The research, led by occupational therapist Amar Nishad and colleagues at Manipal Academy of Higher Education, together with psychiatrist Anil Kumar Mysore Nagaraj of Kasturba Medical College, Mangalore, set out to fill a significant gap. While leisure participation is increasingly recognised in the international literature as a contributor to recovery, well-being and quality of life among people with severe mental illness, most of that evidence comes from high-income Western countries. Evidence from culturally diverse, resource-constrained settings such as India has remained strikingly thin, even though the country bears an enormous burden of schizophrenia and related psychotic disorders.

To understand the lived experience of leisure, the team adopted a descriptive phenomenological approach, a qualitative methodology designed to capture the essence of human experiences as they are perceived by those who live them. Thirteen adults diagnosed with schizophrenia, all in a stable phase of their illness, were purposively recruited from a tertiary hospital and a psychiatric rehabilitation centre in South India. Diagnosis was framed according to the International Classification of Diseases, 11th Revision, and clinical stability helped ensure that participants could engage meaningfully in extended conversation about their daily lives. The researchers collected data through in-depth, face-to-face interviews and subsequently analysed the transcripts using thematic analysis, a systematic process of coding and pattern identification that allows recurring ideas to crystallise into overarching themes. The study was prospectively registered in the Clinical Trials Registry–India under registration number CTRI/2024/05/068132, and the work received institutional ethics approval before any participant was approached.

From the analysis, five major themes emerged. First, participants described leisure as a meaningful and therapeutic activity in its own right. Rather than viewing free-time pursuits as trivial or optional, they characterised them as calming, restorative and purposeful, capable of regulating emotion, occupying the mind and lending structure to otherwise empty hours. One participant’s remark that life would become monotonous without leisure captures the sentiment that runs through the entire dataset: leisure was understood as a buffer against the emptiness, boredom and drift that many people with chronic mental illness report when daily activity narrows.

The second theme mapped the types and patterns of leisure participation. Here the cultural specificity of the findings becomes especially evident. Spiritual and religious activities, such as prayer, temple visits and devotional practices, featured prominently, as did family-oriented pastimes including shared meals, conversations and household involvement. Listening to music, watching television, walking and spending time in natural surroundings also appeared frequently. The researchers observed that these patterns diverge in meaningful ways from the leisure repertoires documented in Western studies, where individualistic and recreational activities often dominate. In this South Indian context, leisure was woven into family life and spiritual practice rather than pursued as a separate domain of personal enjoyment, a distinction with direct consequences for how rehabilitation services should be designed.

The third theme documented the benefits participants attributed to leisure, and these were strikingly multidimensional. Emotionally, leisure activities helped dampen anxiety, quiet racing or distressing thoughts and provide a sense of calm. Cognitively, they demanded and sustained attention, offering gentle mental exercise. Socially, they created opportunities for connection, belonging and conversation, countering the isolation that both symptoms and stigma impose. Participants also reported that leisure bolstered motivation and contributed to what occupational scientists call occupational balance, the equilibrium among work, rest, self-care and play that supports health. Within the framework of the Occupational Therapy Practice Framework, which the authors used to organise their clinical reasoning, these accounts place leisure squarely within the domain of occupations that sustain well-being, not merely as filler between obligations.

The fourth theme addressed the formidable barriers that stand between people with schizophrenia and fulfilling leisure. Fatigue emerged as a persistent obstacle, frequently intertwined with medication side effects, a reality of antipsychotic treatment that clinicians often underestimate when encouraging patients to become more active. Financial constraints limited participation in activities that require travel, materials or fees. Stigma, both enacted and internalised, kept many participants away from public spaces and community events, while limited access to structured opportunities in the surrounding environment compounded the problem. In a health system where mental health services are stretched thin through initiatives such as the District Mental Health Programme, leisure programming rarely features on the agenda at all.

Against those barriers, the study also identified facilitators. Family support proved decisive: relatives who encouraged participation, accompanied participants to activities or simply made space for them at home enabled engagement that would otherwise have been impossible. Personal interest and intrinsic enjoyment sustained involvement over time, and structured daily routines gave leisure a reliable place in the day. These facilitators echo a long-standing principle in psychiatric rehabilitation, namely that recovery is built less on clinical intervention alone than on the scaffolding of relationships, habits and accessible opportunities that surround the individual.

