캄보디아인의 집단 외상과 정신건강

이나빈,민정아,채정호,Lee, Nabin,Min, Jung-Ah,Chae, Jeong-Ho 대한불안의학회 2012 대한불안의학회지 Vol.8 No.2

The mass social trauma, such as organized violence, wars, oppression by dictatorships and massive terrorist attacks, exposes thousands of people to trauma in a short period of time. Therefore, the mass social trauma is distinguished from individualized trauma, such as a violent attack, rape or a traffic accident in that it results in multiple and extended consequences beyond the individual. During the Khmer Rouge regime, one quarter of the Cambodian population was killed as a result of malnutrition, forced labor and mass killings. Until now, its evil continues to affect Cambodian's physical and mental health problems. Although there is ongoing debate, to date, no consensus has been reached supporting a clear set of recommendations for the intervention and longitudinal study regarding the influence of killing field massacre being too little. And comparative cultural studies, such as comparing the East to West or other Asian cultures are also lacking. This article gives an overview of previous study results about the mental health of Cambodians, and suggests a possible research issue and therapeutic interventions to determine the impact of mass trauma to the members of society and post-traumatic recovery factors.

Factors Related to Perceptions of Financial Resources for Disaster Mental Health Services in South Korea

이나빈(Nabin Lee),이송은(Songeun Lee),유선영(Seonyoung Yoo),전경선(Kyoungsun Jeon),심민영(Minyoung Sim),이정현(Jung Hyun Lee) 위기관리 이론과 실천 2020 Crisisonomy Vol.16 No.3

본 연구는 재난심리지원 서비스의 재원에 대한 국민들의 인식을 살펴보고, 개인부담과 조세 등 특정재원 선호에 영향을 미치는 변인을 확인하는 것을 목표로 한다. 이를 위해 연령별, 성별, 지역별할당을 적용하여 수집된 2928명의 데이터를 분석하였다. 우선 ‘특정재원 선호 없음’, ‘개인부담 선호’, ‘조세 선호’로 집단 구분 후 교차분석과 다중 로지스틱회귀분석을 실시하여 각 집단에서 연구변인들의 예측력을 확인하였다. 그 결과, ‘특정재원 선호 없음’에 비해 ‘개인부담 선호’집단을 유의하게 예측하는 변인은 성별, 연령, 심리회복에 필요한 기간 인식, 국가의 심리지원 중요성 인식, 서비스 이용에 대한 사회적 낙인이었다. 반면 ‘특정재원 선호 없음’에 비해 ‘조세 선호’집단을 유의하게예측하는 변인은 학력, 경제적 만족도, 정신건강 문제에 대한 외적귀인, 심리회복에 필요한 기간인식, 국가의 심리지원 중요성 인식, 서비스 이용에 대한 자기 및 사회적 낙인이었다. This study examined the factors influencing preferences for financial resources for post-disaster mental health services, such as out-of-pocket payment and tax burden. The data were collected from 2,928 individuals in South Korea who were classified into three groups according to their preference for financial resources: out-of-pocket payment, tax-based financing, or no preference. A logistic regression was performed to assess the predictive power of each variable in each group. The significant psychosocial factors influencing preference for out-of-pocket payment, compared to the no-preference group, included the perception of the time to recover from post-disaster mental health problems, the perception of importance of national support, and public stigma of seeking mental health services. On the other hands, external attribution for mental illness, the perception of the time to recover from post-disaster mental health problems, the perception of importance of national support, and self and public stigma of seeking mental health services significantly predicted the group who preferred tax-based financing.

세월호 참사 후 재난심리지원 실무자들의 경험을 통해 본 국내 재난심리지원체계의 한계 및 개선방안

이나빈(Lee, Nabin),심기선(Sim, Kisun),한상우(Hahn, Sangwoo),이강욱(Lee, Kanguk),심민영(Sim, Minyoung),채정호(Chae, Jeong-Ho),안현의(Ahn, Hyunnie) 한국정신건강사회복지학회 2015 정신보건과 사회사업 Vol.43 No.4

본 연구는 한국의 재난심리지원체계를 개선하기 위해 세월호 참사 관련 심리지원서비스 제공자들의 시각을 통하여 기존 지원체계의 한계와 보완점을 확인하는 것이 목적이다. 이를 위해 세월호 참사 당시 심리지원을 담당했던 기관 중 3개 기관(안산시 정신건강증진센터, 국립서울병원, 안산정신건강트라우마센터)의 실무자 31명을 대상으로 심층면접을 실시하였고, 이를 녹취하여 내용분석하였다. 분석결과, 39개 개념이 도출되었고, 개념들로부터 14개 하위범주가 추출되었으며, 하위범주들은 6개 상위차원으로 기술되었다. 구체적으로 ① 행정체계(관계 부처들)와 수직적 관계에서 경험한 어려움, ② 집행체계 간 수평적 관계에서 경험한 어려움, ③ 실무자가 속한 기관에서 발생한 어려움, ④ 유가족을 지원하는 과정에서 경험한 어려움, ⑤ 실무자 개인차원에서 경험한 어려움, ⑥ 세월호 참사의 특수성 때문에 경험한 어려움들이었다. 본 연구결과를 바탕으로 실무자들의 보고를 통한 국내 재난심리지원체계의 한계점들을 극복하기 위해서 요구되는 점들을 제안하였다. The Sewol Ferry accident in April of 2014 is considered one of the biggest tragedies in modern Korean history since most victims among the 304 deceased were high school students who were going on a field trip. The Sewol Ferry accident also became a milestone in changing the national disaster response and recovery system in Korea. New laws and policies are being suggested and developed currently. We interviewed 31 crisis responders from three emergency mental health service organizations which worked on the scene immediately after the Sewol Ferry accident with the purpose of finding out how the existing emergency mental health service system actually functioned and what could be improved. After an in-depth interview, we analyzed the data using the Qualitative Content Analysis(QCA) method. Based on our data, we suggested an integrated model of disaster response systems that could be included in the new policies in Korea.

