THE SITUATION OF MENTAL HEALTH PROBLEMS DURING COVID 19 PANDEMIC IN VIETNAM

FOREIGN TRADE UNIVERSITY SCHOOL OF ECONOMICS AND INTERNATIONAL BUSINESS *** MID-TERM REPORT Course: DEVELOPMENT ECONOMICS (KTEE406.1) Instructor: Nguyen Thi Hai Yen (M.A.) THE SITUATION OF MENTAL HEALTH PROBLEMS DURING COVID-19 PANDEMIC IN VIETNAM GROUP 10 Hoàng Ngọc Anh Nguyễn Ngọc Anh Vũ Thị Thanh Vân Ngô Hồng Sơn Vũ Thị Lam Bình Nguyễn Thị Phương Thảo Phạm Lê Huy Trần Nhật Minh Trần Thu Vân Hanoi, 2021 1913340005 1913340007 1913340041 1911150559 2012450011 2013450054 2012150040 2013450042 2013450066 ACKNOWLEDGEMENT This research report is the outcome of three-week-long efforts in brainstorming, doing literature review, writing and fine-turning of group 10- Development Economics course We could not have done this report without initative and guidance from our course lecturer – Ms Nguyen Thi Hai Yen (M.A) Her lectures have not only served as valuable inputs for out completing the report, but also consolidated our humble understanding of Development Economics and Development studies in general We would like to thank Ms.Yen for her commitment to teaching and disseminating meaningful knowledge about development, which, we believe, would be helpful tools for us as future leaders and potential change makers Also, we understand that this report is nowhere near perfect, so we welcome constructive feedback and comments from anyone who is generous enough to spend their time reading our work We would highly appreciate your feedback you may have for our report and take them into wholehearted consideration Thank you Group 10 – Hanoi, 2021 TABLE OF CONTENTS I ABSTRACT II INTRODUCTION III LITERATURE REVIEW CAUSES OF MENTAL HEALTH 1.1 Biological Causes of Mental Disorders 1.1.1 Genetics .3 1.1.2 Infection 1.1.3 Brain defects or injury .3 1.1.4 Prenatal damage 1.2 Non-biological Causes of Mental Disorders 1.2.1 AIDS/HIV 1.2.2 Conflict 1.2.3 Substance 1.2.4 Violence against women INDICATORS FOR MEASURING MENTAL HEALTH .8 2.1 Hospitalization rates 2.1.1 Individual hospitalized for more than 30 days in a year 2.1.2 Unmeet need for mental health care among people with mental disorders 2.1.3 One-year rate of repeat hospitalization for persons with a mental illness 2.2 Divorce rate 2.3 Schooling 2.4 Depression rate 2.5 Suicide rate 10 2.6 Caring for family member with mental illness 11 IMPACT OF ECONOMIC FLUCTUATIONS ON MENTAL HEALTH 11 IV IMPACT OF COVID 19 ON MENTAL HEALTH IN VIETNAM 13 OVERALL ECONOMIC SITUATION IN VIETNAM .13 THE SITUATION OF COVID-19 PANDEMIC IN VIETNAM 14 COVID-19 AFFECTING INDICATORS OF MENTAL HEALTH IN VIETNAM 16 3.1 Divorce rate 16 3.2 Schooling 18 3.3 Depression rate 20 3.4 Hospitalization rates 22 3.5 Suicide rate 22 V EFFORFS TO REDUCE SYMPTOMS OF MENTAL DISORDER .24 MENTAL HEALTH POLICY & STRATEGY 24 MENTAL HEALTH ACTIVITIES 24 2.1 Central level 24 2.2 Regional level 25 INDIVIDUAL EFFORTS 25 VI DISCUSSIONS AND CONCLUSIONS .26 DISCUSSIONS 26 2.CONCLUSION 26 VII REFERENCE .27 I ABSTRACT The Coronavirus disease 2019 (COVID-19) pandemic has endangered human mental health globally by unprecedented consequences including: increasing casualty, social lockdown, unemployment, isolation While psychological support is being provided to patients and healthcare workers, the general public's mental health requires significant attention as well This research paper is to summarize extant literature that reported on the prevalence of symptoms of depression, anxiety, PTSD, and other forms of psychological distress in the general population during the COVID-19 among Vietnamese people’s mental health from the beginning of the outbreak to the present It synthesizes secondary quantitative research and sources of data from international journals and public reports on WHO’s websites following the PRISMA guidelines A manual search on Google Scholar was conducted for additional relevant studies Articles were selected based on the predetermined eligibility criteria In general, it can also be concluded there are many significant differences between the Vietnamese and people in other countries in terms of the level of mental health issues because of the 2020’s success in preventing Covid-19 in Vietnam Particularly, the psychological consequences of COVID-19 are beginning to become more clear with post-traumatic stress, depression, anxiety, and other symptoms associated with quarantine and social-distancing in Vietnam To some extent, this research also mentions the effort of Vietnam in different levels to improve mental life II INTRODUCTION During any outbreak of an infectious disease, the public’s psychological reactions are of great importance in shaping both spread of the disease and the occurrence of emotional distress and social disorder during and after the outbreak However, in Vietnam, sufficient resources are typically not provided to mitigate pandemics’ effects on mental health and wellbeing While this might be understandable in the acute phase of an outbreak, when health systems prioritize testing, reducing transmission and critical patient care, psychological and psychiatric problems seem to be overlooked during pandemic management although they are becoming popular, especially in Vietnam where psychological diseases are taken for granted Meanwhile, in a study of patients who