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How a TV drama is helping address South Korea's mental health crisis

Hit series sheds light on the elephant in the room

| South Korea
Myeongdong shopping district in Seoul: the country is far from ready for a serious discussion about the wrenching topic.   © Reuters

Daphne K. Lee is a journalist based in Taipei and New York City. She mainly writes about human rights, film and culture. Her work has appeared in Goldthread, Popula and The News Lens.

One way to tackle a taboo topic in South Korea is to package it in a television drama series. A good example is this year's hit K-drama It's Okay to Not Be Okay aired by South Korean channel TVN and Netflix, which approaches difficult conversations about mental health with a dark twist on fairy tales.

The story, which follows a typical romance plot intertwined with a murder mystery, owes much of its success to its compelling character arcs. Actress Seo Ye-ji plays an unlikely heroine: Ko Mun-yeong, a children's book author grappling with an anti-social personality disorder whose fairy tales are cruel and gruesome, often featuring zombies and characters without limbs.

Ko develops a quick obsession with Moon Gang-tae, played by Kim Soo-hyun, a caregiver who buries his emotions to better care for his older brother. The three share a journey of personal growth and healing while challenging what it means to be normal.

As suggested by the title, the series attempts to humanize mental illness and, to borrow Director Park Shin-woo's words, show that "all of us are crazy in one way or another." Beyond trying to give ordinary people the courage to admit and overcome their emotional weaknesses, the show sheds light on the elephant in the room: South Korea's mental health crisis.

Take actor Oh Jung-se, who has been praised for his powerful performance as a gifted illustrator diagnosed with autism. In the early days of filming, Oh said he was playing someone "suffering" from autism. He later admitted to having misinterpreted autism as an illness, reflecting the wider misunderstanding of autism among South Koreans.

According to a 2011 study conducted by the Yale Child Study Center, there is a surprisingly high rate of autism prevalence in South Korea. The research revealed that 2.64%, or one out of every 38 children in the country may have autism, more than the previous estimate of 1%. The numbers did not mean that there had been a sudden surge in autism, more that it had been underdiagnosed or undetected. Nearly two-thirds of untreated cases were found in regular schools without special education tailored to autistic students.

In It's Okay to Not Be Okay, Oh's character is bullied in school and at social events where people mistake his erratic social behavior and overexcitement as a threat. This highlights that since autism exists across a wide spectrum that affects communication skills and motor functions, early diagnosis can prove difficult for most people.

The social stigma attached to autism can also discourage families from seeking help. Parents might instead blame their children for underperforming in school, or refuse to acknowledge potential mental health issues. Intense competition for top schools and good employment opportunities in South Korea have also encouraged too much focus on climbing the career ladder. Those who struggle to achieve within South Korea's traditional framework can easily be labeled as weaklings or even failures.

Parents pray for their children's success in the Scholastic Aptitude Test at the Jogye Temple in Seoul in November 2017.   © AP

And while South Korea possesses world-class universal health care, the country's mental health services lag behind the times. Nearly 68% of all mental health facilities and institutions are hospitals, indicating that patients with mental disorders tend to be institutionalized instead of receiving regular counseling at a community level.

This phenomenon is reflected in several side storylines of It's Okay to Not Be Okay, in which psychiatric patients are depicted as having a hard time returning to the outside world. One is a Vietnam War veteran who suffers from post-traumatic stress disorder and who feels incapable of leaving hospital for more than a few hours at a time.

The show's psychiatric hospital, with its panoramic ocean view, seems more fantasy than reality. South Korea's reliance on housing people in substandard mental health facilities people leaves many patients feeling isolated from society. The coronavirus pandemic has added to the dangers of being hospitalized, with one psychiatric ward locked down in February without proper ventilation deemed "a medical disaster."

In South Korea nearly 38 people kill themselves every day, a daunting suicide rate that remains one the highest among the Organization for Economic Cooperation and Development's 37-member countries. With so many people taking their own lives, it is almost as if suicide has become an accepted reality.

Health officials are trying to mitigate the mental health crisis with more services such as 24-hour counseling made available through local welfare centers. Still, authorities are facing increased criticism for neglecting underlying social problems including isolation, loss of community support, and feelings of shame.

South Korea's entertainment industry, in spite of its toxicity, wields enormous power that often ignites social changes. While governments struggle to deliver a basic message such as "it's okay to not be okay," the drama itself appeals to a mass audience with its penetrating screenplay and mystical visual storytelling techniques.

It entertains, educates and reinforces a more positive media narrative surrounding mental health. The bad news is that if South Korea's mental health crisis can only be approached from a fairy tale perspective, it suggests the country is still far from ready for even a serious discussion about this wrenching topic, let alone bringing about real change in how mental illness is treated. Generating buzz is only the first step to curing a collective stigma.

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