The lack of mental health services in remote areas of Viet Nam leaves children and young people in need helpless

"Every child has the fundamental right to life and maximum survival and development, as well as the right to the highest attainable standard of health. Mental health problems in childhood generate costs in adulthood. If left untreated, these conditions severely compromise children's development, their educational attainments and their potential to live fulfilling and productive lives", said Friday Nwaigwe, Chief of Child Survival and Development Programme of UNICEF Viet Nam. "Children with mental disorders face major challenges with stigma, isolation and discrimination, as well as lack of access to health care and education facilities, in violation of their fundamental human rights."

The study highlights that while fledgling mental health and psychosocial services are provided through, among others, social welfare and social protection centres, mental health hospitals and psychosocial units in schools, their quality and coverage is limited, and often focus on severe mental health disorders. 'In terms of doctors, the human resources, specialized in child psychiatry are very limited in Viet Nam. This aspect is largely not being focused on; therefore, in-depth diagnosis and treatment for children with mental disorders are currently very limited' (KII, Officer, Agency of Medical Services Administration (Medical Technical Division) MOH, Hanoi).

In her opening remarks at the workshop, MOLISA Vice Minister Dao Hong Lan emphasised that the findings of the study provide evidence to inform line sectors and provinces in development and implementation of comprehensive service systems to respond to the needs of mental health and psychosocial support for children and young people in Viet Nam.

The report points to a number of recommendations among which the importance for the Vietnamese government to strengthen and increase the quantity and quality of human resources for mental health in the public sector, as well as the number and type of services, particularly those focusing on less severe mental health problems. The study also emphasises the importance of raising awareness of the need to address children and young people's psychosocial wellbeing, all of which cannot be accomplished without appropriate policy frameworks, budgetary allocations and collaboration among different sectors.

Based on a series of interviews with service providers, adults, children/ young people the study highlights the importance of a supportive family environment, good social and peer networks, supportive teachers and role models as protective factor. Higher socio-economic household status also lessens burdens on children, thereby alleviating some potential stresses, as do the availability of services.

This research confirms suicidal ideation and suicide attempts are an issue in Viet Nam and particularly, among children and young people and also looks at the main perceptions around this issue. While the rate of suicide among adolescents in Viet Nam is relatively low compared with other countries in the region, there is growing concern that suicide in Viet Nam is on the rise and actions need to be taken to address this issue. People interviewed tend to view girls as more susceptible than boys to committing suicide. Additionally, in Dien Bien, the availability of poisonous leaves appears to facilitate suicide attempts particularly among Hmong girls, who live near to where the poisonous leaves grow. However, the researchers found limited data to corroborate these perceptions making it necessary to exercise caution before generalising about suicide among particular ethnic groups, or between boys and girls.

Carried out as part of a broader collaboration between UNICEF Viet Nam and the Ministry of Labour, Invalids and Social Affairs, with research and technical expertise provided by the Overseas Development Institute and the Institute for Family and Gender Studies in Hanoi, this study aims to provide an overview of mental health of children and young people in Viet Nam. Findings from this study will inform recommendations on how to address children and young people's mental health and will feed into both existing national level programmes, including the National Programme on Social Support and Rehabilitation for People with Mental Illness and the National Targeted Programme on Health, as well as future programming and legal frameworks that are being planned including the National Strategy on Mental Health, 2016-2025, with a view to 2030.

Notes for Editors:

According to WHO, mental disorders are defined as "a combination of abnormal thoughts, perceptions, emotions, behaviour and relationships with others," whereas biologically based disorders can include depression, bipolar affective disorder, schizophrenia and other psychoses, dementia, intellectual disabilities and developmental disorders including autism (WHO, fact sheet 2016). In addition to biologically based disorders, mental health can also be affected by psychosocial factors that cause distress. According to the Cape Town Principles, 'psychological effects' are defined as those experiences that affect emotions, behaviour, thoughts, memory and learning ability and the perception and understanding of a given situation" (Cape Town Principles, UNICEF 1997). These include social effects on well-being as a result of various factors such as poverty, war, migration, famine, climate change and so on.

This study draws, builds on and complements ongoing work carried out by Overseas Development Institute in partnership with Institute for Family and Gender Studies on gendered social norm change processes (e.g. around the value of girls' education; the gender division of labour and decision-making in the household, marriage, gender-based violence) with young people which is believed to be vital to contextualise mental health and psychosocial wellbeing. Such discriminatory norms are typically influenced by multiple contexts (global discourses and international frameworks, national political ideologies and development trajectories, subnational context), but are also reframed through individual and community experiences and perceptions.

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UNICEF works in some of the world's toughest places, to reach the world's most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children visit www.unicef.org/vietnam .