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VIETNAM ACADEMY OF SOCIAL SCIENCES GRADUATE ACADEMY OF SOCIAL SCIENCES DO ANH HOA SOCIAL WORK SERVICES TOWARDS MENTAL DISORDER-SUFFERING CHILDREN FROM THE PRACTICE OF QUANG NINH PROVINCE Major : Social work Code : 976 01 01 ABSTRACT OF SOCIAL WORK DOCTOR’S DISSERTATION Hanoi, 2021 The work has been implemented at: GRADUATE ACADEMY OF SOCIAL SCIENCES Supervisors: Associ.Prof.Dr Pham Huu Nghi Dr Bui Thi Mai Dong Reviewer 1: Associ.Prof.Dr Nguyen Thanh Binh Reviewer 2: Associ.Prof.Dr Nguyen Duc Chien Reviewer 3: Dr Nguyen Nguyen Ngoc The dissertation shall be defended at the Academy-level Dissertation Assessment Council, at Vietnam Academy of Social Sciences At ……… : ……., of …… /……./……… The Dissertation is available for reference at: - National Library of Vietnam - Library of Graduate Academy of Social Sciences FOREWORDS Rationale At present, children’s material and spirit life is increasingly improved; the works of children protection, care and education are changed positively from awareness to policies and performance method; many progressions for children in Vietnam have been made in short time Through mass media, the people recognize benefits and obligations of children as specified in the United Nations Convention on the Rights of the Child and the Law of the Child 2016 The spiritual and cultural life of children is gradually getting better; the mortality rate of children under year old and under years old decreases; the rates of children’s schooling and universalization of primary and secondary education increase; the number of children with special circumstances being cared for is increasing However, the process of international and regional economic integration on one hand brings many chances and makes the country keep pace with the region and the world, on the other hand creates an environment with many complicated developments and new challenges for the children protection, care and education The number of children with special circumstances tends to increasing; as reported by the localities at the end of 2015, there were more than 26 million children, of whom 1.5 million of children with special circumstances and about 2.5 million of children were in risk of special circumstances The number of disable children was more than 1.2 billion, accounting for 1.4% of total population and 3.1% of total children Among children with intellectual disability, mental disorder-suffering children are one of objects coping with the most difficulties At present, the number of children diagnosed with mental disorder is rather high As reported by the World Health Organization (WHO), the rate of mental disorder-suffering children in the community is recognized from 10% to 20% in developed countries This rate is also estimated same in developing countries where many children are living in poverty, lack of food, illness, violence and war In Vietnam, with studies and surveys made by researchers and organizations that support children, the rate of children with mental health problems in general is in range of 13 % to 20% in developing countries Especially with results of HCMC children’s mental health survey by Le Thi Ngoc Dung et al, it indicates the remarkable rate of 21.3% of children with mental health problems in Ho Chi Minh city Meanwhile, many Vietnamese people remain unknown about the mental disorder in children, they often confuse with some other diseases such as intellectual disability, down, nervous disease Many parents often difficultly accept the fact and hide it from neighboring people; accordingly, they raise their children in a closed environment, not letting them know anything to prevent their children from screaming or hurting yourself The very ambiguity in awareness and direction of care and education of mental disordersuffering children automatically makes their abnormal behavior worse and the gap between these children and society widened Studies about mental disorder-suffering children and supporting services for them and their families are concerned from various aspects by many domestic and foreign researchers When studying about this topic, findings and contributions vary from one author to another, which help to clarify the panorama about the social work services towards mental disordersuffering children In addition, the researchers indicate that a number of mental disorders may start from their childhood It is estimated that one fifth (about 20%) of children and teenagers cope with mental health problems, who need be detected and treated Some common mental disorders in children include anxiety disorders; disruptive behavior and inattention disorders; eating disorders; mood disorders…Children suffering from mental disorders will affect physical development, reduce learning efficiency, often have aggressive behaviors or withdraw from social relationships Especially some mental disorders make children to commit suicide or harm themselves Social work with its birth and professional development over one century worldwide has proved its roles and responsibilities in the field of mental healthcare, especially mental disorder problems in children Providing social work services with mental disorder-suffering children worldwide shows that in addition to medical services, services of caring and supporting mental disorder-suffering children are also widened more comprehensively and flexibly, such as children’s crisis intervention services, early intervention services with specific mental diseases, rapid intervention services, psychotherapy and advice services for children, services of capacity building and family support, assessment and advice and information supply, intensive therapy services… It is demonstrated in the fact that the foregoing comprehensive services are not only effective in intervention but also acts as solid platform helping mental disorder-suffering children better rehabilitate their social functions and integrate into the community Applying and developing such comprehensive services have overcome some restrictions of the traditional intervention model while focusing in medical services Quang Ninh is a province located in the Northeast of Vietnam, covering 611,081.3 km2, with population of over 1.2 million people, including 13 districts, towns and cities with 177 communes, wards and townships It has a