survived SARS-CoV in 2003 in Vietnam and some other countries, the cumulative incidence of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) psychiatric disorders after recovering from the disease was 58.9% (Mak et al., 2009); 25% of patients had post-traumatic stress disorder (PTSD) and 15.6% had depression Preliminary research has shown similar psychosocial effects of the Covid19 pandemic and a rise in psychopathology such as depressive and anxiety disorders Thus, our findings can aid in future research on the impact of an infectious disease on mental health in Vietnam and other countries in the preparation of better care for populations under such circumstances Development Economics – Group 10 III LITERATURE REVIEW When it comes to previous research papers in the world, given the novelty of Covid-19, its emergence and spread has led to widespread anxiety and fear among the public, contributing to cognitive distress (Shah et al., 2020) In one study in China, 22.6% of people from 18-50 years old reported symptoms of depressive disorders and 18.9% reported symptoms of anxiety disorder (Xie et al., 2020) A survey of 4,342 primary and secondary school students in Shanghai linked Covid-19- related school closures to anxiety in 24.9% of the sample, depression in 19.7%, and stress in 15.2% (Tang et al., 2021) Similar findings were reported by a number of other studies (Gonzalez, 2020; Qi et al., 2020; S.-J Zhou et al., 2020) In addition, according to the report published in The Lancet on November 9, 18 percent of COVID-19 patients developed a mental health issue — like depression, anxiety, or dementia — within months of diagnosis Their risk was doubled compared to people who didn’t have COVID-19 A recent survey from Ecuador has also shown that people diagnosed with COVID-19 commonly experience anxiety, insomnia, depression, and post-traumatic stress disorder On the other hand, one of the symptoms caused by Covid-19 is Posttraumatic stress disorder (PSDT) Post-traumatic stress disorder (PTSD) is a severe mental health condition caused by a terrifying event outside the normal range of usual human experience (Belrose, Duffaud, Dutheil, Trichereau, & Trousselard, 2018) Unlike individual level traumatic events, the COVID-19 outbreak has been a continuing crisis for every member of society It is well known that stressful events such as natural disasters and man-made traumas can have a significant mental health impact and can result in conditions such as posttraumatic stress disorder (PTSD) and depression (Kopala-Sibley et al., 2016; Plexousakis et al., 2019; Schwartz et al., 2019) From such research papers, we find out that there are kinds of mental problems that people over the world often suffer in the context of Covid-19, including: anxiety, depression and PTSD Based on these findings, the authors decide to examine whether such symptoms are existent in the Covid-19 pandemic in Vietnam and their level of significance through doing research into previous research conducted in Vietnam and collecting information from scientific articles and books Causes of Mental health Although the exact cause of most mental illnesses is not known, it is becoming clear through research that many of these conditions are caused by an interaction of social, genetic, traumatic and infectious factors.There are some biological and non biological factors are involved in Mental illness 1.1 Biological Causes of Mental Disorders Some mental illnesses have been linked to abnormal functioning of nerve cell circuits or pathways that connect particular brain regions Nerve cells within these brain Development Economics – Group 10 circuits communicate through chemicals called neurotransmitters "Tweaking" these chemicals through medicines, psychotherapy or other medical procedures can help brain circuits run more efficiently In addition, defects in or injury to certain areas of the brain have also been linked to some mental conditions Other biological factors that may be involved in the development of mental illness include: 1.1.1 Genetics Mental illnesses sometimes run in families, suggesting that people who have a family member with a mental illness may be somewhat more likely to develop one themselves Susceptibility is passed on in families through genes Experts believe many mental illnesses are linked to abnormalities in many genes rather than just one or a few and that how these genes interact with the environment is unique for every person (even identical twins) That is why a person inherits a susceptibility to a mental illness and doesn't necessarily develop the illness Mental illness itself occurs from the interaction of multiple genes and other factors such as stress, abuse, or a traumatic event which can influence, or trigger, an illness in a person who has an inherited susceptibility to it 1.1.2 Infection Certain infections have been linked to brain damage and the development of mental illness or the worsening of its symptoms For example, a condition known as pediatric autoimmune neuropsychiatric disorder (PANDAS) associated with the Streptococcus bacteria has been linked to the development of obsessive-compulsive disorder (OCD is a mental illness that causes repeated unwanted thoughts or sensations (obsessions) or the urge to something over and over again (compulsions) ) and