재난심리지원 실무자를 통해 본 세월호 참사 유가족의 애도반응과 재난심리지원 서비스 경험에 대한 질적 연구

이나빈(Lee, Nabin),민지원(Min, Jiwon),한상우(Hahn, Sangwoo),이강욱(Lee, Kanguk),심민영(Sim, Minyoung),채정호(Chae, Jeong-Ho),안현의(Ahn, Hyunnie) 한국정신건강사회복지학회 2017 정신보건과 사회사업 Vol.45 No.3

본 연구는 재난심리지원 실무자의 보고를 통해 초기 대응단계에서 유가족이 경험한 어려움이 무엇이었으며, 초기에 제공된 재난심리지원 서비스에 대해 유가족의 경험이 어떠했는지, 이를 통해 유가족에게 도움이 된 것과 한계점은 무엇인지를 살펴보는 것을 목표로 하였다. 그리고 그 과정에서 유가족이 서비스의 어떤 측면을 긍정적으로 보았는지, 실무자는 어떤 요인을 회복과정의 촉진요인으로 인식하는지를 발견하고자 했다. 이를 위해 세월호 참사 직후 유가족에게 초기 재난심리지원 서비스를 제공했던 실무자 35명의 인터뷰자료를 질적으로 분석하였다. 분석결과, 57개 개념이 도출되었고 개념으로부터 16개 하위범주가 추출되었으며 하위범주는 6개 상위차원으로 기술되었다. 본 연구결과를 바탕으로 세월호 참사 이후 유가족의 초기 심리사회적 반응과 심리지원 서비스 제공을 통한 변화과정을 구조화하였으며 논의를 통해 차후 재난심리지원을 위한 실무자 교육이나 서비스 평가, 재난심리지원 정책 수립단계에서 중요하게 고려해야 할 요소를 제안하였다. This study aims to explore psycho-social experiences of the bereaved family during the initial response stage and how they progressed through the disaster support services by interviewing the disaster support workers. Total of thirty five responders who provided psycho-social support services after the ‘Sewol’ Ferry accident were interviewed indepth. We analyzed the data using the Qualitative Content Analysis (QCA) method. As a result, 57 meaningful concepts were derived from 57 statements, and fall into 16 categories with 6 dimensions. Based on these results of this study, we suggested the changing process an integrated model of the bereaved family’s grief and through carly psycho-social reactions to the disaster support service after the Sewol disaster. Finally, this study recommends important components in decision-making for disaster psychosocial support, its practitioner training and service evaluation. Practical implications for disaster policy issue, training program for disaster workers, support system evaluation as well as suggestions for further research were discussed.

재난심리 지원에 대한 국민 인식도 조사

이송은(Song-Eun Lee),이나빈(Nabin Lee),유선영(Seonyoung Yoo),박도원(Dowon Park),전경선(Kyoungsun Jeon),황태연(Tae-Yeon Hwang),이정현(Jung Hyun Lee) 대한신경정신의학회 2021 신경정신의학 Vol.60 No.1

Objectives This study examined post-disaster mental health problems and related public perception of disaster-related mental health services. The differences of these perceptions according to the disaster experience and disaster type were also investigated. Methods Data were collected via telephone and online surveys, and information from 2928 respondents was analyzed. The participants were allocated across age, sex, and residence area. Results Those who had experienced disasters showed a more negative perception of post-disaster mental health services than those who had not. While natural disaster survivors most often reported financial problems as secondary stressors after a disaster, social disaster survivors were more likely to report mental health problems. Regarding national mental health support for disaster, disaster-experiencing respondents more often tended to prefer mental health services than non-disaster-experiencing respondents. Conclusion The current study can help understand the public perception of disaster-related mental health and the needs of mental health services. These findings could suggest directions and grounds for policies of a national support system for disaster-related mental health.

재난심리지원 업무 종사자의 소진에 대한 이해와 대책

심민영 ( Sim Minyoung ),이나빈 ( Lee Nabin ) 한국정신병리진단분류학회 2021 精神病理學 Vol.25 No.1

Individuals who perform disaster mental health services face a variety of stresses, including workloads, time pressures, role conflicts and ambiguities, and uncertain environments. They are also exposed to the pain of the victim and are required to maintain emotional empathy. These demands placed on disaster mental health workers increase the risk of burnout. Burnout is developed within the work context and characterized by three dimensions; emotional exhaustion, depersonalization, and low personal accomplishment. According to Job demands-resources model, organization should manage work demands and support organization resources for disaster mental health workers. Given the nature of disaster-related work, efficient organizational structure, well-defined roles, supportive organizational culture, and education are important factors in preventing burnout.