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Vietnam

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The problem
In Vietnam only a small part of the territory is covered by mental health services. As in most low income countries, socio-sanitary facilities for mental health are extremely inadequate and, when present, are concentrated in urban areas where large mental asylums drain most of the resources available for mental health.

At local level, an emergency assistance approach is used, rather than a rehabilitative one: for those persons with psychiatric pathologies this means being pushed away and marginalized by their own communities, thus causing additional suffering and contributing to the chronicity of the illness.

Since 2001 the Minister of Health embarked on a ‘National Mental Program’, aiming at the implementation of mental health services with a community-based approach, according to which psychiatric patients shall be provided with adequate assistance in their own residing area. Mental health treatments available at local level shall fully respond to all possible patients’ needs and should be conducive to make those people suffering from mental disabilities able to be autonomous in their daily activities, integrated into their communities and supported by the society.

CITTADINANZA’s answer
Cittadinanza, considering a priority the development of a community-based mental health system, has decided to financially support the Vietnamese government in the development and implementation of its national program.

With the technical assistance of the World Health Organization (WHO), the Vietnamese Ministry of Health carried out a comprehensive assessment by using the ‘WHO-AIMS/Assessment Instrument for Mental Health Systems’, which is a specific instrument for the collecting of information on and the assessing of mental health systems.

Such a ‘mapping’ procedure is of utmost importance in order to define an effective plan of intervention and to monitor all subsequent changes, but it has to be indisputably performed by the relevant actors at local level: only in this way local mental health operators can get acquainted with their situation and thus be actively involved in a down-to-earth reform process.

From the ‘mapping’ exercise it emerged that:
• the mental health facilities network is not sufficient;
• mental health services are mainly of ‘residential’ kind;
• legislation concerning human rights is still inadequate;
• national health service staff is not adequately trained to deal with psychiatric pathologies;
• patients’ associations and families’ associations do not exist.

The results of the WHO-AIMS assessment have been published in the: “WHO-AIMS, Report on Mental Health System in Vietnam” (www.who.int/mental_health/evidence/who_aims_report_viet_nam.pdf).