other mental illnesses in children 1.1.3 Brain defects or injury Defects in or injury to certain areas of the brain have also been linked to some mental illnesses 1.1.4 Prenatal damage Some evidence suggests that a disruption of early fetal brain development or trauma that occurs at the time of birth for example, loss of oxygen to the brain may be a factor in the development of certain conditions, such as autism spectrum disorder 1.2 Non-biological Causes of Mental Disorders 1.2.1 AIDS/HIV Though the AIDS epidemic is a global crisis, the degree of its impact varies dramatically for different regions of the world, and developing nations bearing the burnt of the burden One insufficiently explored aspect of the HIV/AIDS burden is its complicated relationship to mental health Mental disorders related to cognitive impairment, Development Economics – Group 10 substance abuse, and personality can influence behavior in ways that lead to a greater risk of HIV infection Conversely, HIV/AIDS itself can cause a variety of psychological conditions brought on by circumstances, and psychiatric conditions Studies conducted by UNAIDS organization in 2018 have stimated that HIV prevalence among people living with severe mental disorders could be between 1.5% in Asia and up to 19% in Africa Moreover, people living with HIV can experience mental health issues that can affect quality of life and stop them seeking health care, adhering to treatment and continuing in care Studies across 38 countries show that 15% of adults and 25% of adolescents living with HIV reported depression or feeling overwhelmed, which could be a barrier to adherence to antiretroviral therapy In addition, treatment itself can cause a wide range of side-effects on the central nervous system, including depression, nervousness, euphoria, hallucinations and psychosis Studies in Africa found a 24% prevalence of depression among people living with HIV In a conference about Mental Health and the Global Development, the World Health Organization asserts that the mental health consequences of AIDS are “substantial.” In addition to the general emotional responses of “anger, guilt, fear, denial, and despair,” 38 to 73 percent of HIV/AIDS patients will have at least one psychiatric disorder in their lifetimes.135 In fact, most HIV positive psychiatric patients actually experience multiple disorders.136 They classify these disorders in the following four categories: • brain diseases • personality disorders • disorders of motivated behavior • problems that emerge from life circumstances Situations that can contribute to mental health problems for people living with HIV include: • Having trouble getting mental health services • Experiencing a loss of social support, resulting in isolation • Experiencing a loss of employment or worries about being able to perform at work • Having to tell others about an HIV diagnosis • Managing HIV medicines and medical treatment • Dealing with loss, including the loss of relationships or the death of loved ones • Facing stigma and discrimination associated with HIV/AIDS “HIV affects the most vulnerable and marginalized in society, who are also disproportionally affected by mental health issues,” said Michel Sidibé, Executive Director of UNAIDS “By integrating HIV and mental health services we will be able to reach more people with the specialist care and life-saving support they urgently need.” Development Economics – Group 10 1.2.2 Conflict In every population, 1-3% have a psychiatric disorder Where conflict is present, the number may increase due to PTSD, alcoholism/drug abuse and depression arising from conflict-related stress A further group, maybe 30- 40% of the population, may experience symptoms such as sleeplessness, irritability, hopelessness and hypervigilance—symptoms which can persist and become more severe, thus interfering with the normal functioning of individuals This group is not classified as having a psychiatric disorder but may have psychosocial disorders manifested as domestic violence, criminal activities, school dropouts and other anti-social behavior Lastly, following a traumatic event a large part of the population may suffer nightmares, anxiety, and other symptoms of stress, but these are often transient and will decrease in intensity and frequency over time At the core of every conflict is insecurity This insecurity fractures social ties, breaks up families and communities, and displaces populations The total number of refugees and internally displaced people is estimated at 37 million worldwide Insecurity and displacement causes the breakdown of social services such as health and education The stateless and displaced are unable to work in their fields or engage in productive activities, and weak or absent social safety nets there is a slide into poverty or dependence on humanitarian assistance In addition, traumatic experiences directly related to conflict, often involving the loss of family members, participation in or witnessing of violent acts, cause further distress There are several studies conducted on mental health consequences of conflict in Thai-Cambodian border, Algeria, Gaza, Uganda Development Economics – Group 10 Country Study Population % Affected Thai 993 Cambodian Cambodian refugees Border 15% PTSD Gaza Strip 550 torture survivors 