VN030 A short-term Consultant to develop guideline, training package and capacity building on community-based depression management

Background

The burden of depression, in terms of Disability-Adjusted Life Years (DALYs), is among the highest diseases, and proportionally higher in the Asia Pacific) (3.7%) compared to the rest of the world (3%). But this is just the tip of the iceberg because of limitations in regional health system surveillance and the stigma attached to those suffering from the disease (Lancet, 2019; KPMG, 2021).

Depression is particularly harmful as it can cause unproductivity in those who suffer from it who otherwise would be productive. In addition to diminishing work capacity, depression increases mortality from comorbid health conditions and suicide (WHO, 2018), and impairing quality of life and relationships. Women are at particular risk for depression, with prevalence rates ranging from one to two times that of men.

COVID-19 has exacerbated the situation. Job losses, the toll of losing loved ones, and social isolation have all contributed to a mental health crisis. As a result, the depression rate increased. Recent study showed that depression rate is more than triple in the US during the pandemic (Lancet, 2021).

The treatment gap (the number of individuals in need of help versus those who actually receive it) is large (from 75 to 95%), with the vast majority of those in need of depression care receiving little or no treatment (WHO, 2011; Pim C et al, 2018).

Similar to other low- and middle-income countries (LMIC), Viet Nam has significant barriers contributing to this treatment gap, including lack of human resource in mental health. The number of trained psychiatrists in Vietnam 0.9 is well below the WHO’s recommendation of 10.0 professionals per 100,000 population: 0.9 (KPMG, 2021). Furthermore, psychologists are not yet officially recognized and mental health care are separated from general health care, especially primary health care. Other barriers are significant stigma, limited and/or misleading knowledge in the general public about depression and mental health. The situation is more challenging when funding for mental healthcare is especially low in the region including Viet Nam, especially when compared to the burden it causes in Disability Adjusted Life Years (DALYs) (KPMG, 2021).

Ho Chi Minh city (HCMC) is the biggest city in Viet Nam with more than 10 million people. Similar to other provinces and cities in Viet Nam, the city is not yet met the need for management of non-communicable diseases (NCDs) and mental health care in general and depression management in particular for the population. To address huge treatment gap of NCD and mental disorders, especially depression which is worse due to heavy suffering from COVIS-19, the city needs to strengthen the capacity of the district health centers (DHCs) and Commune Health Stations (CHS)s. This is a challenging task because currently people don’t trust the CHSs and the capacity of these health facilities in term of human resource and equipment is limited.

The Department of Health (DOH) of HCMC requested support from the WHO for strengthening Primary Care focusing on management of non-communicable diseases (NCD) and mental disorders. The Organization has been working with related institutes to support the city with management of hypertension and diabetes at 43 selected commune health stations (CHSs) of 10 district health centers (DHC). Capacity building for these 10 DHCs in management of common mental disorders is also ongoing. Now the organization is planning to support moving some essential services of mental health care down to CHSs. As agreed with the DOH of HCMC, the service of screening, psychoeducation, basic psychotherapy for community-based depression management should be the entry point for mental health care at CHSs.

Planned timelines

Start date:  15 July 2023

End date:   31 Dec 2023

Address for applications:

Administrative Officer

World Health Organization

UN Building, 304 Kim Ma Street, Hanoi, Viet Nam

Or by email at: wpvnmapplicants@who.int