Depression in North Korean refugees: a mixed methods study

Abstract

Objective: The objective of this study is to investigate beliefs and experiences about depression in North Korean refugees (NKRs) using both quantitative and qualitative methods. Study design: We used an exploratory sequential mixed methods study design with a quantitative survey followed by an in-depth individual interview. Methods: 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. Results: 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. Conclusions: 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. (C) 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.