VietNamNet Bridge – Mental healthcare, though considered a big medical problem of the 21st century, has not received much attention in Viet Nam despite efforts from the Government to raise awareness.

Doctor at Mai Huong Daycare Psychiatric Hospital in Ha Noi uses electroencephalogram to check for mental disorder for a patient.

Dr Ngo Thanh Hoi, director of the Ha Noi-based Mai Huong Daycare Psychiatric Hospital, said that mental health illnesses still carry a stigma and sufferers face a lot of discrimination.

“Whenever people think about mental health illnesses, they will certainly think about madness and strange behaviour,” said Hoi. “They don’t understand that mental illnesses are preventable and curable if they get timely diagnosis.”

Hoi also blamed the discrimination towards mental health illnesses for the lack of investment in the mental healthcare sector, which has made it less attractive for doctors. “For about 10 years now, the attractiveness of mental healthcare has been the lowest among medical fields for medical students,” said Dr Hoi.

Ha Noi Medical University has sometimes had a psychiatry faculty. However, since 2004, there has not been enough interest in the field to warrant a psychiatric faculty for undergraduate students, and only a very few students go on to study psychiatry after undergraduate studies.

An official from the university’s Undergraduate Training Department said this lack of interest was because students did not want to enter such a difficult and hard speciality.

Dr Hoi said that three good doctors of his hospital left for other fields despite being offered 35 per cent more salary to stay.

“Mental healthcare should get more investment to meet the high demand of the people,” he said.

Statistics from National Psychiatric Hospital No 1 show that at the moment, there are 32 psychiatric hospitals in 63 cities and provinces nationwide. Otherwise there are only psychiatric departments under the centres for social diseases and in general hospitals. The number of psychiatric doctors is 100,000 people to one.

“We are facing a great shortage of human resources and inadequate medicine and equipment,” said the National Psychiatric Hospital’s director Than Van Quang. He added that with a strategic project, to be completed by 2025, the country would try to ensure that all cities and provinces have hospitals which specialise in mental healthcare.

“The number of one psychiatric doctor per 100,000 people in Viet Nam is now the lowest in the region, and it should be raised to three or four in the near future,” he said.

When a national programme focused on building a model for community-based mental healthcare was established in 1999, the awareness of the public about mental health increased significantly. However, about 50 per cent of the population still have limited knowledge about this issue, according to Quang.

The result of a national survey in 1999-2000 showed that the prevalence of 10 common mental illnesses was about 15 per cent. In 2003, the study “Young Lives” showed that the prevalence of mental disorders in primary school children was about 20 per cent, and for new mothers (babies 6-18 months) it was also 20 per cent.

Forgotten illness

An expert of the World Health Organisation (WHO), who spoke to Viet Nam News to mark World Mental Health Day, called mental diseases a forgotten and hidden illness.

“People with mental disorders are some of the most neglected people in the world,” said Dr Jean-Marc Olive, WHO representative in Viet Nam.

“In many communities, mental illness is not considered a real medical condition, but viewed as a weakness of character,” he said.

WHO reports that there are nearly 54 million people around the world with severe mental health disorders such as schizophrenia and bipolar disorder. In addition, 154 million people suffer from depression. Latest figures show that nearly 1 million people commit suicide each year.

Dr Olive said mental disorders are increasingly prevalent in developing countries. “This increase is a result of persistent poverty-driven conditions such as poor education, housing, job prospects, overworking, rapid socio-economic changes, conflicts in fragile states and natural disasters,” he said.

At the same time, more than 50 per cent of developing countries do not provide any care for persons with mental disorders in the community. As a result, more than 75 per cent of people with major depressive disorders in developing countries are inadequately treated.

Regarding Viet Nam, Dr Olive said the Government had made a significant effort to treat mental illness with its national target programme for building a community-based mental healthcare model.

“Thanks to this model, people with schizophrenia and epilepsy are managed in their community, and discrimination is reduced,” he said. “This greatly contributes to the reduction of hardship for both the patients and their families.”

However, he pointed out that other mental illnesses – especially depression – were not yet recognised in the model.

“That means that people with these other conditions are not provided with adequate care and treatment in the community or at health facilities,” he said. “An additional problem is that the concept of a mental disorder, the early stage of mental illness, is not yet well understood.”

“Due to this lack of understanding, mental health problems are regarded solely as issues of the health sector; the mental health programme tends to focus on clinical aspects, rather than on early detection and prevention which involves other sectors and the whole community,” he said.

Dr Olive said this year’s message for World Mental Health Day was “Making Mental Health a Global Priority: Scaling up Services through Citizen Advocacy and Action”, adding that the theme recognises that the best way to create change was through concerted action and advocacy in each community around the world. Each person has the power to change, and the ability to create a different world for mental health care, treatment, and promotion.

“I urge you all not to be part of a problem – but a part of the solution,” he said.

(Source: Viet Nam News)