20% PTSD Algeria, Cambodia, Ethiopia and Gaza 3,047 refugees, internally displaced persons (IDPs), and post conflict survious Authors and Year Mollica et al., 1993 55% Depression El Sarraj et al., 1996 De Jong et 17% among non-traumatized vs al., 2001 Psychopathology: 44% of those who experienced violence Lifetime prevalence: 29% PTSD 12% Depression 25% Anxiety Disorder Uganda IDPs Muller al., 2002 Trauma Group: 55 experienced trauma 53% PTSD et 58 did not experience 62% General Anxiety Disorder trauma 71% Major Depressive Disorder Non-trauma Group: 5% Anxiety Disorder Depression or PTSD No Source: Trauma, War and Violence Public Mental Health in a Socio-Cultural Context, edited by Joop de Jong, 2002 1.2.3 Substance Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa Multiple national population surveys in US have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa Data show high rates of comorbid substance use disorders and anxiety disorders—which include generalized anxiety disorder, panic disorder, and posttraumatic stress disorder Substance use disorders also co-occur at high prevalence with mental disorders, such as depression and bipolar disorder, attention-deficit hyperactivity disorder (ADHD), psychotic illness, borderline personality disorder, and antisocial Development Economics – Group 10 16 Source: Ministry of Health Portal In the early stage of the 4th epidemic, the number of Covid-19 cases was quite low, while now, the number of cases has increased dramatically, almost over 10,000 cases per day As a result, the hospitalization rates due to Covid-19 also increased rapidly That situation prompted the government to immediately enforce the lockdown for big cities Therefore, a lot of businesses and production activities in the economy had to stop, leading to a more severe recession of the economy The recession state of the economy has created certain effects on people’s mental health until now Covid-19 affecting indicators of mental health in Vietnam Being under-resourced and neighbors with China, where cases of Covid-19 initially emerged, Vietnam was in a precarious position of potentially having an explosion of Covid-19 cases Fortunately, Vietnamese government controlled the pandemic quite well throughout 2020 However, the new pandemic appeared in early May 2021 has posed even more difficult challenges for the Vietnamese people This new epidemic has caused a lot of damage to the economy when many production and business activities had to be closed for a long time due to the implementation of the government’s social distancing order This foreshadows a stronger recession of the economy in 2021 And as we discussed earlier, the economic downturn will have a huge impact on people’s mental health To clarify this issue, we will observe some important indicators of mental health in Vietnam, including divorce rate, schooling, depression rate, hospitalization rates and suicide rate Generally, the situation of the Covid-19 pandemic in 2020 has not caused too much negative effects on people’s mental health yet But, the more stressful situation of the pandemic in 2021 predicts worse indicators of mental health 3.1 Divorce rate Development Economics – Group 10 17 Divorce rate is an important indicator of people’s mental health The increasing divorce rate is expected to express a negative situation of mental health And vice versa, the decreasing divorce rate is expected to express a positive situation of mental health As we have known that, all relationships involve a degree of conflict, and it’s normal to argue more during stressful times Relationship counselors consistently rank financial stress, boredom, disagreements about parenting, and arguing about household chores as the most common sources of relationship trouble During the lockdown time of Vietnam in 2020, with many couples stuck in the house, homeschooling children, and facing added financial uncertainty, it should come as no surprise that the Covid-19 pandemic is placing additional strain on relationships that were already struggling Moreover, support systems have become more difficult to access Venting to friends over coffee or spending a night out just isn’t an option right now If you’ve been using these outlets to manage stress, or, perhaps, to avoid dealing with deeper problems, you may find yourself suddenly in the position of having to confront your difference head on Therefore, it’s no surprise that many marriages have reached their breaking point As a result, divorce rate was predicted to increase slightly in 2020 in Vietnam However, data collected on the number of divorces in Vietnam from 2013 to 2020 were surprising In general, according to the trendline, divorce rate during this time still increased from 18.31% (2013) to 22.76% (2020) Nevertheless, in 2020, which is the first year of the Covid-19 pandemic, divorce rate decreased slightly from 25.7% (2019) to 22.76% (2020) Source: Statista.com One way of understanding this surprising situation is through the collective disaster response curve, a model charting the phases through which a community moves in the wake of trauma The curve shows increased energy and a sense of Development Economics – Group 10 18 community cohesion in the period of time immediately following a disaster —it’s the “We’ll get through this together!” phase