Depression in North Korean refugees: a mixed methods study

• Published in: Public health (London) Vol. 185; pp. 283 - 289
• Main Authors: Han, H.R., Chung, Y., Kim, K., Lee, J.E., Kim, M.T.
• Format: Journal Article
• Language: English
• Published: Houndsmill Elsevier Ltd 01-08-2020; Elsevier Science Ltd
• Subjects: Asian cultural groups; Depression; Educational systems; Emotional disorders; Emotions; Health care; Health services utilization; Help seeking behavior; Interviews; Loneliness; Mental depression; Mental health; Mental health services; Mixed methods; Mixed methods research; Mood; North Korean refugees; Polls & surveys; Qualitative analysis; Qualitative research; Refugees; Research methodology; Self determination; Social interactions; Social support; Support networks; North Korean refugees; Mixed methods; Depression
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2020.05.046

The objective of this study is to investigate beliefs and experiences about depression in North Korean refugees (NKRs) using both quantitative and qualitative methods.
We used an exploratory sequential mixed methods study design with a quantitative survey followed by an in-depth individual interview.
We surveyed 329 NKRs who had been in South Korea for at least a year. Eleven participants were selected from the survey sample to complete an additional individual in-depth interview to obtain further understanding about depression among NKRs in their own words and context.
About 44% of the sample had mild to severe depression; only 16% indicated that they were being treated for mood disorder. Individual in-depth interviews yielded key themes related to NKRs’ depression beliefs and experiences: recognizing depression, factors contributing to depression, overcoming depression, and barriers to seeking help and treatment. Integration of quantitative and qualitative data revealed that although loneliness was one of the prominent subthemes contributing to depression, strong self-determination was noted as being critical to overcoming depression among those who had moderate to moderately severe depression but had no social support.
Future efforts should be directed toward an enhanced support network and targeted education about the South Korean healthcare system, particularly in relation to mental health treatment.
•It is unclear about depression experiences among North Korean refugees (NKRs).•NKRs in South Korea had high levels of depression with limited social support.•In-depth interviews using vignettes offered emic perspectives on depression in NKRs.•Data integration revealed complex interplays between depression and social support.•Future efforts should help NKRs better understand the South Korean health system.