The fifth and final theme captured participants’ aspirations for the future. Far from being resigned to restricted lives, many articulated concrete hopes: to learn new skills, to return to activities abandoned at illness onset, to spend more time outdoors and to contribute to family and community life. The researchers argue that these aspirations represent an untapped clinical resource. When treatment planning incorporates a person’s own leisure goals, motivation and adherence tend to improve, and the recovery process becomes genuinely person-centred rather than symptom-centred.

The technical rigour of the study deserves note. By recruiting purposively from both a tertiary hospital and a rehabilitation centre, the team captured a range of service experiences. Descriptive phenomenology, combined with thematic analysis, allowed the researchers to bracket their assumptions and foreground participants’ own words. Reporting followed the Standards for Reporting Qualitative Research, and symptom severity was monitored using instruments such as the Brief Psychiatric Rating Scale in the broader clinical assessment. The authors nonetheless caution that findings from a single South Indian region, drawn from thirteen stable-phase participants, cannot be generalised wholesale to all people with schizophrenia, and that individuals experiencing acute illness may describe their relationship to leisure very differently.

Why does this matter beyond India? Schizophrenia affects roughly one in three hundred people worldwide, and functional recovery, defined by engagement in meaningful activity and social roles, lags far behind symptom control in most health systems. Leisure occupies a peculiar blind spot: it is neither work, which rehabilitation services vigorously target, nor self-care, which families typically manage, and so it falls through the cracks. Yet as this study demonstrates, leisure is precisely where emotional regulation, social connection and daily structure converge. For a person whose working life has been disrupted and whose social world has contracted, a devotional song, an evening walk or a family gathering may be the most consequential occupation of the day.

The practical recommendations that flow from the findings are concrete. The authors call for mental health services to integrate culturally meaningful, accessible and family-inclusive leisure opportunities into routine care. In practice, that means occupational therapists assessing leisure interests alongside functional skills, psychiatrists weighing the activity-limiting effects of medication regimens, community programmes designing low-cost group activities, and families being coached as partners rather than bystanders. It also means tackling stigma at the community level, since no amount of internal motivation can compensate for exclusion from public life.

The study, funded through open access support from Manipal Academy of Higher Education, arrives at a moment when global mental health policy, including the World Health Organization’s emphasis on community-based and rights-based care, is pushing services to look beyond hospital walls. Its message is deceptively simple: ask people with schizophrenia what they want to do with their free time, and build services around the answer. In the words of the participants, leisure keeps life from becoming monotonous. The research suggests clinicians and policymakers should take that phrase seriously, not as sentiment but as clinical guidance grounded in the lived experience of recovery.

The backdrop to the consortium’s launch is a stubborn gap between the scale of the problem and the resources devoted to it. Eating disorders, including anorexia nervosa, bulimia nervosa and binge-eating disorder, affect millions of people worldwide and are associated with some of the highest mortality rates of any psychiatric illness, yet the research field has historically competed for attention and funding against far better-resourced areas of medicine. Scarcity does more than shrink laboratory budgets; it fractures the community itself. Clinicians, basic scientists, statisticians, carers and people who have survived eating disorders often work in parallel rather than in partnership, duplicating effort and slowing the translation of discoveries into new therapies. CoRe-ED was created to attack that fragmentation directly. Its stated mission, as an international charity, is to promote innovation in eating disorders research by empowering all voices — not only those of senior academics at wealthy institutions — and by supporting the development of new treatments. The founding bet was simple: a deliberately open, international network could accomplish what isolated, underfunded groups working alone could not.

To test whether that bet was paying off, the team behind the consortium turned its own growth into a research project. Between 25 September 2024 and 31 December 2025 — a window of roughly fifteen months — everyone who registered with CoRe-ED completed an online registration form and consented to the use of deidentified, aggregated data for research. Deidentification strips away names, contact details and other personal identifiers before analysis, so that researchers examine only group-level patterns rather than any individual’s responses. The team first profiled registrants by primary country of residence and professional or personal roles, then examined what members expected from the consortium and how they experienced it. For those expectations and experiences, the researchers applied inductive thematic analysis, a qualitative method that codes free-text responses and survey comments without imposing a predefined framework, letting themes emerge from the data itself. Three further evidence streams fed the study: feedback surveys from ten CoRe-ED events, tracked engagement with the consortium’s collaborative initiatives, and a separate overarching survey of registrants’ overall experiences. The work received ethics approval from a Bellberry Limited Human Research Ethics Committee, and every participant provided written online consent.