of disaster response After a period of time, the energy wears off, and disillusionment and depression can set in During this period, couples may begin to struggle During 2020, the situation of the Covid-19 pandemic in Vietnam was not too bad The Vietnamese government controlled the pandemic very well and people did not have too many times of social distancing As a result, the feeling of “We’ll get through this together!” will last longer However, according to more stressful situation of the Covid-19 pandemic in 2021, divorce rate is predicted to increase slightly, and this can show a more negative state of people’s mental health So, why this situation will happen in 2021? According to an article in England, the pandemic was like “the perfect storm” for couples, with lockdowns and social distancing causing them to spend increased amounts of time together This has, in many cases, acted as a catalyst for break-ups that may already have been on the cards, especially if previous separate routines had served to mask problems And with a very long time of social distancing from May to now in Vietnam, the divorce rate is likely to increase 3.2 Schooling According to many previous studies, high education attainment can be considered as a positive indicator of students’ mental health And vice versa, low education attainment is a negative indicator of mental health The closure of schools due to the Covid-19 pandemic is one of the most important factors that strongly affect the level of education attainment of students Development Economics – Group 10 19 Across the world, the closure of schools to prevent community transmission of Covid-19 left more than 1.5 billion children out of school, prompting the DirectorGeneral of the United Nations Educational, Scientific and Cultural Organization (UNESCO), Audrey Azoulay, to warn that "the global scale and speed of the current educational disruption is unparalleled and, if prolonged, could threaten the right to education" (UNESCO, 2020) In Viet Nam, due to the Covid-19 pandemic, the country mandated the closure of all educational institutions, affecting more than 25 million Vietnamese students, at the beginning of February 2020 when the first Covid-19 infections were reported Where possible, teaching and instruction was moved online It was only in May 2020 that the country decided to reopen schools with the necessary sanitation and health protocols However, from May 2021, when the pandemic broke out again, educational institutions had to continue to close During the implementation of online learning at home, many surveys have showed that most students feel “sad and bored” During the first days of online learning, they have not felt there are too many difficulties yet However, when the online learning time is longer, they feel sadder and more bored One way of understanding this situation is that schools are vital for the well-being of children, providing stability, key support services (including MHPSS), and social recourse in the form of peers and teachers Daily routine and access to social infrastructure are crucial for building resilience in children The routine of going to school provides an anchor for students, which was uprooted during the pandemic, causing lethargy and frustration (Lee, 2020) Therefore, the situation of prolonged online learning is considered as a negative impact on students’ mental health Secondly, during the process of online learning, students have to face with more problems, including self-study ability, high concentration ability, and technical problems, … According to the below chart, most of the students are encountering problems of self-study ability due to studying less than required or they did not study (accounted for 51,4%) However, this situation is not too surprising because online learning can cause many temptations that make it difficult for students to fully focus on the lecture Additionally, there are a lot of other problems that are hard to solve such as minor health problems or technical problems These problems can negatively affect students’ learning outcomes and reduce their education attainment Development Economics – Group 10 20 Source: Statista.com 3.3 Depression rate With increasing divorce rate and low education attainment, depression rate in Vietnam is predicted to increase during the Covid-19 pandemic Along with divorce rate and education attainment, depression rate is also considered as an important indicator of people’s mental health The increasing depression rate will express a bad situation of mental health And vice versa, the decreasing depression rate shows a good situation of mental health An online questionnaire regarding attitudes toward Covid-19 along with psychological parameters, including the Impact of Event Scale-Revised (IESR) Depression, Anxiety, Stress Scale-21 (DASS-21) was conducted This online questionnaire was conducted on April 1, 2020, when the Covid-19 pandemic began to thrive in Vietnam At that time, with the increasing numbers of cases locally and worldwide, Vietnam implemented a partial lockdown where residents must stay at home and can only go outside for “essential needs.” Jobs were affected, with many workers left without a job or were furloughed as the economy ground to a halt With prolonged quarantines, restrictions on public