Skype therapy? South Korea’s lack of mental health help forces stressed out foreign students to seek it online

When 25-year-old Martyna Posluszna first moved to Seoul from her native Poland last year, she thought she would feel right at home. She quickly made friends and even found herself a Korean boyfriend. But 12 months in to her two-year masters programme at Yonsei University, one of the most prestigious in South Korea, struggles adapting to life in the country provoked a panic attack that landed Posluszna in a private hospital. She was diagnosed with anxiety, and was charged US$800 for a half-day as an inpatient. Worried about having another attack, she decided to seek regular counselling through a private therapist. But she struggled to find one who spoke English, and the ones who did were more interested in prescribing her medication, which she did not want. A single session also set her back about 90,000 won (US$75), which she found to be prohibitively expensive. So the international trade and finance student decided to turn to the internet for help, and ultimately found herself an online therapist. Sessions with this professional psychologist, conducted using software such as Skype, are priced at about US$40 per one-hour session. She has had six so far – one a week for the past six weeks – and said the therapy “definitely helps”. “I find it oddly satisfying,” she said. “It does give you way more freedom.” South Korea develops smartphone app to curb student suicide Posluszna’s experience highlights the lack of options for many in South Korea when tackling mental health issues. Across the country’s more than 200 universities, options for treatment and education vary widely. “There are strong stigmas towards mental health in Korea, and it is one reason people are not getting psychological help at the initial stage of the problem, possibly contributing to the extremely high rate of suicide,” said Dr Jeanyung Chey, a professor of clinical psychology at Seoul National University. South Korea has some of the highest suicide rates of any developed country – second only to Lithuania among members of the Organisation for Economic Cooperation and Development. In 2016, suicide was the leading cause of death for those aged between nine and 24 in the country, according to local media. The reason for this is unclear, though deaths have been linked to the competitiveness of South Korean society, where young people are pressured to succeed academically and mental health problems have long been stigmatised. Chey said that many of the country’s misconceptions about mental health stem from a lack of education on the subject in most high schools and universities. And as record numbers of foreign students move there to study – 142,205 last year, compared to just 12,000 in 2003, according to the National Institute for International Education – the country’s reluctance to engage with mental health issues is beginning to affect them, too. Especially in an education system that values obedience over curiosity, where professors can often come across as domineering and are not used to being questioned. K-beauty: the ugly face of South Korea’s obsession with women looking forever flawless One 29-year-old from Latin America, who did not want to be named, said that her university in Seoul had been keen to accept foreign students, but subsequently made little effort to integrate them. “I don’t think my international approach was ever really appreciated in classes, group projects, or lab projects,” she said. At a friend’s recommendation, she had signed up for online therapy before moving to South Korea, having been made aware of the difficulties she would face adjusting to academic life in the country and overcoming the various cultural challenges there. Foreigners who are employed in South Korea face even greater stresses when trying to seek help because of concerns about losing their jobs or work visas if their employers find out, according to Dr Chad Ebesutani, a psychologist from Hawaii who counsels mostly English speakers at his clinic in Seoul. He said part of his job involves simply convincing clients that their information will remain confidential. “There are limited English-speaking, Western-trained therapists in Korea,” he said. “The online movement is a growing movement, I don’t think it’s going to stop.” On university campuses, however, the situation may be improving thanks to the increasing demand for counselling services, according to Seoul National University’s Chey. Several top-tier universities now offer free counselling services in both Korean and English, but awareness campaigns are often lacking, and programmes can vary greatly from school to school. Posluszna said one of the first things she did after enrolling at Yonsei was to approach the student leadership about counselling services, but she was met with mostly blank stares. “It’s not the student’s fault, it goes higher. It’s because those facilities aren’t made known to everyone,” she said. Another student at Yonsei who asked to remain anonymous said she had no idea her school offered English counselling services until she too suffered from panic attacks. “They don’t advertise that, it’s not known. With something as delicate as mental health, you have to look into it by yourself,” she said. From July 16, all foreigners – including students – who stay in South Korea for longer than six months will be compelled by law to join the state health insurance system. Most foreign students currently pay about 100,000 won (US$84) a year for private health insurance, according to Yonhap news agency. State health insurance premiums are about 678,000 won (US$567) a year, and do not cover consultations with a mental health professional.