The headline numbers are striking for a field that has often struggled to fill a single conference room. In roughly fifteen months, 960 individuals from 37 countries across five continents registered with the consortium, a geographic spread few would have predicted for a field so often dismissed as niche. The membership is deliberately heterogeneous. Alongside academic researchers and health professionals, the register includes people with lived experience of eating disorders, advocates, representatives of not-for-profit organisations and industry professionals. That composition matters scientifically as well as symbolically. Collaborative-science research consistently shows that multidisciplinary, community-engaged teams ask different questions, access different kinds of data and reach different audiences than single-discipline groups working alone. By counting who actually signs up — rather than who is merely invited — the study provides an empirical snapshot of whether the consortium’s inclusive design attracts the full spectrum of stakeholders or only the usual academic suspects. On this early evidence, the answer is the former: the registrant base mirrors the broad coalition the founders set out to build.

What, then, did nearly a thousand people want from membership? The inductive analysis distilled registrants’ expectations into a set of recurring themes: networking and community building; contributing to and collaborating on research; learning and professional development; advocacy; the facilitation of innovation; the integration of lived experience into research; global collaboration; and mentorship. Read together, the themes amount to a diagnosis of what the field has been missing. The demand for networking and community building suggests that many registrants felt professionally isolated within their home institutions. The emphasis on learning and professional development points to gaps in training that national systems have not filled. Calls for mentorship signal that early-career researchers and emerging advocates lack structured guidance, while the repeated demand for integrating lived experience into research reflects a broader international movement to involve patients and survivors as genuine partners rather than passive subjects of study. Notably, these expectations were reported across roles and regions, indicating that the appetite for connection and co-production cuts across career stage, discipline and geography rather than being confined to any single constituency.

The consortium’s most ambitious response to those expectations is a structured initiative called the Next Big Research Idea. Instead of waiting for funding agencies to set the agenda from the top down, CoRe-ED convened 18 internationally distributed multidisciplinary teams, drawn from 20 countries, to develop collaborative eating disorders research proposals together. The format echoes the sandpit or idea-incubator models used successfully in other research domains: participants from different disciplines and backgrounds are deliberately mixed into teams, given a shared problem space and supported to co-develop project ideas that no single discipline could generate alone. In this case, the teams spanned the full stakeholder spectrum — combining researchers, clinicians and lived experience perspectives — across time zones and continents. The initiative matters for two reasons. First, it converts diffuse enthusiasm for collaboration into concrete, potentially fundable research plans, shortening the distance between an unmet clinical need and a structured proposal. Second, it operationalises the consortium’s founding principle that innovation should emerge from the whole community, including voices that traditional funding pipelines frequently filter out. By the standards of a field long labelled niche, mobilising eighteen teams across twenty countries in fifteen months is a remarkable result.

Registrants’ day-to-day experience appears to match that ambition. Feedback from the ten CoRe-ED events held during the study window, together with the overarching survey of overall experiences, indicated high satisfaction with the consortium’s activities. Respondents particularly valued the diversity of presenters, the global perspectives on display, the inclusive environment and the opportunities to learn from and connect with others. Those four factors are far from incidental. Research on professional networks shows that perceived inclusiveness and speaker diversity strongly predict whether participants return to future events, volunteer for working groups and recruit their colleagues — the behaviours that convert a mailing list into a functioning community. High satisfaction with global perspectives also suggests the consortium is not simply exporting a single national model of research culture, but genuinely knitting together different national traditions, health systems and patient communities. For an organisation whose founding premise is that every voice matters, positive feedback on inclusiveness is arguably the most important early signal that its design principles are working in practice and not merely on paper.

