

By Lee Kyung-min

A woman surnamed Ahn, 34, was admitted to a mental hospital in Gyeonggi Province in 2006 and stayed there for eight years until 2014.

"One day, when I was in my dormitory near my work, I heard my mother's voice, calling me to come home," Ahn said. "I rushed home and asked my mom about it. But she said, with a worried look on her face, she did not call me."

Ahn and her mother went to a psychiatric hospital and a doctor diagnosed her with schizophrenia, symptoms of which include auditory hallucinations, saying she needed immediate hospitalization.

"There was nothing I could do. All I remember was how embarrassed, ashamed and guilty my mom looked in front of the doctor. I didn't want my mom being that way to another person because of me."

At the confinement facility that housed about 100 women, all she hoped for was to go outside to see the sunlight, to leave just for a short while from behind the cold, rusty iron bars.

"Patients were allowed outdoors once in a while, only the well-behaved ones. We would go outside for about an hour near the mountain and have fresh air."

Her symptoms soon subsided after taking medication, but the hospital did not discharge her.

She was among many patients that had simply no idea what to do to get out, and became worried about what to do after getting out and surviving with the harshest social stigma associated with mental disorder patients.

Out of about 100 patients there, Ahn thought, two-thirds were like her, who either no longer had symptoms or whose symptoms were manageable with medication, and would have no major difficulty maintaining a "normal" life outside the facility.

"I wished there had been another doctor that I could get a second opinion from. Who knows? I might not have been there wasting what could have been the most beautiful years of my young adult life."

Such unfortunate instances like hers will occur considerably less, according to the Ministry of Health and Welfare.

Under the revised health law that took effect today, a doctor can order an involuntary commitment of a suspected patient for only up to 14 days for further diagnosis with the consent of the patient's legal guardians. Up to three months of hospitalization is allowed only after another doctor at a separate state-run hospital agrees with the detention.

Starting next May, the hospital must submit a report to a special committee within three days of admitting a patient. The committee, comprised of up to 30 members with expertise in psychiatry, law and human rights, as well as recovered mental patients, will determine whether the patient needs hospitalization and notify the hospital of assessment results within 30 days. If the committee decides against hospitalization, the patient must be released.

Such measures are a drastic change from the earlier law that allowed a doctor, without a second opinion, to hospitalize a patient for up to six months with the consent of the patient's legal guardians. The earlier law stipulated the stay be renewed every six months, but the revised law makes it every three months with the agreement of two doctors on the diagnosis.

Seoul National University neuropsychiatrist Chung Dong-chun said the biggest misconception about mental disorders such as schizophrenia is that it requires permanent seclusion from society.

When under stress, schizophrenia patients and those at risk of the disease release more dopamine, a compound present in the body as a neurotransmitter, which can in turn disrupt brain activity, resulting in visual, auditory or tactile hallucinations. It could be chronic but is a manageable disease.

"Take diabetes patients, for example. They have to watch what they eat, exercise, check blood sugar levels and take medication, every single day. That is not so different from what some of the mental patients have to go through."

Contrary to popular belief, many mental patients are not violent, according to Song Seung-yeon, 34, an activist and mental health social worker.

"The public perception of mental patients is extremely distorted and is similar to those depicted in the 1975 movie One Flew Over the Cuckoo's Nest starring Jack Nicholson, which is not entirely a fair or accurate description of the facility."

Of course there are those with severe illness that need confinement, but not as many as the patients held in psychiatric wards in Korea, he added.

According to data by the National Center for Mental Health, the number of patients hospitalized for mental disorders is on a steady rise with 72,325 in 2008, 75,282 in 2010, 80,569 in 2012, and 81,625 in 2014.

This is in stark contrast to the numbers in the U.S. Germany, Italy and Sweden, all of which after 2000 have been on the decline, according to the data.

According to 2013 data by the OECD on the length of stay for mental and behavioral disorders, patients in Korea were kept almost 120 days, almost twice as long as the next country in the rank _ Israel with less than 60 days. The OECD average hovered around 20 days.

Such a figure is inevitable given that more than 90 percent of psychiatric hospitals are private-run, with their profits relying heavily on the number of patients and length of their stays.

Song said, "Hospitals are profit-oriented institutions. With doctors' income directly on the line, would they be able to truly put the patients' will and well-being before protecting their self interest?"

Patients have long been silenced, he continued, when they are directly affected by the doctors' decision and government policies.

"Doctors should reflect whether they have truly considered patients' rights to remain free. Rather than labeling them as objects requiring treatment under strict confinement, I urge them to think what would happen to the patients afterwards," he said.

In most developed countries, involuntary admission is determined by at least two physicians or by a court, a disinterested party to hospital business.

"For a patient to be admitted involuntarily, a court order is needed in the U.S., France and Germany while Australia, Taiwan and Japan require determination of an independent body," a health ministry official said.

According to Kim Min, an official at Korean Disabled People's Development Institute, a similar law on the mental health system including psychiatric patients' treatment was first enacted in the U.S. in 1946 and revised in 1963 and 1980.

"The U.S. increased support for housing and helped the patients better resettle in their communities. Rather than confining patients in a ward, patients are encouraged to manage their diseases in far less restraining environments."