Perceived barriers to psychiatric help-seeking in South Korea by age groups: text mining analyzes of social media big data | BMC Psychiatry

A total of 97,730,360 articles were identified for the period in question. Table 2 shows the 20 keywords most frequently associated with ‘psychiatry,’ ‘internal medicine,’ and ‘surgery’ in this corpus. The word most frequently associated with ‘psychiatry’ was ‘information’ (7.8%; Table 2). The word most frequently associated with both ‘internal medicine’ and ‘surgery’ was ‘symptom.’

Table 2 The 20 words that were most frequently associated with psychiatry, internal medicine, and surgery

Among the texts, 6,097,369 contained keywords associated with psychiatry, including 2,323,303 texts from web communities (36.4%), 1,896,239 texts from blogs (31.1%), and 1,963,827 texts from Twitter (32.2%).

We identified approximately 3,000 words associated with ‘psychiatry’ according to their frequency. Many of these words were linked to the topic of discrimination. A recurring theme was concern that disclosure of having a mental illness would be disadvantageous due to government policy or social stigma. Consequently, these words were classified in the ‘structural discrimination’ word group. These terms/words included ‘medical record,’ ‘public official employment,’ ‘buying insurance,’ ‘disadvantage,’ and ‘non-insurance’ (Table 3). Another recurring theme was stereotypes and prejudice associated with mental illness. This word group was labeled the ‘public prejudice group’ and included the terms/words ‘mad person,’ ‘negative attitude,’ ‘prejudice,’ ‘stigma,’ and ‘sympathy.’ Words expressing concern regarding adverse drug effects were classified in the ‘adverse drug effect’ word group and included the terms/words ‘adverse effect,’ ‘tolerance,’ ‘withdrawal symptom,’ ‘addiction,’ and ‘dependence.’ Words expressing concern regarding medical costs were classified in the ‘low accessibility’ word group and included the terms/words ‘medical fee,’ ‘medication fee,’ ‘expensive,’ ‘burdensome,’ and ‘counseling fee.’ Although these terms/words could have been classified in the ‘structural discrimination’ word group, we created the ‘low accessibility’ word group to highlight a distinct barrier to psychiatric treatment.

Table 3 The 10 words that were most frequently associated with each barrier

Figure 2 shows the frequency of keywords in each of the following categories: structural discrimination, public prejudice, adverse drug effects, and low accessibility. Structural discrimination was the greatest barrier to receiving psychiatric treatment, accounting for 34% of all of the keywords. Public prejudice was the next biggest barrier (27.8%), followed by adverse drug effects (18.6%), and low accessibility (16.1%). The 10 words that were most frequently associated with each barrier are shown in Table 3. In the structural discrimination section, ‘medical record’ was overwhelmingly the most frequently used term, followed by ‘public official employment,’ ‘insurance,’ ‘disadvantage, ‘ ‘non-insurance,’ ‘disadvantage in seeking jobs,’ ‘university,’ ‘browsing records,’ ‘F-code diagnosis,’ and ‘entrance examination.’ ‘Mad person’ was the most frequently used term in the public prejudice section, followed by ‘negative perception,’ ‘prejudice,’ ‘stigma,’ ‘sympathy,’ ‘abnormal,’ ‘finger-pointing,’ ‘tag,’ ‘ other’s view,’ and ‘loser.’ Concerns about medication in the adverse drug effects section were clear from words/terms such as ‘adverse effect,’ followed by ‘tolerance,’ ‘withdrawal symptom,’ ‘addiction,’ ‘dependence,’ ‘potent,’ ‘taking duration,’ ‘discontinuation,’ ‘sequela,’ and ‘overdose.’ The low accessibility section included ‘medical fee’ followed by ‘medication price,’ ‘expensive,’ ‘burdensome,’ ‘counseling fee,’ ‘treatment cost,’ ‘copay,’ ‘high cost,’ ‘subsidy,’ and ‘poor .’

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Barriers according to keywords

Data from selected web communities were also separated into the following four groups: teenagers, 20- to 30-year-old job seekers, 30- to 40-year-old mothers with children, and 50- to 60-year-old seniors. Figure 3 shows the barriers to psychiatric treatment arranged by age group. Structural discrimination was the greatest barrier to treatment in the teenagers (51%), young job seekers (64%), and mothers with children (43%), followed by public prejudice, low accessibility, and adverse drug effects. However, in the seniors group, public prejudice (49%) was the greatest barrier to treatment, followed by adverse drug effects and structural discrimination. The seniors group was least concerned about low accessibility, whereas accessibility was of greater concern to the other groups than adverse drug effects. ‘Record’ was the word most frequently associated with barriers to treatment in all groups except the seniors group, whereas ‘university’ was only linked to the teenagers group, ‘public official’ was only linked to the jobseekers group, and ‘buying insurance’ was only linked to the mothers with children group. ‘Prejudice’ and ‘negative perception’ were only linked to the seniors group (Table 4).

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Barriers according to keywords, arranged by age group

Table 4 The five words that were most frequently associated with barriers, arranged by age group