Observations and perspectives of peer professionals involved in civil commitment rulings for individuals with mental illnesses in South Korea

Abstract

Background

Following the 2016 South Korean statutory revision that governs psychiatric civil commitment, five regional Admission Suitability Review Boards (ASRBs) were established in 2017. These mental health tribunals were designed to provide public oversight of involuntary hospitalization of people diagnosed with mental illnesses. Most ASRBs are composed of psychiatrists or non-peer mental health professionals. Handful of ASRBs also invited peer professionals—individuals with lived experience of mental illness in recovery—to their civil commitment rulings for deliberation. This study describes observations and perspectives of those peer professionals who served on ASRBs, including their recommendations for improving the processes and outcomes of ASRB hearings.

Methods

Nine peer professionals who have served on ASRBs since 2017 participated in semi-structured individual interviews. Seven were currently practicing peer support services outside the ASRB. Virtual interviews, conducted from October 2023 to November 2023 ranged from 31 to 98 min (M = 72 min). We identified themes and codes through reiterative thematic analysis of verbatim transcripts.

Findings

Four themes emerged from participant narratives. Peer professionals reported mental illness prejudice and discrimination during ASRB hearings, described structural hurdles and barriers embedded in the statute that authorized ASRBs, offered areas for improving ASRB processes, and described mutual growth of peer professionals and their non-peer board member colleagues that can occur when peer professionals participate in ASRB hearings.

Conclusion

Peer professionals play critical roles in ASRBs, which are mandated to ensure fairness for individuals petitioned for civil commitment. By Bridging the gap between petitioned individuals and non-peer colleagues, peer professionals enrich the deliberation process with knowledge and perspectives gained from their own lived experiences. Efforts to enhance procedural justice of ASRBs include clarifying and strengthening ASRB policies and procedures, as well as providing training and technical assistance. These effort should ensure that the voices of petitioned individuals and other stakeholders are heard through ASRB deliberation.