This study aimed to compare current mental health status between North Korean defectors and South Korean natives. The proportions of depression/anxiety and the experience of suicidal ideation from 593 North Korean defectors were compared with South Koreans (n = 2372). Logistic regression analyses were conducted to determine the associated variables. As a result, the rates of depression/anxiety and suicidal ideation were significantly higher among North Korean defectors. North Koreans also had more than twice the number of escape attempts associated with high rates of depression/anxiety, and being female and single, longer durations of stay abroad, more than twice the number of escape attempts, and longer durations after entrance to South Korea were related to high rates of suicidal ideation. From these results, additional efforts are needed to identify the North Korean defectors who are at high risk for poor mental health and to provide appropriate medical services and social support.