM) analysis was performed to adjust for other covariates. @*Results@#The group with 1-year suicidality had significantly lower income. It had a lower proportion of full-time employment, and higher percentages of part-time employment and unemployment. The GLM analysis results showed that marital and occupational status had no significant association with 1-year suicidality. Neuroticism and openness were positively associated with 1-year suicidality, whereas conscientiousness and extraversion had a negative association. Interactions between marital status and neuroticism, conscientiousness, and occupational status were significant. @*Conclusion@#Individualized social and psychological interventions for suicide prevention are required according to individual personality traits.
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Objective@#Suicide is a complex phenomenon; therefore, it should be approached in light of sociocultural perspectives and the general attitude toward suicide. This study aimed to extract factors from the Attitude Toward Suicide Scale (ATTS) and investigate the relationship between attitudes toward suicide and suicidal behavior (i.e., suicidal idea, plan, and attempt) by using a representative sample of Korean adults. @*Methods@#Three thousand Koreans aged 19 to 75 years were surveyed cross-sectionally in 2013 and 2018. The data collected were subjected to exploratory factor analysis. Extracted attitude factors were compared using a suicidal behavior continuum. Univariate and multivariate logistic models were constructed to compare the association between attitude factors and suicidal behaviors. @*Results@#Among the participants, 477 (15.9%) experienced suicidal idea only, 85 (2.8%) had a suicidal plan without attempt, and 58 (1.9%) attempted suicide. Four meaningful factors were extracted from the factor analysis: “permissiveness,” “unjustified behavior,” “preventability/readiness to help,” and “loneliness.” “Permissiveness,” “unjustified behavior,” and “loneliness” factors showed significant trends across the suicidal behavior continuum. Permissive attitude toward suicide increased the odds of suicidal idea, suicidal plan, and suicide attempt (adjusted odds ratio [aOR]=1.49, 95% confidence interval [CI]=1.25–1.79; aOR=2.79, 95% CI=1.84–4.25; aOR=2.67, 95% CI=1.65–4.33), while attitude toward suicide as unjustified behavior decreased the odds of suicidal ideation and attempt (aOR=0.79, 95% CI=0.67–0.94; aOR=0.64, 95% CI=0.42–0.99). @*Conclusion@#A significant association was found between attitude toward suicide and suicidal behaviors. Attitude toward suicide is a modifiable factor that can be used to develop prevention policies.
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Objectives@#The aim of this study was to identify risk and protective factors of suicidality among Korean military officers. @*Methods@#This study was conducted on 3162 military officers. Data were collected by online survey after obtaining informed consent. Demographic characteristics, depression, anxiety, suicidality, social support, stress, and attitude toward suicide were evaluated using structured instruments and self-report questionnaires. Suicidality was defined as having a suicidal idea, a suicide plan, or attempting suicide. Statistical analysis was performed using logistic regression to investigate associations between potential risk and protective factors and suicidality. @*Results@#Depression (odds ratio [OR]=16.313, 95% confidence interval [CI]=10.028–26.539), anxiety (OR=14.377, 95% CI=8.680–23.812), and stress (OR=8.116, 95% CI=4.637–14.207) were positively associated with suicidality. On the other hand, good social networks and an unaccepting attitude toward suicide were negatively associated with suicidality (OR=0.131, 95% CI=0.072–0.240). No significant correlation was observed between living status and suicidality (OR=0.991, 95% CI=0.598–1.642). @*Conclusion@#Depression, anxiety, and stress were found to be risk factors of suicidality among Korean military officers. In contrast, good social networks and unaccepting attitudes toward suicide acted as protective factors. Hence, preventive interventions that place focus on risk and protective factors should be developed and implemented to mitigate suicidality.
