Mental Health, Aging and the Aged in Korean Culture

Conference held at Belmont Center for Comprehensive Treatment on October 6, 2004

New Directions in Geriatric Behavioral Health: Serving Older Persons of Different Cultures The Mental Health Association of Southeastern Pennsylvania

Yeon Kyung Chee, Ph.D.
Center for Applied Research on Aging and Health
Thomas Jefferson University

[Slides used during presentation]

Korean Older Adults

• Korean Population in the US
  • Immigration opened in 1903
  • 798,849 in 1990;
  • 1,228,427 in 2000(54% increase)
  • 4th largest Asian group

• Koreans Elders
  • Increasing by 309% from 1980 to 1990
  • 3rd largest older Asian group in Philadelphia
  • Average 74 years old
  • 91% foreign born: "Followers of Children"
  • 50% high school+; $20,000 income/yr
  • 22% living alone

Shin,Shin, & Blanchette (2001); Sohn (2004); US Census (2000)

Views on Aging

• High regard for filial piety
  • Expressions of elder respect:
  • Giving care/service
  • Obeying orders
  • Seeking advice
  • Giving precedence
  • Bowing
  • Respecting elders in public
  • Using honorific language
  • Giving gifts
  • Serving choice foods
  • Showing polite manners
  • Celebrating birthdays
  • Furnishing seat/place
  • Worshipping ancestors
  • Holding funeral rite
• Family cohesion and interdependence
  • Favor support by the eldest son & daughter-in-law (43%); spouse (31%)
• Positive emotions and being active lead to longevity
• End-of-life issues:
  • Prefer to die at home
  • Customs of burial and visiting tombs: Maintaining a sense of family unity

Chee (2000); Park et al. (2004); Rhee, 1994; Shin, Shin, & Blanchette (2001)

Psychiatric Disorders in Korean Elders

• Generally low lifetime prevalence of mental disorders
• High prevalence among men:
  • Alcohol abuse and dependence
• High prevalence among women:
  • Anxiety disorder
  • Affective disorder
  • Phobia

Yamamoto, Rhee, & Chang (1994)

Culture Specific Conceptualization of Depression

• Folk illness: Hwabyung
  • DSM IV definition - a Korean syndrome of anger and resentment
• Interpretations of illness
  • Growing old
  • Character related
  • Emotional distress, (e.g., loneliness)
  • Inferiority
• Assessment of depressive symptoms
  • Need of culture fair measurements and diagnostic tools

Noh, Avison, Kaspar (1992); Pang (1998)

Utilization of Health Care

• 21% of Korean elders uninsured
• Limited use of US health care system:
  • Language problems
  • Cultural barrier (values, preferences)
  • Unfamiliar systems
  • Unfamiliar food (inpatient care)
• Most visit with clinician of Korean ethnicity
• Preference for family caregiving to institutionalization:
• Stigma of non-filial children

Chee, & Levkoff (2001); Shin, Shin, & Blanchette (2001)

Mental Health Services Needs

• 35% felt "moderate to a lot of" stress
  • Self-care
  • Turn to spouse/family, friends
  • Religious leaders
  • Biomedical treatment
  • Alternative medicine

Pang (1998, 2000); Shin, Shin, & Blanchette (2001); Sohn (2004)

Summary

• Need mutual understandings of cultures
• Bilingual and bicultural health services
• Education and prevention
• Social networking and support
  • Access to information and resources
  • Establish ties to Korean social, medical services, and religious institutions

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