Unification Media Group (UMG): Temporary psychiatric facilities have reportedly been established in South Pyongan Province due to a recent rise in schizophrenia cases in the region. The temporary facilities have been built to quarantine and treat patients, who during tough economic times have become addicted to recreational drugs, and are doing things like setting fire to their own homes and damaging public property. Reporter Seol is here to tell us more about these developments.
Seol Song Ah (Seol): The rise of marketization has increased consumerism within the North Korean population. This has gradually increased over the years, but now the situation has taken a turn for the worse. Harsher sanctions imposed on North Korea have thrown the markets into disarray, while the North Korean authorities continue to collect unreasonably high taxes in parallel. The competition for economic survival has intensified, leading to a highly stressful environment. Victims are becoming increasingly dependent on alcohol and illicit drugs, and this is being reflected in a recent rise in the number of patients suffering from schizophrenia and psychosis.
In response, the North Korean authorities have established a rehab clinic in South Pyongan Province to combat the issue. All “diagnosed” patients are forcibly sent to the clinic, mostly by their families, and are subject to Electroconvulsive therapy (ECT). The authorities collect treatment fees in return. Following a successful rehabilitation, patients are subject to a police interrogation about the source of their drugs. This interrogation can become a new source of stress and there have been some cases where it triggered a relapse.
On today’s program, I would like to share some stories from across the country illustrating the spread of mental illness in North Korean society as a side of effect of marketization.
UMG: I was told that every region in North Korea had a psychiatric hospital. What are the differences between existing hospitals and the newly constructed facility?
Seol: Every North Korean province has a “No. 49 hospital,” and larger cities have their own hospitals for the area. The government previously introduced Article 49 (giving the hospitals their name), a law ordering the detainment of patients with mental illnesses, back in 1965. These hospitals are officially registered with the state, but the facilities are more like detention centers than hospitals, and they’re located away from civilian areas. The “No.49 hospital” in South Pyongan Province is located in Yangduk county, an area famous for its deep forests.
Treatments are free in name only. Most patients are sent with the family’s consent and suffer from hereditary conditions. The rate of successful reintegration back into society is known to be less than 10%, and former patients are readmitted if they relapse.
On the other hand, the new psychiatric facility built in South Pyongan two years ago is being called the “addiction relief hospital’ and is operating temporarily. It was built in response to public disturbances caused by addicts under the influence of illicit drugs. Patients caught committing arson or damaging public property are forcibly admitted into the hospital by their respective local governments.
UMG: One may interpret the installation of the temporary facility as a response to these particular incidents. What kind of treatment do the patients receive, and how long are they treated for?
Seol: They primarily receive ECT. Depending on the symptoms, patients are also sometimes medicated with drugs. The regular treatment period is one month, and the family has to foot the bill. The contradiction of North Korea’s “universal free healthcare” also becomes apparent here. However, the rate of successful recovery has been claimed at over 50% at this hospital, according to our South Pyongan sources.
The real issue at hand is the increasing number of patients. North Korea doesn’t have a national budget, like South Korea, to tackle the issue through a systematic approach. There are no mental health clinics or counseling offices, which is not a good environment for mental health in general. Counseling services would at least offer alternatives to cope with mental stress, but people are told to endure their pain and “just believe in the Supreme Leader (Kim Jong Un) and everything will be fine”. So people are naturally turning to drugs to relieve their anger and distress.
One South Pyongan source recently told Daily NK that the number of philopon (methamphetamine) users is continuously rising, and went on to say that “the biggest problem is that most residents don’t understand that even a small dosage, over a period of time, can trigger symptoms of schizophrenia. They don’t have a grasp of the extent of their dependence.”
UMG: It sounds like patients admitted to this hospital are severe cases.
Seol: Our sources told us that 90% of the patients are drug addicts with higher potential for abuse and approximately 9% show signs of alcohol dependence. There are cases where first time users of methamphetamine are also showing signs of schizophrenia.
In July, for example, a businessman in Songchon County smoked ice (methamphetamine) for a whole month after his business failed, and later set his whole house on fire, which spread and also burnt down his neighbor’s house. There are other cases where people are setting fire to public buildings or their own homes and some end up dying in the fire.
“Ms. Park, a women in her 40s, was a well known donju (the nouveau-riche of North Korea) in Seoksu-dong, Sunchon City. But she began to develop a meth habit following a downturn in her business. One day, she suddenly began smashing her refrigerator and TV with an axe and broke all the glass windows on her apartment balcony,” one source in South Pyongan Province said.
She then briefly regained composure and was about to jump out the window and commit suicide, but fortunately her husband grabbed her in the nick of time. Someone rang the hospital, and she was released after receiving ECT for two months. It seems she hasn’t been able to lead a normal life since and continues to use the substance.
UMG: It’s such an unfortunate state of affairs. Going back to the hospital, where is it located?
Seol: Unlike the “No. 49 Hospital,” this facility is located in the center of the city. It‘s being run in a government-owned building in Kangpo-dong, Sunchon City in South Pyongan Province, on the way to Ryongbong-ri. Due to the number of patients causing social and public incidents, the facility is seen as a quick solution to prevent further damage.
UMG: Are minors also being admitted into the facility?
Seol: There was a case involving a 17-year-old from Pyongsong City. Kim Jong Suk Middle School No. 1 is situated just outside the entrance to downtown Pyongsong. A new apartment building was constructed near the school around three years ago. A gold mine site manager from North Pyongan Province moved into the new apartment with his son and daughter, and led a peaceful life until his son became addicted to meth. They say that he would often threaten his mother with a kitchen knife for money. Which ultimately ended up with him attacking her.
The parents, after much discussion, sent him to the facility. Minors can only be admitted with their parent’s consent.
UMG: Earlier you mentioned that fully-recovered patients are interrogated by the state police. Could you tell us more about this?
Seol: The police classify recovered patients as drug addicts. These patients, although they’re willful arsonists, can’t be arrested at the scene of the crime due to their mental illness. However, they are deemed to be normal after they’re discharged from hospital. So then they’re immediately sent to the police for questioning. The primary goal is to identify their source of drugs. A source with knowledge of the situation said this can cause additional stress for the patients, causing them to relapse and be readmitted.
“Consumption levels are rising, but the lack of jobs and rise in taxes is playing on the minds of most residents. If the authorities don’t set out a plan to counter this, there will be more mental health issues in the future,” he explained.
It is not yet known whether similar temporary facilities have been established across the country or only in South Pyongan Province.