life, and worries of job security, there might be rising levels of psychiatric issues such as anxiety, stress, and depression amongst the population Surprisingly, there is generally a low prevalence of reported depression, anxiety, and stress symptoms based on the surveys This finding explains a study's results of Vietnamese researchers with the Vietnam government's successful attempt at keeping infections low and death rate at zero, with early intervention and intensive control measures to curb the spread of the virus Development Economics – Group 10 21 The research suggested that respondents who had an education level of postgraduate have significantly higher stress levels than those with an education level of high school and below One postulation that could explain this phenomenon could be that those with a higher education attainment have invested significantly more resources and as such may possibly have a higher expectation for their future employment Additionally, higher education often comes with greater financial stress upon students because of steeper tuition fees This effect of higher education and financial stress was explored in the UK, which showed that students with greater financial stress were associated with worse mental health outcomes With Covid-19 causing many countries to close their borders, economies contracting as a result of reduced trade and companies forced to reduce the number of employees, the prospects within the job market remain bleak in terms of number of available spots and the impact on their potential salary Higher expectations and financial stress of those with higher educational attainment coupled with the massive impact of COVID-19 on jobs could have contributed to them having greater levels of stress The study’s results suggest that respondents who were fired due to Covid-19 reported higher levels of stress, anxiety, and depression When faced with job losses, individuals experience stress related conditions and even physical symptoms The results also suggest the respondents were more likely to experience stress after contact with a suspected case of Covid-19 Besides the fear of severe complications of Covid-19, it is likely that respondents are worried that they might have to be isolated after contracting the disease Isolation could lead to loneliness and even lead to suicidal ideations Another postulation would be that respondents were more stressed because they were afraid that they would become asymptomatic carriers and propagate the transmission of the disease to others who may belong to a more vulnerable group A larger family size is associated with higher levels of depression, anxiety, and stress This association was also previously established in a South Korean study, which showed that a larger household size was associated with greater stress amongst family members This may be due to increased levels of concern with other family members contracting the disease Previous studies on the psychological impact of Covid-19 where about 75.2% reported they were worried or somewhat worried about other family members getting the disease With larger families, there is greater financial stress on the breadwinners It is important for mental health professionals to explore their concerns and focus on promoting positive coping styles, which were shown to be a protective factor against depression and anxiety during the Covid-19 outbreak In general, according to the above study, there is a low prevalence of reported depression, anxiety, and stress symptoms However, the study was conducted on April 1, 2020, when the situation of Covid-19 pandemic in Vietnam was not too bad with quite low Covid-19 cases Unfortunately, the more stressful situation of Covid-19 pandemic Development Economics – Group 10 22 in 2021 is predicted to raise the depression rate and shows a bad situation of people’s mental health 3.4 Hospitalization rates Hospitalization rates are the next indicator of mental health that we concern Increasing hospitalization rates are a bad indicator of mental health Whereas, decreasing hospitalization rates are a good indicator According to statistics of the Ministry of Health in 2017, in Vietnam, about 15% of the population suffers from common stress-related mental disorders, million people have severe mental disorders The announcement at the Institute of Mental Health showed that 30% of the Vietnamese population suffers from mental disorders, of which the rate of depression accounts for 25% According to specialist doctors, this is incomplete statistics Because in fact, the number of patients being treated is very low, only 20% of those infected go to the doctor As a result, hospitalization rates in Vietnam before the Covid-19 pandemic were quite low The reason many people think that they only have physical fatigue, not a mental illness, or a mental illness, but it is not too important, not worth paying attention to Additionally, many people are also worried that if they get sick, it will affect their social relationships around them, so many people choose to hide their illness, don't go to the doctor Moreover, few people go to the right mental health and psychology specialties, but many people go to other specialties And so, the few patients who are properly examined by the psychological specialty are very few