Ask a North Korean: how do you treat mental illness?

Many North Koreans have mental health problems but I did not realise you could see a psychiatrist before coming to South Korea. I hadn’t even heard the word “psychiatrist”.

Because counsellors and psychotherapists also do not exist in North Korea, people have to deal with emotional problems with the help of their families and friends, or on their own.

There are some psychiatric institutions where people designated mentally ill are locked up. They are called “Number 49 hospitals” – I’m not sure why, but that’s what people call them.

They tend to be found deep in the mountains, far away from where people live. I’m not sure how patients are looked after, or who is in charge of Number 49 hospitals, but they don’t seem related to general hospitals in any way.

You can’t get sent to these institutions without the permission of your family. Because of rumours that patients are beaten and starved by the staff, most families are reluctant to send their loved ones away even if they have problems with their mental health.

Some families do send their relatives away, but in my experience they are unlikely to get better after a stay in hospital. Rather, they return home dejected and worse than before. If a discharged patient is told that they’re going to be sent back to a Number 49 hospital they become terrified. You can only guess how frightening these places must be.

People say that it’s the smart people who become mentally ill. There are ambitious and talented people in North Korean society, but because they are faced with numerous constraints and restrictions they often become deeply frustrated.I did not witness many cases of depression in North Korea, but I did see many disturbed people suffering from hallucinations or nervous breakdowns in my neighbourhood, and they were all smart once.

Many North Koreans think that these problems are caused by a lack of nutrients. People who suffer usually come from low-income households. When they start eating better, they get better, so it’s believed that if you are well fed, mental disorders will go away.

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A version of this article originally appeared on NK News. To submit a question, send it with your name and city to ask@nknews.org