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Background@#Although childhood maltreatment is a known risk factor for adulthood mental health, the impact of different types of childhood maltreatment on mental disorders is not yet clear. This study explored the association of each type of childhood maltreatment with adulthood mental disorders and suicidality in South Korea. @*Methods@#A total of 5,102 individuals from the general populations over the age of 18 responded to the Korean version of the Composite International Diagnostic Interview and questions about childhood maltreatment (emotional neglect, psychological abuse, physical abuse, and sexual abuse). To evaluate the odds ratio for mental disorders and suicidality associated with each type of childhood maltreatment, we used logistic regression analysis. @*Results@#About 17.0% of the respondents reported having experienced a type of maltreatment in childhood. According to the type, 9.4% reported physical abuse, 9.3% reported emotional neglect, 7.9% reported psychological abuse, and 3.8% reported sexual abuse. Exposure to each type of childhood maltreatment was associated with most types of mental disorders after adjusting for sociodemographic factors. Each type of childhood maltreatment victim was associated with suicidality (suicidal ideations, suicide plans, and suicide attempts).Dose-response patterns for suicide attempts were observed in all types of victims. Moreover, the respondents who experienced frequent childhood emotional neglect were 14 times more likely to have attempted suicide. @*Conclusion@#Childhood maltreatment was associated with mental health in adulthood.The findings show the need for early detection and intervention of victims of childhood maltreatment to minimize its negative impact on adult mental health.
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Background@#The frequencies of South Korean soldiers' depression and resulting suicide are increasing every year. Thus, this study aimed to develop and confirm the reliability and validity of a simple short form depression screening scale for soldiers. @*Methods@#This study was conducted as part of a 2013 research project named ‘The Epidemiological Study on the Prevalence of Depression in Military Service and a Search for High Risk Group Management.’ Clinical depression was diagnosed using the Korean version of the Mini International Neuropsychiatric Interview and suicide risk was assessed through the Korean version of the Composite International Diagnostic Interview. Furthermore, the Center for Epidemiological Studies for Depression Scale (CES-D), the Stress Response Inventory, and the Barret Impulsiveness Scale were employed. Of the 20 CES-D items, three of the most correlated items with clinical diagnosis were derived to form the short form scale.Analyses for internal consistency, concurrent validity, and factor analysis were implemented for its validation. We performed a receiver operating curve (ROC) analysis using a clinical diagnosis of depression as a gold standard to calculate the area under the curve (AUC) value, cut-off score, and corresponding sensitivity and specificity to that cut-off score. @*Results@#According to the results of the correlation analysis, 7, 18, and 4 were selected to be on our scale. The three-item scale was reliable with a Cronbach's alpha value of 0.720, and a factor was derived from the factor analysis. The ROC analysis showed a high discriminant validity, with an AUC value of 0.891. The sensitivity and specificity were 84.8% and 78.2%, and 71.7% and 91.6%, respectively, for each when the selected cut-off scores were 2 and 3, respectively. Depression screened through the scale when the cut-off score was 2 or 3 was significantly associated with suicidality, stress, and social support. @*Conclusion@#The depression screening questionnaire for Korean soldiers developed through this study demonstrated high reliability and validity. Since it comprises only three items, it can be utilized easily and frequently. It is expected to be employed in a large-scale suicide prevention project targeting military soldiers in the future; it will be beneficial in selecting high-risk groups for depression.
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Background@#Although childhood maltreatment is a known risk factor for adulthood mental health, the impact of different types of childhood maltreatment on mental disorders is not yet clear. This study explored the association of each type of childhood maltreatment with adulthood mental disorders and suicidality in South Korea. @*Methods@#A total of 5,102 individuals from the general populations over the age of 18 responded to the Korean version of the Composite International Diagnostic Interview and questions about childhood maltreatment (emotional neglect, psychological abuse, physical abuse, and sexual abuse). To evaluate the odds ratio for mental disorders and suicidality associated with each type of childhood maltreatment, we used logistic regression analysis. @*Results@#About 17.0% of the respondents reported having experienced a type of maltreatment in childhood. According to the type, 9.4% reported physical abuse, 9.3% reported emotional neglect, 7.9% reported psychological abuse, and 3.8% reported sexual abuse. Exposure to each type of childhood maltreatment was associated with most types of mental disorders after adjusting for sociodemographic factors. Each type of childhood maltreatment victim was associated with suicidality (suicidal ideations, suicide plans, and suicide attempts).Dose-response patterns for suicide attempts were observed in all types of victims. Moreover, the respondents who experienced frequent childhood emotional neglect were 14 times more likely to have attempted suicide. @*Conclusion@#Childhood maltreatment was associated with mental health in adulthood.The findings show the need for early detection and intervention of victims of childhood maltreatment to minimize its negative impact on adult mental health.