The study’s title names a deliberate transition: from establishment to network consolidation. In the language of network science, a young consortium must first solve the establishment problem — attracting members, establishing legitimacy and creating initial touchpoints such as a registration pathway and launch events. It then faces a harder challenge: consolidation, the conversion of a loose collection of individual sign-ups into an interconnected web of working relationships. The evidence assembled here suggests CoRe-ED is navigating that second transition. Its programming — regular events, the multidisciplinary Next Big Research Idea teams and activities oriented toward learning, mentorship and advocacy — maps closely onto the expectations registrants reported when they joined. That alignment between what members asked for at sign-up and what the organisation delivered afterwards is presented in the study as evidence that the consortium is responding to its community rather than broadcasting at it. The structure also appears designed to compound: every event and every multidisciplinary team forges new ties between members, raising the likelihood of future collaborations, co-authored papers and jointly submitted grants. In a field historically made up of small, scattered laboratories, that compounding effect may matter more than any single initiative.

There are, however, important caveats that any careful reader should weigh. The authors are not neutral observers: Professor Gemma Sharp is the founding director of the consortium, and Hao Hu and Peter Wigley are its directors, a competing interest they disclose transparently in the paper. The registrant base is likewise self-selected; people who choose to join an international consortium are by definition already motivated, and their enthusiasm may not represent the wider clinical and research community, including sceptics who never signed up. The study measures expectations, satisfaction and engagement — that is, perceptions — rather than hard outcomes. No data yet exist on whether CoRe-ED membership translates into funded grants, published trials, new therapies or improved patient outcomes, and the analysis covers only the consortium’s first fifteen months of existence. The research itself received no specific grant funding from public, commercial or not-for-profit agencies, and the article is published open access under a Creative Commons licence, allowing anyone to read the full evidence base and interrogate its conclusions firsthand.

The authors are clear about what must come next. Future research, they conclude, should examine longer-term experiences — including impacts on research outputs, mentorship, the co-design of studies and the translation of findings into health policy — to better understand how the consortium evolves in response to the needs of its international community. Those questions will determine whether CoRe-ED’s early momentum hardens into durable scientific infrastructure or fades into well-attended events. Even at this early stage, however, the study offers a template that extends well beyond eating disorders. It demonstrates that a small, dedicated team can document the growth of a global research community with much of the rigour applied to a clinical trial: a defined enrolment window, consented data collection, systematic qualitative analysis, triangulation across surveys and events, and transparent disclosure of conflicts of interest. For any underfunded field wondering whether a bottom-up, charity-led consortium can compete with traditional top-down institutions, the first fifteen months of CoRe-ED provide an unusually well-documented proof of concept — and a reminder that, in science as in medicine, community itself can be a therapeutic intervention.

The study emerges from a backdrop of growing mental health concerns globally and within South Korea, where societal change has heightened awareness yet the stigma surrounding mental illness remains formidable. Despite increased availability of mental health resources and campaigns aimed at promoting psychological well-being, Korean men continue to demonstrate a marked reluctance to engage with these services. This paradox prompted Kim and Kim to scrutinize the underlying cultural forces that shape their attitudes and behaviors related to mental health care.

At the heart of the study is the concept of stigma, which is multifaceted and culturally embedded. Stigma, in this context, entails negative attitudes and discriminatory behaviors directed toward individuals experiencing mental health issues. In many cultures, stigma acts as a formidable barrier that discourages individuals from seeking treatment due to fear of being judged or marginalized. In the Korean setting, stigma is compounded by traditional societal expectations surrounding mental fortitude and self-reliance, especially for men. This dual-layered stigma fosters silence and denial, thwarting efforts to normalize mental health conversations.

Masculine norms play an equally pivotal role in shaping mental health help-seeking behaviors. The study highlights how traditional Korean masculine ideals emphasize traits such as stoicism, emotional control, and toughness. From a young age, Korean men are socialized to embody these standards, often equating mental health struggles with personal weakness or failure. This ingrained association between masculinity and emotional suppression creates an internal conflict for men who may want to seek help but fear damaging their masculine identity. The research illuminates the psychological toll of maintaining these norms while grappling with mental health challenges.

Moreover, the study’s analysis extends into the cultural dimension of “face,” a complex social construct that refers to an individual’s public image and reputation within their community. In Korean society, “face” is intricately linked to honor, dignity, and social standing. Mental health problems are often perceived as jeopardizing one’s “face,” rendering individuals vulnerable to social exclusion and shame. The researchers posit that the concern over losing “face” operates as a powerful deterrent against acknowledging psychological distress or accessing mental health services. This dynamic underscores the collectivist nature of Korean culture, where the image conveyed to others often supersedes individual health concerns.

