Tragic outcome for psychiatric patient seeking help for diet pill addiction

Tragic outcome for psychiatric patient seeking help for diet pill addiction

When the news broke, I couldn’t ignore it. The deceased young woman was reportedly at the Korean hospital for treatment of a weight loss drug addiction. News portals showed CCTV (closed circuit TV) footage of the woman, where she was forcibly restrained on a bed by hospital staff whose large bodies seemed to engulf her in the cell-like solitary confinement.

She was a bright, well-off woman in her early 30s, educated abroad and working in the fashion industry. Although she had been seeing a psychiatrist as an outpatient at a general hospital, her parents ultimately decided that hospitalisation at a private clinic run by a celebrity doctor would be better for her. But things took a tragic turn. The woman died at the hospital 17 days after admission.

The CCTV footage showed the young woman complaining of severe stomach pain, begging to be released, and eventually being restrained on the bed. On the first day of her hospitalisation, she had a confrontation with a nurse because she refused to change into a patient gown. I wondered if this young woman had been denied therapeutic interventions from the moment of confinement. Her parents fought relentlessly for months to obtain the CCTV footage, eventually taking their case to the media.

At first, I hesitated to get involved, but I couldn’t ignore the first forum on the issue, held at the National Assembly building on the afternoon of Friday, August 23. Earlier that morning, various psychiatric patient organisations that had co-organised the forum gathered in front of the National Assembly for a rally and press conference. But when I arrived in the oppressive heat, I only found a few unimpressive, reactionary campaign trucks and the official guards—nothing else.

The border between patients with and without dignity

Twenty-three years ago, I was hospitalised, but my experience was exceptional—a rare moment in time. An optimistic atmosphere surrounded inpatient programs for eating disorders, leading to the creation of several new facilities, including the one where I was the very first patient. The recently opened inpatient ward was a remodelled private apartment, with the homey atmosphere carefully preserved.

There were no narrow, bureaucratic hallways, solitary confinement rooms, or even a nurse’s station. Instead, there were three ordinary-sized rooms with two or three cosy beds, a family kitchen, and a living room with a home video system. We wore our own clothes, not patient gowns. Instead of security staff, two nurses were on duty with us each day. The one similarity to other hospitals was the psychiatrists’ absence from the ward—they visited once a week, like distant fathers.

The hospital where I was treated was likely a rare case in the history of Korean psychiatry and existed for only four or five years. It catered exclusively to young women suffering from eating disorders, who were seen as not truly insane but intellectual, perhaps stubborn, and certainly vulnerable. The environment was designed from the outset to warmly welcome these young women, treating them not as patients to be managed but as individuals to be cared for.

The most ironic part was that our newly adorned ward had once been the home of an elderly psychiatrist—the entire third floor of his private clinic building. This man, a senior alumnus of the eating disorder ward’s founder, generously moved out to allow his junior colleague to establish the ward in the affluent neighbourhood of Gangnam. Different hospital units occupied the lower floors: the second floor housed the inpatient ward, and the ground floor was the outpatient clinic, both run by the building’s owner, the psychiatrist who had moved out. The lower floors catered to more ‘general’ psychiatric patients, all of whom were, predictably, clad in patient gowns. I imagined those downstairs as inhabiting a sort of purgatory—while the basement kitchen, from which our meals were delivered via a small elevator three times a day, represented hell itself. 

The psychiatrist downstairs was a passionate music lover and an amateur opera singer who held monthly classical music concerts for his patients. As soon as these formal, somewhat dull performances concluded, patients engaged in an off-key celebration to the accompaniment of loud karaoke music. The sounds would reach us upstairs, carried by vibrations through the building.

We used to joke, especially when I hurt myself and disappointed the nurses, that if we caused too much trouble, we would be sent downstairs. It felt like I was standing on a thin line between dignity and the loss of it, saved only by a narrow margin. Upstairs, in our specialised ward, I could leisurely flip through the coffee table books the psychiatrist had brought back as souvenirs from his European tour. 

Witnesses of human rights infringement

As I entered the hall, I picked up a booklet from the desk by the door, walked straight to the front row, and sat. The hall soon began filling, and I noticed several National Assembly members seated together across from the stage. Among them was Ms Nam, a beautiful and charismatic woman who had been a major force in mental health equity issues. I had contacted her before, and she had helped us bring attention to eating disorder issues during last year’s parliamentary inspection of the administration. The other two women were also prominent figures—visually impaired and leading advocates for disability rights.

After the National Assembly members delivered their congratulatory addresses, the first testimony session opened the discussion. Mental health activists with lived experiences recounted their traumatic episodes of forced hospitalisation, where they were isolated and tied to beds for long hours without proper explanation. Among them was the mother of the deceased young woman, fighting to hold back tears as she accused the hospital of malpractice. I sat, unable to move. How could this have happened?

The other activists had been diagnosed with schizophrenia or bipolar disorder, and their most harrowing iatrogenic experiences occurred during acute phases when they were wandering or acting out in public. These episodes often led to their forceful confinement in dubious hospitals. But the bereaved mother’s daughter—a brilliant young woman—might have faced an entirely different situation.

