Psychiatric health risks in North Korean refugee youths tend to be higher than those of South Korean youths, according to recent research by Kyung Hee University Hospital at Gangdong (KHUHG) Professor Hong Min-ha’s team. The team’s results, titled “Psychiatric Health Risks in North Korean Refugee Youths Resettled in South Korea,” were published in the May 2025 issue of the international medical journal JAMA Network Open and further spotlighted by various news outlets late August.

Mental Health Concerns of North Korean Refugee Youths

Previous research, such as Prof. Hong’s 2022 joint research on “Assessing Mental Illness Risk Among North Korean Refugees and Immigrants Resettled in South Korea,” have revealed increased mental health risks among adult North Korean refugees compared to South Koreans. The May 2025 study was an extension of these past results and went deeper by analyzing young North Korean refugees aged 1 to 18.

In their latest research, the KHUHG team found that North Korean refugee youth groups are at about 1.3 times greater risk than those of South Korean peers in overall mental health issues. The process of escaping the highly censored autocratic country further heightens their vulnerability to mental health issues even after their resettlement in South Korea.

As seen in earlier studies, the May findings revealed substantial gaps between youths from the North and South across various mental health categories, even though the two groups share the same ethnic and cultural backgrounds. Crucially, contrary to the team’s initial hypothesis that this mental health gap would narrow as refugee children spent more years growing up in the South, the disparity persisted. “That is the most crucial finding of this study,” Prof. Hong emphasized.

North Korean Youths: More Vulnerable to Mental Illness

In the study, the team closely compared two sample groups consisting of 1,618 North Korean refugee youths and more than 308,000 South Korean youths, who were matched by sex and age at a ratio of 1 to 10, using the National Health Insurance Service database.

According to the findings, North Korean refugee youths faced a 29% higher overall risk of developing psychiatric disorders. They were particularly vulnerable to conditions such as post-traumatic stress disorder (2.33 times higher than South Koreans), attention-deficit/hyperactivity disorder (1.67 times), bipolar disorder (1.61 times), major depressive disorder (1.53 times), and anxiety (1.25 times).

Time-stratified analyses showed that the higher risk was evident across all periods — from the first two years after resettlement to beyond the 10-year mark. Notably, the hazard ratio for mental illness remained significantly high throughout, suggesting that early-life hardships and migration stress have left long-lasting scars on mental health.

Significance of the Study

The team’s research is significant, as it was the first nationwide cohort study to track the mental health risks of North Korean refugee children and adolescents in South Korea. Unlike previous small-scale or regional surveys, the study provides population-level evidence, making it a landmark contribution in understanding the underlying psychiatric challenges faced by refugee youths. The findings also underscore the urgent need for long-term structural support and provide crucial evidence for shaping mental health policies tailored to refugee youths in South Korea.

Prof. Hong emphasized that while the findings highlight psychiatric risks, the broader significance lies in how society responds. “A truly mature society is one that pays attention to its minorities,” Hong said, stressing that sustained interest in refugee and multicultural families will be vital for building an inclusive future.

Prof. Hong Min-ha

Photo: KHUHG (khnmc.or.kr)

She also noted that future research should explore the underlying causes of these risks and the long-term effects of resettlement, with a goal to develop more effective support. According to Hong, the study’s results are not only relevant to psychiatry but also carry implications for broader fields such as public health, education, and social policy, providing a basis for practical measures to better integrate refugee youths into South Korean society.

The study provides crucial evidence that North Korean refugee youths remain significantly more vulnerable to mental health disorders than South Korean peers, even after years of resettlement. The study's broader significance lies in guiding the development of sustainable mental health policies and support systems that go beyond temporary aid. The findings are expected to inform not only psychiatry but also public health, education, and social welfare strategies, offering a foundation for creating a more inclusive society.