coastline of 250 km, a border of 132 km adjacent with China and Mong Cai international border gate Located in the key economic development area of the Northern region (Hanoi - Hai Phong - Quang Ninh), it has the largest coal industrial park in the country and Ha Long Bay that is one of the natural wonders of the world attracting domestic and foreign tourists Geographical advantages such as seaports, borders and natural resources are the strength for Quang Ninh's economic sectors to develop, such as industry, transportation, tourism, trade and services Quang Ninh is also one of the leading provinces in the country in terms of effective implementation of the Project on Development of Social Work Profession, the Project on Care and Function Rehabilitation for the mental patients, mentally disturbed patients, which assist the disadvantaged groups and contribute to ensuring social security According to statistics of Department of Labor Invalids and Social Affairs in 2019, in Quang Ninh there were about 319,807 children at age of 016 With the survey statistics of Quang Ninh Center for Social Work obtained for implementing the province-level scientific research project of “Studying and suggesting solutions for reducing mental disturbance in Quang Ninh province”, it shows that the rate of mental disorders in children in Quang Ninh is 10.1% over 3,656 children under the survey At present, social work services for intervention and supporting mental disorder-suffering children and their families in Quang Ninh are few, scatted and incompliant with needs of families whose children are suffering from mental disorder; social work services are supplied in restricted and unprofessional manner by the local community, especially at public and private health establishments, social assistance establishments in Quang Ninh, which have not been properly concerned by agencies and people There are some studies concerning children with special circumstances and social work in Quang Ninh, in which mental disorder-suffering children are mentioned However, there is not any study intensive in social work services for mental disorder-suffering children from theoretical and practical aspects Therefore, designing programs or projects on mental disorder-suffering children care and protection in Quang Ninh remains lack of scientific basis, which results in ineffective support, intervention, psychotherapy or even negative consequences; in addition, it causes difficulties in time, expenses and health of mental disorder-suffering children and their families in screening, diagnosis and early intervention Besides, studies about social work services for mental disordersuffering children remain restricted and unknown, meanwhile there is only few about it The author therefore selects the topic of “Social work services towards mental disorder-suffering children from the practice in Quang Ninh” as his dissertation topic 2.1 Objectives of study The dissertation aims at clarifying theoretical and practical perquisites of social work services towards mental disorder-suffering children On such basis, measures for improving knowledge and skills of parents and caregivers of mental disorder-suffering children are proposed; and suggestions for enhancing quality, efficiency of social work services towards mental disordersuffering children in Quang Ninh province are also provided 2.2 Tasks of study (1) Provide overview on studies and determine, clarify theoretical issues on social work services towards mental disorder-suffering children; factors affecting social work services towards mental disorder-suffering children in Quang Ninh province (2) Survey and assess the actual situation of social work services towards mental disorder-suffering children in Quang Ninh province and factors affecting social work services towards mental disorder-suffering children in Quang Ninh province (3) Experiment effects of training, disseminate knowledge and skills to instruct and help parents and caregivers of mental disorder-suffering children (4) Propose some suggestions for more effective care and support for mental disorder-suffering children 2.3 Questionnaire for study (1) At present is there any social work service towards mental disorder-suffering children? (2) Is there any factor affecting social work services towards mental disorder-suffering children in Quang Ninh? (3) Which knowledge and skills should parents, caregivers of mental disorder-suffering children have for caring and supporting mental disordersuffering children at families? (4) What are solutions for improving efficiency of social work services in supporting mental disorder-suffering children in Quang Ninh province? 2.4 Hypothesis of study (1) At present there are some social work services for intervening and supporting mental disorder-suffering children being implemented in Quang Ninh, such as screening, early intervention for mental disorder-suffering children; consultancy and advice for families of mental disorder-suffering children; connection, referral, policy support; communication and education for awareness enhancement and training (2) Social work services towards mental disorder-suffering children in Quang Ninh is influenced by various factors: policies, laws; providers of social work services; characteristics of mental disorder-suffering children; families of mental disorder-suffering children; service providing establishments, etc 3) Parents, caregivers of mental disorder-suffering children in Quang Ninh are lack of knowledge and skills to care for and educate their children, so they need to be trained, equipped with knowledge and skills to care for their children better (4) In the coming time, in order to improve the effectiveness of social work services in supporting mental disorder-suffering children, many complete solutions on policies, service provision, service providers’ professional quality enhancement should be deployed in Quang Ninh Subject, object and scope of study 3.1 Subject of study Social work services towards mental disorder-suffering children 3.2 Object of study -110 parents and caregivers of mental disorder-suffering children - 90 officials, doctors, social workers (care-staff, psychotherapy doers at social assistance establishments, clinic psychology officials; kindergarten teachers) 3.3 Scope of study Restrictions on study content: There