South Korea is one of the most wired countries in the world. But that level of connectivity is a double-edged sword in a society that some experts say is becoming increasingly addicted to the Internet and where 95% of adults own a smartphone.
"Korea has an environment that allows easy access to computer games and other activities online," says Sungwon Roh, a psychiatrist at Seoul's Hanyang University who studies Internet addiction. "You can connect to your smartphone anywhere. Every neighborhood has what we call a 'PC bang' or, in English, PC café. Here, Koreans of all ages can access the Internet very easily."
And those PC bangs are often shiny places with big, comfy chairs, huge screens and fast Internet, all for about a dollar an hour. Most are open 24 hours a day. So it's no wonder some customers overstay their welcome.
"I've seen a lot of customers come here late in the afternoon and leave the next morning. That's pretty common," says Lee Kae Seong, the owner of the OZ PC Bang in Seoul's upmarket Gangnam neighborhood. Some, he says, stay a day or two. And others become... well, ripe.
"Some customers who play for too long, I'm sorry to say, they get smelly," he says. "And other customers start to complain. So we have to ask them to leave."
Stories like these help explain why Roh says South Korea is facing a public health crisis — one he sees firsthand while treating patients at his hospital.
"Here I see dramatic cases of both adolescents and adults come to seek professional help," he says, "because they started to have serious problems in their health, relationships with their family or studies at school from game addiction. Some students will refuse to go to school or even inflict physical force on their parents."
To some parents in the United States, this might sound distressingly familiar even though mental health experts are still debating the extent of the problem. The American Psychiatric Association does not recognize Internet or online game addiction as a unique mental disorder.
But the South Korean authorities know the country has a problem: Almost 20% of the population — nearly 10 million people — are at serious risk of Internet addiction, according to a 2018 government survey. Roh says the country is trying to do something about it.
"There are regional education offices that provide services such as in-school counseling, screening surveys, preventive disciplines and, for severe cases, addiction camps," he says. Almost all of the services are financed by the government, at the national or municipal levels, and have been for more than a decade.
One of the camps started by the national government, the National Center for Youth Internet Addiction Treatment, is three hours south of Seoul in the mountainous Muju region.
"We're targeting teenagers who are heavily dependent on the Internet and smartphones," says Shim Yong-chool, the director. They're referred either by their parents or concerned teachers. And all their tech devices are seized when they arrive for the two- to four-week program.
While they're here, he says, "We help students find a new hobby. Students who are overly dependent on Internet and smartphones will be doing only that [using their phones] when they have extra time. So, we are showing them many other options so they can spend their free time in a healthier way."
Art classes, volunteering at a local senior center and board games are all on the agenda for the group of 32 girls, ages 13 to 19, on the fifth day of their two-week stay this summer. They're gathered in a classroom playing a word association game that prompts frequent howls of laughter and huge smiles. And no selfies!
The center's director says there have been more boys than girls treated there. More of the boys come for game addiction, while girls have tended to be hooked on social media, he says. But that's not always the case.
Speaking almost in a whisper, a 16-year-old girl says her time at the center has been a painful experience. The center requests NPR not use the names or show the faces of the young people receiving treatment there for privacy reasons.
She recalls feeling "nervous" when she first handed over her phone. "I've had my phone since my first year in elementary school. I've never been without it since. So I was worried," she says.
She is less worried five days into the program. She has made some new friends and says she now realizes she can live without her phone. It used to consume her for eight hours a day or more, especially if she was gaming.
Another girl, who is 14, is still struggling. "My hands get shaky, I can't concentrate," she says. "When I go back to the dormitory to get some rest, I keep thinking of Facebook. There are hearts there I can collect from a game, but they'll go away if I don't take them in three days. That worries me."
She constantly checks for her phone, too, she says. And she thinks about the games she's not playing, like Overwatch, which she says she's good at. Back at home, she would play during the day, after school. Her mother knew she had a problem, the girl says, so her mother would turn the Internet off by bedtime at 10 p.m. The 14-year-old would wait for her mother to fall asleep around 11 p.m., then plug it back in and play until dawn. Then she would go to school.
She didn't eat much. Every minute spent eating, she says, was a minute lost gaming.
Is being at the center helping? "No, I don't think so," she says. Is she just counting the days until she gets your phone back? "Yes," she says. And looks down at the floor.
Shim is more hopeful about her chances.
The 14-year-old girl just started, he says. She'll be better by the end of the two-week camp, he adds. And then there's the aftercare.
"Each local government has an institution that works with the Ministry of Gender Equality and Family," he says. "We connect the students to these institutions after the camp so they can receive counseling continuously. It does not end at the camp, we follow up with students through other relevant institutions so that students can constantly get counseling."
But Shim is worried about the size of the problem.
"The percentage of teenagers dependent on Internet and smartphones is actually increasing," he says. "So, our organization is expanding and trying to get ready to accept more students."
The group is building more facilities to accommodate those students to deal with a problem it knows isn't going away.
In May, the World Health Organization added "gaming disorder" to its list of recognized addictions. That decision hasn't gone over well with South Korea's lucrative esports industry, which fears the economic fallout and stigmatization such a designation may bring. But it may bring more resources to a system already struggling to deal with the problem at hand.
The WHO move may also help the U.S. government and mental health professionals to focus on these problems.
"It is important for the U.S. government and relevant experts to pay attention to this issue," says psychiatrist Roh, "to screen out addicted students and provide adequate therapy to those diagnosed with game addiction."
South Korea already has its public health crisis, he says. If the U.S. doesn't act, it won't be far behind.
Kang Jae-un contributed reporting to this story in Seoul.