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Background@#The frequencies of South Korean soldiers' depression and resulting suicide are increasing every year. Thus, this study aimed to develop and confirm the reliability and validity of a simple short form depression screening scale for soldiers. @*Methods@#This study was conducted as part of a 2013 research project named ‘The Epidemiological Study on the Prevalence of Depression in Military Service and a Search for High Risk Group Management.’ Clinical depression was diagnosed using the Korean version of the Mini International Neuropsychiatric Interview and suicide risk was assessed through the Korean version of the Composite International Diagnostic Interview. Furthermore, the Center for Epidemiological Studies for Depression Scale (CES-D), the Stress Response Inventory, and the Barret Impulsiveness Scale were employed. Of the 20 CES-D items, three of the most correlated items with clinical diagnosis were derived to form the short form scale.Analyses for internal consistency, concurrent validity, and factor analysis were implemented for its validation. We performed a receiver operating curve (ROC) analysis using a clinical diagnosis of depression as a gold standard to calculate the area under the curve (AUC) value, cut-off score, and corresponding sensitivity and specificity to that cut-off score. @*Results@#According to the results of the correlation analysis, 7, 18, and 4 were selected to be on our scale. The three-item scale was reliable with a Cronbach's alpha value of 0.720, and a factor was derived from the factor analysis. The ROC analysis showed a high discriminant validity, with an AUC value of 0.891. The sensitivity and specificity were 84.8% and 78.2%, and 71.7% and 91.6%, respectively, for each when the selected cut-off scores were 2 and 3, respectively. Depression screened through the scale when the cut-off score was 2 or 3 was significantly associated with suicidality, stress, and social support. @*Conclusion@#The depression screening questionnaire for Korean soldiers developed through this study demonstrated high reliability and validity. Since it comprises only three items, it can be utilized easily and frequently. It is expected to be employed in a large-scale suicide prevention project targeting military soldiers in the future; it will be beneficial in selecting high-risk groups for depression.
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Background@#This study investigated the impact of getting older than the mean marriage age on mental disorders and suicidality among never-married people. @*Methods@#We performed an epidemiological survey, a nationwide study of mental disorders, in 2016. In this study, a multi-stage cluster sampling was adopted. The Korean version of the Composite International Diagnostic Interview was conducted with 5,102 respondents aged 18 years or above. The associations between never-married status, mental disorders, and suicidality were explored according to whether the mean age of first marriage (men = 32.8 years; women = 30.1 years) had passed. @*Results@#Never-married status over the mean marriage age was associated with agoraphobia, obsessive–compulsive disorder, mood disorders, and major depressive disorder after adjusting for sociodemographic factors. Respondents with never-married status above the mean marriage age were associated with suicide attempts (adjusted odds ratio [aOR], 3.21;95% confidence interval [CI], 1.36–7.60) after controlling for sociodemographic factors and lifetime prevalence of mental disorders, while respondents with never-married status under the mean marriage age were not. Moreover, in respondents with never-married status, getting older than the mean marriage age was associated with suicidal ideations (aOR, 1.49;95% CI, 1.04–2.15) and suicide attempts (aOR, 3.38; 95% CI, 1.46–7.84) after controlling for sociodemographic factors and lifetime prevalence of mental disorders. @*Conclusion@#Never-married status above the mean first marriage age was associated with mental disorders and suicidality. These findings suggest the need for a national strategy to develop an environment where people with never-married status do not suffer even if their marriage is delayed.
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Objectives@#ZZThe purpose of this study is to investigate the interest level, perception and attitude of suicide high-risk group towardthe media’s suicide report, and also to provide the fundamental data in order to strengthen both the standard and the recommendationof media coverage in Korea. @*Methods@#ZZWe analyzed the data from the 2013 The Korea National Suicide Survey. The study included 1500 participants aged between19 and 75 years. The participants were selected through the regional multi-layer stratification method using the sampling frameof the 2010 Census. One-on-one face-to-face interviews investigated the interest level, opinions, and attitudes toward suicide reportsand collected data on past suicide history and demographic data. The collected data were evaluated using multiple logistic regressionanalysis. A probability level of p < 0.05 was considered statistically significant. @*Results@#ZZThe suicide high risk groups with histories of suicidal ideations or attempts showed more interest in suicidal reports [suicidalthought odds ratio (OR) = 1.81, 95% confidence interval (CI) = 1.40–2.34 ; suicidal attempt OR = 3.21, 95% Cl = 1.52–6.78]. However,there was no difference among the groups in thought that suicide reports incite suicide (suicidal thought OR = 1.26, 95% Cl = 0.92–1.73 ; suicidal attempt OR = 0.96, 95% Cl = 0.44–2.09). The suicide high risk groups showed a positive attitude toward suicide reports,but it was not statistically significant (suicidal thought OR = 1.10, 95% Cl = 0.41–2.92 ; suicidal attempt OR = 1.10, 95% Cl = 0.76–1.59). @*Conclusions@#ZZWe suggest the need of careful attitude of media suicidal reports not to bring about copycat suicides. and also we offersuicide prevention campaign based on media leverage.
