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[In North Korea], psychiatric conditions are often considered to be the patient's fault and a source of deep shame for for friends and family. Psychiatric conditions are also inextricably tied to politics and ultimately the country's caste system, known as "songbun".
Mental health and politics have become conflated. If you come from a questionable line in terms of your political loyalty, then it's sometimes believed that you're more prone toward mental health disorders than you are if you come from a revolutionary line.