There was a significant class divide between them. Unlike the others, she had access to the most renowned psychiatrists in Korea, and her condition didn’t involve psychosis. She was confident, assertive, and unafraid to demand what she needed. So why couldn’t she find a safe place, as I had 20 years ago? How did she lose her dignity so quickly and absurdly?

The absolute judgment of feudal expertise

Initially, my curiosity concerned how the hospital managed its budget. Specifically, I wondered how much of the National Insurance funds allocated for alcohol addiction treatment were actually invested in specialised care. The news report led me to suspect that the hospital might have failed to deliver on its promised programs, especially those involving specialised therapists for addiction. If so, what was the root cause? Was it driven by the need to keep beds fully occupied for profitability, or was it struggling to hire adequate treatment staff? Why was this young woman confined to a stifling solitary room, tied to a bed, seemingly without receiving adequate medical care, in an urgent situation? Were the expected programs non-existent? If so, why? Most importantly, were staff truly prepared to address weight loss drug addiction, the treatment of which required a different approach to alcohol addiction?

Since the early to mid-2000s, when a few experimental inpatient programs for eating disorders were launched in Seoul but soon disappeared, my understanding is that Korea lacks proper inpatient care for such conditions.

Those early attempts were unsustainable due to several factors:

(1) the National Insurance never covered eating disorder treatments, and it still doesn’t today—after all, eating disorders are often dismissed as mere “women’s whining,” with the pervasive belief that women are naturally unwell;

(2) so we patients were forced to shoulder the entire financial burden; but

(3) despite all that, the wards couldn’t accommodate enough patients to be profitable.

So, when a YouTuber’s personal story about her battle with bulimia went viral—detailing how she was hospitalised but received no specialised care, only being instructed to eat regular meals and nothing more—I was dismayed. Desperate from hunger and the urge to binge, this young woman self-harmed and was eventually discharged. Her story sparked widespread concern and debate, but many reactions were ignorant.

Some people argued that she should have remained in the hospital no matter what, while others suggested her psychiatric issues should have been treated before addressing her disordered eating. The former group seemed unaware that more comprehensive treatment programs for eating disorders could exist beyond simply enforcing meal schedules, while the latter clearly misunderstood eating disorders as complex psychological issues, not mere problems of willpower or lifestyle.

Listen, please listen to the patient

In 2024, if I were to be hospitalised with no option but to enter a general psychiatric inpatient ward, what would my treatment look like? Would I be subjected to the same routine—wearing a patient gown, spending idle hours in bed, receiving three meals daily, and little more? If I refused to comply, expressing my dissatisfaction, would I, too, be forcibly confined, tied to a bed, and neglected?

Human rights lawyers speaking as panellists at the forum revealed that warnings about Korea’s psychiatric system and its malpractice have been issued repeatedly since the 1990s. Yet, here we are in 2024, and the municipal government responsible for overseeing the hospital in question has again concluded that the solitary confinement and restraint procedures did not violate regulatory time limits. They maintained that “the administrative body cannot judge the legality of treatments executed by physicians based on their medical decisions.”

Normalisation of disasters that once preyed on the weak

We are already witnessing the climate crisis and the disasters of the Capitalocene becoming normalised. I never imagined that psychiatric care, too, would deteriorate rather than improve, but that is the reality we face today.

Take eating disorders as an example. In Korea, we still lack a proper psychiatric care system for these conditions, not to mention academic societies, associations, or charitable foundations dedicated to them. Large general hospitals prioritise profits, starting by closing unprofitable pediatric wards. In this environment, expecting specialised care for eating disorder patients seems unrealistic. And what about those suffering from weight loss drug addiction or rapidly proliferating drug addiction? Sadly, they may have no choice but to save themselves like us.

The irony is stark: President Yoon recently announced the Nationwide Mental Health Investment Support Project, aiming to provide counselling service packages to one million people during his term. He stated, “We are enjoying the most prosperous time materially since people have lived on the Korean Peninsula, but many still feel their lives are unfortunate.” But what if this discontent and despair are rational responses rather than signs of weak or undisciplined minds?

The Committee’s first campaign recruited user-generated content to promote messages of love, cheer, and consolation for vulnerable people at risk of suicide. But what about the rapidly deteriorating medical system as a whole or the corruption of society? This situation brings to mind Jenny Diski’s critique of Thrive by Richard Layard and David M. Clark, published in The Guardian 10 years ago.

The authors argued that mental health could be “fixed” through CBT, emphasising its cost-effectiveness for society. However, Diski questioned the oversimplification of complex mental health issues, the focus on individual responsibility over societal factors, and the lack of consideration for the broader social and economic conditions that contribute to mental distress.

Tragic, senseless outcome

A young woman died, tragically and senselessly, much like many vulnerable people who have perished in the shadows of shabby psychiatric hospitals—stripped of dignity, mired in poverty, and battling psychosis.

She sought only to lose some weight, while her parents hoped to speed up her recovery from addiction by enrolling her in a renowned psychiatrist’s inpatient program. Yet the government remains silent, and no one appears willing to take responsibility for this tragedy. But I refuse to stop asking questions.

REFERENCES

[UK] Richard Layard, David M. Clark, Thrive: The Power of Psychological Therapy, Penguin, 2015

[US] Richard Layard, David M. Clark, Thrive: How Better Mental Health Care Transforms Lives and Saves Money, Princeton University Press, 2016