Kim and Kim adopted a comprehensive mixed-methods approach, combining quantitative surveys with qualitative interviews to capture the breadth and depth of Korean men’s experiences. Their extensive data collection included diverse age groups, socioeconomic statuses, and urban versus rural residency, creating a robust picture of how stigma, masculine norms, and “face” intersect across societal layers. The qualitative narratives reveal poignant personal stories of men grappling with inner turmoil while navigating external pressures to conform to cultural ideals.

Technically, the study employed validated psychometric instruments to measure stigma and adherence to masculine norms, allowing for precise statistical correlation analyses. Findings demonstrated a strong negative correlation between adherence to traditional masculine norms and willingness to seek mental health help. Notably, the study identified stigma related to “face” concerns as a mediating factor that amplifies this effect. These insights provide a valuable blueprint for mental health practitioners aiming to design culturally sensitive interventions tailored for Korean men.

One of the most striking implications of the study is the need for a paradigm shift in public mental health messaging and services. Rather than promoting help-seeking solely through generic campaigns, tailored approaches that directly address masculine norms and concerns over “face” are crucial. For instance, interventions that reframe seeking psychological help as an act of strength and responsible masculinity could dismantle prevailing stereotypes. Additionally, integrating mental health discussions in safe, male-centric spaces such as workplaces or community organizations may encourage openness and peer support.

The broader psychological community stands to benefit from this research as it highlights universal challenges of mental health stigma experienced within culturally specific frameworks. Although the Korean context has distinct elements, parallels can be drawn to other collectivist cultures where honor and reputation influence health behaviors. Thus, the study propels international dialogue on how culture-specific constructs interact with gender norms to shape mental health outcomes, emphasizing the necessity of culturally competent care.

In terms of clinical practice, the research informs mental health professionals about the importance of culturally attuned assessment and intervention strategies. Understanding patients’ concerns about stigma and “face” can aid therapists in creating trusting environments that validate masculine identities while encouraging vulnerability. Furthermore, the study advocates for integrating mental health literacy in broader educational systems to dismantle misconceptions and promote positive conversations from an early age.

As South Korea continues to modernize and globalize, shifts in cultural attitudes toward mental health may gradually emerge. However, entrenched stigma and traditional masculine ideals remain significant challenges. Kim and Kim’s study serves as a timely reminder that mental health advancement requires not only systemic changes but also deep engagement with the cultural fabric that shapes individual choices. Encouraging Korean men to seek help necessitates confronting long-standing societal norms and fostering environments where mental health is decoupled from stigma and shame.

Importantly, this research also adds to the growing body of knowledge emphasizing intersectionality in mental health studies. The interplay between gender, culture, and psychological well-being is intricate and demands holistic research frameworks. Future studies building on Kim and Kim’s work may explore how other identity factors such as age, occupation, and socioeconomic status interact with stigma and masculine norms to affect mental health trajectories.

The study’s insights extend beyond academic circles into public policy and community health planning. Policymakers are urged to consider cultural barriers in the allocation of resources and development of outreach programs targeting vulnerable populations. Tailored public health initiatives that incorporate cultural competence training for healthcare providers can mitigate disparities in help-seeking behaviors and improve mental health outcomes for Korean men.

Furthermore, the researchers advocate for the integration of digital mental health platforms designed to circumvent traditional stigma associated with face-to-face consultations. Given Korea’s advanced technological infrastructure and high internet penetration, confidential and culturally sensitive online services may enhance accessibility and anonymity, potentially reducing fear of judgment.

In conclusion, Kim and Kim’s investigation profoundly contributes to understanding the complex, culturally embedded barriers to mental health help-seeking among Korean men. By shedding light on the influential roles of stigma, masculine norms, and “face,” the study charts a path toward more effective, culturally responsive mental health services. As mental health challenges continue to rise globally, such culturally nuanced research is indispensable in crafting interventions that resonate with diverse populations and ultimately save lives.

Subject of Research: Mental health help-seeking behaviors among Korean men and the influence of stigma, masculine norms, and the cultural concept of “face.”

Article Title: Mental health help-seeking among Korean men: the influence of stigma, masculine norms, and face.

Article References:
Kim, S., Kim, D. Mental health help-seeking among Korean men: the influence of stigma, masculine norms, and face. BMC Psychol 13, 461 (2025). https://doi.org/10.1186/s40359-025-02793-y

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