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Objectives@#ZZThe purpose of this study is to investigate the interest level, perception and attitude of suicide high-risk group towardthe media’s suicide report, and also to provide the fundamental data in order to strengthen both the standard and the recommendationof media coverage in Korea. @*Methods@#ZZWe analyzed the data from the 2013 The Korea National Suicide Survey. The study included 1500 participants aged between19 and 75 years. The participants were selected through the regional multi-layer stratification method using the sampling frameof the 2010 Census. One-on-one face-to-face interviews investigated the interest level, opinions, and attitudes toward suicide reportsand collected data on past suicide history and demographic data. The collected data were evaluated using multiple logistic regressionanalysis. A probability level of p < 0.05 was considered statistically significant. @*Results@#ZZThe suicide high risk groups with histories of suicidal ideations or attempts showed more interest in suicidal reports [suicidalthought odds ratio (OR) = 1.81, 95% confidence interval (CI) = 1.40–2.34 ; suicidal attempt OR = 3.21, 95% Cl = 1.52–6.78]. However,there was no difference among the groups in thought that suicide reports incite suicide (suicidal thought OR = 1.26, 95% Cl = 0.92–1.73 ; suicidal attempt OR = 0.96, 95% Cl = 0.44–2.09). The suicide high risk groups showed a positive attitude toward suicide reports,but it was not statistically significant (suicidal thought OR = 1.10, 95% Cl = 0.41–2.92 ; suicidal attempt OR = 1.10, 95% Cl = 0.76–1.59). @*Conclusions@#ZZWe suggest the need of careful attitude of media suicidal reports not to bring about copycat suicides. and also we offersuicide prevention campaign based on media leverage.
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Suicide is a serious problem worldwide, especially in Korea, but the factors affecting suicide are complex and diverse. Therefore, a medical policy should be developed to help establish an effective national suicide prevention policy in Korea. To reduce suicide rates effectively, some of the current suicide prevention policies need to be improved. This study proposes the following steps to do so: 1) standardizing the suicide attempt management system, 2) strengthening effective counseling programs in the psychiatric field, and 3) strengthening early psychiatric interventions in patients with a physical illness. These improvements should be considered high-priority measures for ensuring successful suicide prevention at the national level.
Subject(s)
Humans , Counseling , Korea , SuicideABSTRACT
OBJECTIVES: Suicide is a complex phenomenon not only caused by the individual's mental illness and economic situation, but also occurred in sociocultural contexts and relationships around the individual. Therefore, the attitudes, which include collective norms, thoughts and feelings of a population, toward suicide play a fundamental role in the prevention of suicide. Factor structure of Attitudes Toward Suicide (ATTS), developed by Renberg, is also various in different sociocultural contexts. This is the first study to investigate factor structure of ATTS along with nationwide sample of Korean adults.METHODS: This study analyzed the factor structure and reliability of ATTS in 1500 regionally stratified Korean adults. Exploratory factor analysis was performed by using principal axis factoring and varimax rotation.RESULTS: The selection of 33 ATTS items based on internal consistency and communality was conducted. Five factors were analyzed, which were named ‘Good reason,’ ‘Negative gaze,’ ‘Predictability,’ ‘Means of escape,’ and ‘Common secret,’ respectively. Explained total variance was 41.94%, and the internal consistency ranged from 0.516 to 0.740.CONCLUSIONS: Each of the five factors contains different semantic dimensions. Consistent with previous studies, factors containing permissive attitude toward suicide was high in those with history of suicidal thought and of suicide attempt. It is notable that the ‘Good reason’ showed higher score in elderly. This may be related to socioeconomic or physical adversities which have been considered the major cause of suicide in elderly.
