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Psychiatry Investig > Volume 20(5); 2023 > Article
Psychiatry Investigation 2023;20(5):452-460.
DOI:    Published online May 25, 2023.
Standardized Suicide Prevention Program for Gatekeeper Intervention of North Korean Defectors in South Korea
Yeon Jung Lee1  , Hyeon-Ah Lee2  , Kyong Ah Kim3  , Myungjae Baik4  , Jong-Woo Paik4  , Jinmi Seol5  , Sang Min Lee4  , Eun-Jin Lee6  , Haewoo Lee7  , Meerae Lim5  , Jin Yong Jun8  , Seon Wan Ki9  , Hong Jin Jeon10  , Sun Jung Kwon11  , Hwa-Young Lee2 
1Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University, College of Medicine, Seoul, Republic of Korea
2Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, College of Medicine, Cheonan, Republic of Korea
3Department of Psychology, Sungkyunkwan University, Seoul, Republic of Korea
4Department of Psychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
5Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
6Department of Social Welfare, Suwon Science College, Hwaseong, Republic of Korea
7Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea
8Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
9Department of Psychiatry and Behavioral Neurosciences, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
10Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
11Republic of Korea Air Force, Daejeon, Republic of Korea
Correspondence: Hwa-Young Lee ,Tel: +82-41-570-3871, Fax: +82-41-592-3804, Email:
Received: January 9, 2023   Revised: January 25, 2023   Accepted: January 29, 2023   Published online: May 25, 2023
*Yeon Jung Lee and Hyeon-Ah Lee contributed equally to this study as co-first authors.
North Korean defectors (NKDs) have experienced substantial difficulties during the migration and settlement in South Korea. They have a high prevalence of depression, post-traumatic stress disorder, and suicidal behaviors. The high prevalence of mental disorders among NKDs can lead to a high suicide rate. However, there are no suicide prevention programs for NKDs. This study aims to customize a suicide prevention program with content suitable for NKDs’ particular circumstances.
A multidisciplinary research team developed this program based on domestic and international gatekeeper training programs for suicide prevention and articles related to suicide prevention.
We developed a multi-part gatekeeper training program, “Suicide CARE for NKDs.” In the “Introduction,” trainees learn about the need for the program and its importance. In “Careful observation,” trainees learn to recognize linguistic, behavioral, and situational signals of suicide risk. In “Active listening,” trainees learn how to ask about suicidal thoughts and to listen empathetically. In “Risk evaluation and expert referral,” trainees learn to evaluate suicide risk and to connect NKDs with institutes or services.
We expect this program to become useful for training gatekeepers to prevent suicide among NKD. A future follow-up study is needed to confirm the efficacy of the program.
Key words   Suicide; Prevention; Gatekeeper; North Korean Defectors


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