When the Covid-19 pandemic broke out around the world, Vietnam's implementation of social distancing is likely to make it more difficult for people to go to the hospital for mental health problems As a result, hospitalization rates due to mental illnesses are predicted to continue decreasing However, this is not an indicator of good mental health 3.5 Suicide rate The suicide rate is the last indicator of mental health that we want to observe to point out the situation of mental health during the Covid-19 pandemic in Vietnam The increasing suicide rate will express worse mental health Whereas, the decreasing suicide rate will show a good situation of people’s mental health At the onset of the pandemic, several mental health experts warned the world to prepare for a concurrent increase in the rate of suicide using phrases such as “a tsunami of suicide”, “dual pandemic of suicide and Covid-19″, and “suicide mortality and COVID-19- a perfect storm” (Banerjee et al., 2021; McIntyre and Lee, 2020; Reger et al., 2020; Thakur and Jain, 2020) Analyses of the actual suicide rate during the Covid-19 pandemic based on national and regional/local health statistics from across the world, however, provide a Development Economics – Group 10 23 different picture A majority of such comprehensive data-based studies report a modest reduction in the total suicide rate whereas the remainder report no significant net increase in the suicide rate during the first year of the Covid-19 pandemic The situation is the same in Vietnam From 2015 to 2019, the suicide rate in Vietnam did not change much Moreover, in 2019, the rate decreased slightly from 7.6% to 7.5% Shortly, even in the time of Covid-19 pandemic, this situation is expected to remain unchanged Source: Statista.com However, the lack of increase in suicides since the pandemic began seems to be very surprising This situation can be explained by some factors Firstly, that is the positive perspective of Vietnamese people about their government during the Covid-19 pandemic Vietnam is one of the best epidemic prevention countries in the world and always tries its best in tracing to minimize the number of Covid-19 cases in society Additionally, the emergence of many vaccines all over the world has further strengthened people’s beliefs about the disappearance of the pandemic in the near future Secondly, certain protective methods have been operating since the pandemic's early months Communities have actively tried to support at-risk individuals, people have connected in new ways, and some relationships have been strengthened by households spending more time with each other For some people, everyday stresses might have been reduced during stay-at-home periods, and for others, the collective feeling of “we’re all in this together” might have been beneficial Those could be important reasons why the suicide rate in Vietnam has not increased during the Covid19 pandemic up until now However, we still need to take precautions, because there is a new epidemic in Vietnam now with a very high number of Covid-19 cases per day Development Economics – Group 10 24 =) Generally, in Vietnam, the early stage of the Covid-19 pandemic (in 2020) has not left too many negative effects on people’s mental health However, entering 2021, with the increasingly stressful development of the pandemic, people's mental health is predicted to be affected more negatively and we need to prepare in advance with appropriate precautions and treatment V EFFORFS TO REDUCE SYMPTOMS OF MENTAL DISORDER When it comes to the efforts to reduce symptoms of mental disorder, there is a wide range of evidence-based preventive programmes and policies available for reducing symptoms of mental disorder Making effective programmes and policies widely available would provide countries and communities with a spectrum of preventive tools to tackle mental disorders Mental health Policy & Strategy According to Patel & Jané-Llopis, 2005; Musisi, Molica & Weiss, 2005; Anderson et al., 2005, changes in legislation, policy formulation and resource allocation can provide countries and regions with substantial improvements in mental health of the population Some studies have shown that poor health status was a negative factor for mental health during the pandemic.( Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China.Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, Ho RCInt J Environ Res Public Health 2020 Mar 6; 17(5):.) Vietnamese government has implemented some interventions for people who facing with mental health problems , such as an interim relief package (63 trillion VND) for specific people during the pandemic (eg, furloughed workers, unpaid leave workers, freelancers, the poor, or nearpoor individuals, etc) These short-term interventions could partly mitigate socioeconomic burden Conversely, according to research on mental health system in Vietnam The World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) Despite mental health legislation to protect human rights, practical implementation of the legislation is weak Mental health activities 2.1 Central level Generally, the mental healthcare industry in Vietnam is still developing The government has established the National Mental Health Programe (NMHP)(VietnamBriefing, Kyssha Mah) In 2010, the Prime Minister