Subject(s)
Adult , Aged , Humans , Factor Analysis, Statistical , Korea , Semantics , SuicideABSTRACT
The revised Mental Health Act, in which the legal status and role of “the committee for the appropriateness of hospitalization” as an administrative committee, which has been launched since June 2017, is discussed. The German and British laws were reviewed in comparison with the Korean laws, focusing on the similarities and differences among the laws and which parts require revision. This study reported that patient care should be considered not only from a constitutional point of view, but also from a health care point of view. Self-determination and medical paternalism are both important but generally incompatible values. In recent days, objective and fair diagnosis from medical experts have been challenging. The current Mental Health Act was inevitably revised to actively accept the decisions of the Constitutional Court and apparently guarantee the basic rights of people in the future. The pros and cons of “the committee for the appropriateness of hospitalization” and which parts need to be revised to perform its role properly as a guardian of the admission procedure are assessed. This should reflect the current reality of the mental health medical community. In addition, a face-to-face examination should be made in principle. Nevertheless, the basic rights of the mentally ill are not guaranteed based on current law because of the shortage of budget and human resources. The final option maybe the introduction of a judicial system on involuntary admission. Legitimacy and professionalism are engagements that should be adhered to when treating psychiatric patients.
Subject(s)
Humans , Budgets , Delivery of Health Care , Diagnosis , Hospitalization , Illegitimacy , Jurisprudence , Mental Health , Mentally Ill Persons , Paternalism , Patient Care , ProfessionalismABSTRACT
BACKGROUND: Few studies have examined the association between childhood bullying and adulthood mental disorders based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. We investigated the association of childhood peer bullying with Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) psychiatric disorders and suicidality in adults. METHODS: A total of 5,102 respondents aged 18 or over completed the Korean version of the Composite International Diagnostic Interview for DSM-IV psychiatric disorders and a questionnaire for suicidal ideas, plans, and attempts. We evaluated peer bullying using an item in the Adverse Childhood Experiences International Questionnaire. Logistic regression analyses were used to identify the association between victimization of peer bullying, adult psychiatric disorders, and suicidality. RESULTS: Around 8.8% of the general population in Korea reported the experience of being bullied when growing up. Bullying experience was associated with an increase in the adulthood prevalence of nicotine use disorders (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.75–3.49), alcohol use disorders (aOR, 1.93; 95% CI, 1.49–2.51), mood disorders (aOR, 4.23; 95% CI, 3.01–5.94), and anxiety disorders (aOR, 2.89; 95% CI, 1.89–4.43) after adjusting for sociodemographic variables. Among anxiety disorders, the OR for post-traumatic stress disorder (aOR, 9.95; 95% CI, 5.62–17.63) was notably high. Frequent victimization (many times) was significantly associated with suicidality even after adjusting for sociodemographic variables and lifetime prevalence of psychiatric disorders, whereas occasional victimization (once or a few times) was not. CONCLUSION: Childhood bullying experience was associated with adult psychiatric disorders and suicidality. The findings indicated the importance of the early detection and management of childhood peer bullying to reduce detrimental adulthood consequences.
Subject(s)
Adult , Humans , Anxiety Disorders , Bullying , Crime Victims , Cross-Sectional Studies , Diagnostic and Statistical Manual of Mental Disorders , Korea , Logistic Models , Mental Disorders , Mood Disorders , Odds Ratio , Prevalence , Stress Disorders, Post-Traumatic , Suicide , Surveys and Questionnaires , Tobacco Use DisorderABSTRACT
BACKGROUND/AIMS: Little evidence is available about the effect of change in nonalcoholic fatty liver disease (NAFLD) status on risk of diabetes mellitus (DM) development. In this study, we tried to analyze the DM risk according to change in NAFLD status over time. METHODS: Among a total of 10,141 individuals for whom routine healthcare assessment was performed, 2,726 subjects were selected according to the inclusion/exclusion criteria. NAFLD status change was determined by using serial abdominal ultrasonography and fatty liver index (FLI) during the follow-up period. RESULTS: Subjects were categorized according to change in NAFLD status as follows: 670 subjects in the persistent NAFLD group, 155 subjects in the resolved NAFLD group, 498 subjects in the incident NAFLD group, and 1,403 subjects in the no NAFLD group. Multivariate Cox regression analysis revealed that incident NAFLD (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.08 to 3.50; p=0.026) and persistent NAFLD (HR, 3.59; 95% CI, 2.05 to 6.27; p<0.001) were independent risk factors for predicting DM development, whereas the risk with resolved NAFLD was not significantly different from that with no NAFLD. FLI could reproduce the results acquired by ultrasonography. CONCLUSIONS: This study demonstrated that future DM risk could be influenced by changes in NAFLD status over time. Resolution of NAFLD could reduce the risk of future DM development, while the development of new NAFLD could increase the risk of DM development.
