hospitalizations (a higher number of hospitalizations was observed in Korea), patients’
social functioning and care needs (Japanese patients had poorer functioning and required
more care), optimal social involvement (the highest level of social involvement was
observed in Korea), and an alternative caregiver in the family (fewer among families in
Korea). Therefore, although Korean patients have a higher level of social functioning and
social involvement, they also experience more hospital admissions. The results regarding
coping strategies also suggest that patient social involvement with family is better in Korean
families and that there are more strategies for coping with “patients’ social involvement” in
Korea. In contrast, although the overall scores for personal stigma were worse for Korean
families, the personal stigma score for “If I had a problem like John’s, I would not tell
anyone” was worse for Japanese families. Thus, Japanese families of patients with
schizophrenia would be more likely to hide their own mental illness from others, compared
to Korean families. This likelihood is correlated with their high degree of “resignation” as a
family coping strategy. Conversely, Korean families would be more likely to hide their
mental illness through “avoidance” of a family member with schizophrenia.
These findings are in agreement with the cognitive and behavioral characteristics observed
in cross-cultural qualitative studies that have explored the mental health beliefs and helpseeking
attitudes of Korean-American parents of children with schizophrenia (Donnely,
2005). In the traditional Korean culture, a marriage signifies the union of two families rather
than two individuals. Therefore, families of patients with mental illness worry about the
marriage prospects for their other children if one child has a mental disorder. Furthermore,
it has been reported that Korean families with children with mental disorders even object to
visits by researchers. They fear that neighbors might recognize the investigators, thus
revealing their child’s mental disorder (Donnely, 2005). Family shame could be explained by
the Confucian concept of filial piety, which states that no person should bring dishonor to
the family (Sung, 1992). Children with schizophrenia are incapable of following the
principles of filial piety, thus risking shame and violating traditional Korean beliefs
(Donnely, 2005).
The results of the present correlation analysis demonstrated many differences between
Japan and Korea in terms of factors that affect personal stigma and coping strategies. In
particular, it is interesting to note that “coercion” and “avoidance” as family coping
strategies were correlated with many aspects of personal stigma in Korea, but these
strategies were not correlated with personal stigma in Japan. In contrast, the idea that “it is
best to avoid people with a problem like John’s” was correlated with almost all factors of
coping in Korea.