6.25 War has taken the lives of countless people and ripped apart families and communities. The direct victims of war, along with refugees, families separated by war, and war orphans, suffered severe psychological trauma. Symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) were prevalent in an environment where their very survival was at stake. Social awareness of mental health was very minimal at the time, and trauma often went untreated, repressed, or silenced. Mental illness was regarded as shameful, and with communities in disarray, individuals were compelled to suffer in isolation. This repressed pain was transmitted through generations, leading to unstable emotional development and social isolation in future generations [1].

South Korea’s rapid growth and industrialization, known as the “Miracle on the Han River,” were accompanied by an economic revival that resulted in significant rural decline, urban concentration, and increased labor intensity. Many rural youth migrated to cities, where they encountered low wages, long working hours, loneliness, and identity confusion. Community foundations were rapidly disintegrating, and the nuclearization of the family, which traditionally provided emotional and social support, was diminishing. The urban poor, female workers, and victims of industrial accidents faced heightened exposure to mental illness due to their precarious living conditions and a lack of adequate care and counseling support. Mental health problems had existed in the “shadows” of industrialization, but society dismissed them as individual weaknesses and ignored institutional responses. Suicide rates were on the rise, and issues such as alcohol dependence and domestic violence emerged as side effects of community disintegration and mental stress [1,2].

Since the 1997 foreign exchange crisis, Korean society has fully embraced the neoliberal system of restructuring, layoffs, and the proliferation of contingent labor. In this process, the family could no longer function as a social safety net, and individuals were compelled to compete for survival in the labor market. The family’s caregiving role was weakened as the head of the household lost their job, prompting all family members to enter the labor market to make a living. Consequently, family conflicts, depression, anxiety, and burnout spread throughout society, with suicide rates soaring among middle-aged men, depression and self-harm among adolescents, and stress from dual labor affecting women. During this period, South Korea had the highest suicide rate among OECD countries, and the number of people with mental illnesses steadily increased [3]. However, mental health continued to be deeply stigmatized, and repression, concealment, and self-blame were more prevalent than treatment [2].

Since the 2010s, South Korea has become an ultra-elderly society, with single-person households making up over one-third of all households. The traditional family has largely disappeared, and social connections that can provide care and emotional support have diminished. Young people are experiencing anxiety and lethargy due to unemployment, housing instability, and uncertainty about the future, while the elderly suffer from loneliness and depression stemming from social disconnection. Suicide rates among the elderly are among the highest in the world, and loneliness among middle-aged people is also a growing social issue. In this social context, mental health issues have emerged as a systemic concern affecting all social classes and age groups, viewed as a consequence of fractured social connections and community disintegration. Previous study describes it as “the emotional breakdown caused by the disintegration of community,” and defines it as a structural mental health crisis, not just an individual problem [4,5].

In the early 2020s, the COVID-19 pandemic sparked a new mental health crisis in South Korean society. During the pandemic, family reunions declined, and isolation and disconnection increased. In particular, young people, the elderly, and workers in exposed occupations reported extreme anxiety, depression, and feelings of helplessness. During the pandemic, the rise of contactless technology has brought convenience in daily life, yet it has also caused a sense of disconnection and human alienation [5]. The demand for psychiatric care has skyrocketed, and the importance of mental health has ascended to the forefront of the social agenda, to the point where the term “psychological quarantine” has been coined. Previous studies argue that the mental health crisis is no longer a problem that can be solved by the will of the individual or within the family and call for acommunity-based mental health care system [6]. Paradoxically, the pandemic has highlighted the importance of care, relationships, and restorative communities [6].

Furthermore, the Sewol ferry disaster and the Itaewon incident represent more than mere tragedies; they illustrate institutional incompetence and the decline of social justice. These collective events have left many Koreans suffering from post-traumatic stress disorder (PTSD), anxiety, depression, and other prolonged psychological repercussions, impacting not only the victims and their families but also society as a whole [5].

In summary, structural changes such as industrialization, individualization, and community disintegration have resulted in a wide array of mental health issues, including suicide, addiction, isolation, depression, and trauma, which have escalated into a national crisis. To address the mental health crisis, we need more than just treatment and counseling; we need community recovery, social solidarity, and the publicization of care. Reconstructing the networks of relationships that have been damaged by industrialization and restoring human living conditions can be the starting point for true mental health recovery [5-7].

Therefore, to proactively respond to these changes, psychiatric nursing must overcome the limitations of a clinically oriented approach and explore multifaceted strategies such as preventive approaches, community integration, disaster nursing, addiction nursing, and social engagement. Practical nursing practices aimed at improving the mental health of the entire population are urgently needed.

Early detection and prevention are key to addressing mental health issues. Systems should be established to identify and intervene in individuals’ emotional disturbances before they escalate into severe mental illnesses. To achieve this, regular mental health assessments should be conducted systematically in everyday settings such as schools, workplaces, and communities. Psychiatric nurses should play a vital role in this process. A prevention-oriented approach can significantly contribute to enhancing the quality of life of individuals and reducing societal costs.

Social isolation resulting from aging and the rise of single-person households has profound implications for mental health. In particular, reclusive, isolated, and elderly individuals have limited access to healthcare; therefore, psychiatric nurses must actively reach out to them through “house calls,” community-based programs, and online psychological support services. This is not just nursing care, but an extension of care that restores social relationships and marks the beginning of community integration.

As substance addiction and behavioral addictions, such as gaming, the internet, and gambling, continue to rise, addressing the problem of addiction necessitates a more holistic and multidisciplinary nursing approach. Psychiatric nurses must possess the expertise to integrate addiction psychoeducation, family intervention, rehabilitation programs, and detoxification. Addiction is not merely an act of dependence, but a complex phenomenon that involves physical, mental, and social issues. Therefore, nursing care should be holistic rather than fragmented.

After large-scale disasters, such as climate crises, accidents, and infectious diseases, psychological trauma is often overlooked. Psychiatric nurses should not only provide short-term psychological support but also establish a victim-centered, long-term trauma recovery continuum of care. Within a national trauma management system, the expertise of psychiatric nurses can play a pivotal role in community recovery.

The social stigmatization of mental illness remains profound, resulting in treatment avoidance and delayed recovery. To address this, psychiatric nurses must be more than just treatment providers; they should actively participate in public education, awareness campaigns, and shape public discourse in collaboration with the media. Additionally, institutional frameworks should be established to ensure that the expertise and experience of psychiatric nurses are reflected in health policy-making.

These five directions are not merely optional strategies; they present the path that psychiatric nursing must follow in these changing times. The quality of a society’s mental health reflects its level of well-being, and meaningful change cannot occur without expanding the role of psychiatric nursing and strengthening its institutional foundations. Psychiatric nursing now faces the challenge of evolving from a therapeutic role to fulfill its responsibilities as a preventive, coordinating, and policy-shaping entity.