Subject(s)
Delivery of Health Care , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Fatty Liver , Follow-Up Studies , Non-alcoholic Fatty Liver Disease , Obesity , Risk Factors , UltrasonographyABSTRACT
Suicide is a serious problem worldwide, especially in Korea, but the factors affecting suicide are complex and diverse. Therefore, a medical policy should be developed to help establish an effective national suicide prevention policy in Korea. To reduce suicide rates effectively, some of the current suicide prevention policies need to be improved. This study proposes the following steps to do so: 1) standardizing the suicide attempt management system, 2) strengthening effective counseling programs in the psychiatric field, and 3) strengthening early psychiatric interventions in patients with a physical illness. These improvements should be considered high-priority measures for ensuring successful suicide prevention at the national level.
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OBJECTIVES: This study investigates the relationships between soldiers' social relations, stress, and depressive symptoms. We also investigated the effect of previous suicide-related behaviors on their correlations. METHODS: This study was conducted on a total of 1000 soldiers. Study subjects were tested using clinical scales including the Korean Mini-International Neuropsychiatric Interview, the Center for Epidemiological Studies for Depression Scale, the Worker's Stress Response Inventory and the Lubbens Social Network Scale-6. Sociodemographic characteristics and history of suicide-related behaviors were also examined. In order to investigate the relationships between stress, depression, and social relations in groups with and without a history of suicide-related behavior, one-way correlation analysis was performed. RESULTS: Depressive symptoms and stress were positively correlated when sociodemographic factors are controlled, regardless of past history of suicide-related behaviors. Depressive symptoms and social relations showed a weak negative correlation. Furthermore, stress and social relations showed a weak negative correlation. When the stress response was additionally controlled, there was no significant correlation between depressive symptoms and social relations. There was a stronger correlation between the group with a history of suicide-related behavior and the group without suicide - related behavior. CONCLUSION: There was a significant positive correlation between depressive symptoms and stress, and this correlation was greater in patients with a history of suicidal behavior than in those without prior suicidal behavior. In addition, social relations did not directly affect depressive symptoms but was found to mediate stress indirectly.
Subject(s)
Humans , Depression , Epidemiologic Studies , Military Personnel , Suicide , Weights and MeasuresABSTRACT
The Korean Mental Health Act has been radically reformed recently in order to improve psychiatric patients' human rights by regulating the compulsory admission process. However, the expert group brought up questions about difficulties in practice and incoherence in its philosophy before the Act was implemented. There are already discussions concerning the next revision of the Act. In such a situation, lessons can be learned from the experiences of other countries. Articles on psychiatric compulsory admission were comprehensively reviewed with the focus on legal criteria, and found that current trends worldwide include a move towards broad diagnostic criteria, use of capacity and treatability test, and treatment in the interest of health rather than safety. In addition, we introduce the Whittington scale, an assessment tool for the appropriateness of hospitalization used in the Connecticut Mental Health Center, US, as a reference for the similar procedure being implemented soon in Korea.
Subject(s)
Connecticut , Dangerous Behavior , Hospitalization , Human Rights , Korea , Mental Disorders , Mental Health , PhilosophyABSTRACT
The Korean Mental Health Act, enacted in 1995, was entirely amended 20 years later and the amendment was passed by the National Assembly plenary session on May 19. 2015. The amended Mental Health Act reflects the recent rapid changes in the mental health environment and contributes one more step toward securing human rights for people with mental illness. However, after review of some major issues, it is doubtful whether there was sufficient discussion on the national mental health policy and whether a national consensus was obtained. This paper describes some problems within the amended Act and discusses several ways to improve the Act. Patients' autonomy and medical paternalism are typical major concerns in the field of medical ethics. Especially for patients with mental illness, it is difficult to maintain a balance between those two concerns because there is often an inability to assign responsibility for those concerns. Therefore, a revised Act should take into account these two concerns. When creating subordinate legislation ahead of the enactment of the amendments on May 30, 2016, establishment of a more reasonable and efficient system is expected ; if there has been sufficient discussion with related organizations and professionals and sufficient consideration of the realities of various medical fields. Such expectations should improve public mental health welfare.