Psychiatrist Luke Kim remembers the day the resident he was supervising presented a certain patient to him. A 55-year-old, poorly educated immigrant woman from a rural agricultural area in South Korea reported vague gastrointestinal problems, fatigue and a lack of interest in life. Although the resident suspected she had major depression, the patient denied feeling sad or depressed.
Kim advised the resident to ask the woman about traditional Korean concepts of mental illness, specifically, haan (feelings of repressed resentment and anger) and wha-byung, which has many overlapping symptoms with major depression and anxiety and is listed in the DSM-IV-TR as a culture-bound syndrome.
When the resident returned to the patient, she immediately responded to his new line of questioning and became animated with emotion. She poured out her bitter feelings about being mistreated for years by her husband and in-laws. Based on this, the resident could more confidently develop a treatment plan for the patient.
"I find that when evaluating depression in the Korean elderly, results are more fruitful if one uses traditional folk concepts than asking directly if they feel sad or depressed," says Kim, who served as a teacher and volunteer faculty member for 35 years with the UC Davis Department of Psychiatry and Behavioral Sciences.
When Kim retired in 2006, he wondered how he could continue to help foster multicultural training in psychiatry. His solution: he and his wife, Grace, donated $250,000 to establish the Luke and Grace Kim Endowed Professorship in Cultural Psychiatry. The donation, supplemented by contributions from the psychiatry department and the School of Medicine, established the endowment.
A life of adaptation
Kim knows firsthand how difficult it is to adapt to a new culture. Born in what is now North Korea, Kim was interned during World War II at the age of 14 by the Imperial Japanese Army, which ruled Korea until Japan's surrender in 1945. Soon after, Soviet troops moved into North Korea and helped establish a communist government. Along with his schoolmates, Kim demonstrated against the communist ideology and teaching in the middle school. Russian planes fired upon the demonstration, killing some two dozen of his fellow students and wounding scores more.
The Communists also began persecuting Christians, and Kim's father was targeted for arrest. The entire family fled to South Korea. They rebuilt their lives in Seoul, but their misfortune continued with the outbreak of the Korean War four years later. Kim's mother was kidnapped by Communist agents in Seoul, which was occupied by the North Korean military. The family never heard from her again. Kim and his family endured starvation, separation, homelessness and refugee camp life over the next three years. Kim then joined the South Korean military. Following discharge, he graduated from Seoul National University, School of Medicine, in 1956. He came to the United States, where he earned his doctorate in clinical psychology at the University of Arizona. He completed his psychiatric residency at Buffalo State Hospital in New York and Napa State Hospital in California.
Grace Kim, too, is no stranger to adapting to a new culture. She also escaped from North to South Korea and then emigrated to the United States in 1961. The Kims were married a year later. Grace earned degrees in education and counseling and taught at Davis Senior High School for 24 years. The Kims have two adult sons and four grandchildren.
Focus on culture
During his career at UC Davis, Kim devoted his time to promoting cultural psychiatry. About 18 years ago, Kim initiated a seminar on culture, ethnicity and mental illness for second-year psychiatric residents, which was the beginning of a training program on cultural psychiatry at UC Davis. In 1999, the Diversity Advisory Committee was established in the Department of Psychiatry and Behavioral Sciences. UC Davis resident training in cultural psychiatry took off, expanding exponentially. Today, the department has become a nationally recognized training program and educational center in cultural psychiatry.
"Culture makes such a big difference in mental health and illness," says Kim. He cites differences in value orientation between Asian and Western cultures: Westerners emphasize independence, self-reliance and privacy, while Asians are more family and community oriented, preferring interdependence.
Different clinical idioms also emerge, according to Kim. Westerners tend to have more psychologically oriented feelings, such as sadness, loneliness and depression, in contrast to more somatically oriented complaints among Asians such as headaches, fatigue and indigestion.
The Luke and Grace Kim Professorship supports teaching, research and public service within the department. The major goal is to foster academic excellence and innovative research in the field of cultural psychiatry. The professorship also supports cultural competence training and education initiatives for medical students, residents and faculty.
First holder of professorship
Francis Lu, a leading figure in cultural psychiatry and the intersection of psychiatry, religion and spirituality, has been named the first holder of the Luke and Grace Kim Professorship in Cultural Psychiatry. Lu is also a professor and director of Cultural Psychiatry for the department.
Before joining UC Davis, Lu was a professor of clinical psychiatry at UC San Francisco and served as its director of the Cultural Competence and Diversity Program for the Department of Psychiatry at San Francisco General Hospital.
In 2002, he received the National Alliance for The Mentally Ill Exemplary Psychiatrist Award "for exceptional cultural awareness and sensitivity." In 2008, Lu received the Association for Academic Psychiatry Lifetime Achievement in Education Award for his contributions to psychiatric education.
Lu received his bachelor's degree in sociology from Columbia College in New York City in 1971, and his medical degree from Dartmouth Medical School in 1974. He is a diplomate of the American Board of Psychiatry and Neurology.