of Viet Nam approved the National Project on Social Work Profession Development (2010-2020) to be implemented by MOLISA with the aim of training 60,000 social work staff, including both social workers and managers, Development Economics – Group 10 25 by 2020 Based on that, on 24 October 2013, the MOLISA issued the Circular No 07/2013/TT-BLDTBXH regulating professional standards of social work collaborators at commune/ ward/town level It tasks the social work collaborators with helping people with mental illnesses and people with mental disorders including: collecting and receiving information or requests for help from beneficiaries; monitoring and assessing their health situation, family and social relationships and what kind of support they need ranging from counselling, consultancy, therapy, education, prevention to separation; participating in the implementation of policies and programs supporting the beneficiaries; and participating in communication efforts to raise awareness for families and communities on mental health Dealing with high rates of post-traumatic stress and increased rates of depression/anxiety associated with the COVID 19 pandemic, Vietnamese government's rigorous campaign to combat misinformation alongside consistent equivocal messages about the virus may have protected against the effects of quarantine, facilitating optimistic attitudes and trust in the government, reducing catastrophic appraisals of health (Front Psychiatry, 08 January 2021) 2.2 Regional level The Department of Psychiatry at Hanoi Medical University and the National Institute of Mental Health provide programs for psychiatrists in training General medical students can choose to a one-year specialization in psychiatry—although its interest remains low relative to other medical fields Developing the mental health care infrastructure will require foreign educational institutions and professional training programs to strengthen Vietnam’s clinical capacity and skills Collaborating with local institutions to enhance existing education or establishing independent training services can help improve the current situation ((VietnamBriefing, Kyssha Mah) Individual efforts “Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community.” So that, self-help is the best way to reduce the burden of mental health problem According to Timothy J.Legg and Adam Felman on April 13 2020, a person coping with mental health difficulties will usually need to make changes to their lifestyle to facilitate wellness.Such changes might include reducing alcohol intake, sleeping more, and eating a balanced, nutritious diet People may need to take time away from work or resolve issues with personal relationships that may be causing damage to their mental health People with conditions such as an anxiety or depressive disorder may benefit from relaxation techniques, which include deep breathing, meditation, and mindfulness Having a support network, whether via self-help groups or close friends and family, can also be essential to recovery from mental illness Development Economics – Group 10 26 VI DISCUSSIONS AND CONCLUSIONS Discussions We acknowledge that there are many limitations to this report This report is not systematic and does not have concrete data measuring changes in the mental health of the Vietnamese throughout the global pandemic In light of this, however, we believe this can motivate further research into the impact of COVID 19 on mental health of Vietnamese people and the effective solutions to deal with the problems 2.Conclusion The psychological consequences of COVID-19 are beginning to become more clear with post-traumatic stress, depression, anxiety, and other symptoms associated with quarantine and social-distancing being observed Vietnam was (and still is) successful in responding to COVID-19, but, inevitably, did not completely avoid these psychological consequences So that, this report provided comprehensive information on the impacts of COVID 19 on mental health of Vietnamese people Development Economics – Group 10 27 VII REFERENCE Herrman H, Saxena S, Moodie R Promoting mental health: Concepts Emerging Evidence Practice Geneva, World Health Organization, 2005 Waddell G, Burton AK Is work good for your health and wellbeing? 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World Bank? - proceedings of a November 2003 seminar and an overview of World Bank interventi ons in mental health (English) Washington, D.C : World Bank Group http://documents.worldbank.org/curated/en/59463152049045387 2/Mental-health-and-the-global-development-agenda-what-role-for-the-World-Bankproceedings-of-a-November-2003-seminar-and-an-overview-of-World-Bankinterventions-in-mental-health Development Economics – Group 10 ... to observe to point out the situation of mental health during the Covid- 19 pandemic in Vietnam The increasing suicide rate will express worse mental health Whereas, the decreasing suicide rate... SITUATION IN VIETNAM .13 THE SITUATION OF COVID- 19 PANDEMIC IN VIETNAM 14 COVID- 19 AFFECTING INDICATORS OF MENTAL HEALTH IN VIETNAM 16 3.1 Divorce rate 16 3.2 Schooling... papers, we find out that there are kinds of mental problems that people over the world often suffer in the context of Covid- 19, including: anxiety, depression and PTSD Based on these findings, the authors