are many social work services towards mental disorder-suffering children, however, it focuses on studying the most popular and basic services in Vietnam today: screening and early intervention for mental disorder-suffering children; counseling and advising for mental disorder-suffering children’s families; connection, referral, policy support; communication, education, awareness raising, training At the same time, it analyzes a number of factors affecting social work services towards mental disorder-suffering children in Quang Ninh, such as policies, laws; providers of social work services; characteristics of mental disorder-suffering children; families of mental disorder-suffering children; service providing establishments Mental disorder-suffering children mentioned in the dissertation are at the age of – 16 and have been diagnosed as mental disorder patients by health establishments and social assistance establishments Restriction on location of study: The study is implemented at some agencies in Quang Ninh: Quang Ninh Social Work Center; Van Don district Health Center; Quang Ninh Obstetrics and Pediatrics Hospital; Mental Health Protection Hospital; Bureaus of Labour, Invalids and Social Affairs at district, town and city levels; some private social assistance establishments; system of Social Work Offices in Quang Ninh province Time of study: From May 2016 to May 2019; datum and figures on social work services towards mental disorder-suffering children have been collected since 2011 Methodology and methods of study 4.1 Methodology of study To implement this dissertation, methodology of dialectical materialism and historical materialism are applied by the author In order to help mental disorder-suffering children develop better, we must put the study in natural laws, principles put in common relationship, in living environment with directly or indirectly affecting factors, it depends on the awareness level of children, families, communities and policies and regimes, social work services that support mental disorder-suffering children with the relationship of resources mobilization (internal and external resources) 4.2 Methods of study To solve the proposed tasks of study, the following methods are adopted in combination: Document analysis method; Observation method; Specialist method; Experimenting method; Questionnaire-based interview; Indepth interview method; Group discussion method; Mathematical statistics method; qualitative data processing method New findings of the Dissertation It systemizes theoretically social work services towards mental disorder-suffering children, clarifies some relevant concepts and adds some concepts and theories to be applied in social work towards mental disordersuffering children; significance of social work services and roles of social work services providers in intervening and supporting mental disorder-suffering children and their families Through study, it is to suggest solutions for regularly training, disseminating knowledge and skills for instructing parents and caregivers of mental disorder-suffering children in order to enhance efficiency in mental disorder-suffering children assistance Its findings are basis for proposing policies and can be applied in the development of intervention models, social work services towards mental disorder-suffering children at public and private health establishments and social assistance establishments in Quang Ninh and thorough the country Theoretical and practical significance of the Dissertation 6.1 Theoretical significance It gives general overview on theoretical issues on social work services towards mental disorder-suffering children; clarifies some relevant concepts; adds some concepts and theories to be applied in social work towards mental disorder-suffering children 6.2 Practical significance It shall indicate actual situation of social work services towards mental disorder-suffering children, also of factors affecting social work services towards mental disorder-suffering children in Quang Ninh, at the same time assessing efficiency of training, disseminating knowledge and skills for instructing parents and caregivers of mental disorder-suffering children Its findings can be useful reference for teaching and learning social work for those who are suffering from mental health problems in general, providing social work services to support mental disorder-suffering children in particular at universities and colleges in Vietnam Besides, its findings is also a ground for counseling and proposing to competent authorities for amendment and revision of some policies for mental disorder-suffering children and social work services provided in Quang Ninh province Structure of the dissertation In addition to the forewords, conclusions and recommendations, list of the author’s published works related to the dissertation, list of reference materials and appendixes, the Dissertation are divided into four chapters: - Chapter 1: Literature review of the topic - Chapter 2: Theoretical issues on social work services towards mental disorder-suffering children - Chapter 3: Actuality of social work services towards mental disordersuffering children in Quang Ninh province - Chapter 4: Experimenting the training, disseminating knowledge and skills, instructing to assist mental disorder-suffering children for parents and caregivers CHAPTER LITERATURE REVIEW OF THE TOPIC 1.1 Literature review of foreign studies 1.1.1 Studies on mental disorder-suffering children Foreign studies show that to 10% of children and teenagers suffer from mental disorders which need be treated This rate is higher at urban areas with crowed population and social disadvantages, especially at puberty Pressure from transfer exams and academic burden, children who have to live in difficult circumstances or live with parents who suffer from depression… are related to mental health problems in children 1.1.2 Studies on social work services towards mental disordersuffering children Foreign researchers have focused on studying these services since the early 1980s in various fields of social life such as economy, culture and education However, under the aspect of social work, it is an essential field to be concerned and studied more intensively Social work is a career and professional action, therefore there are many studies about social work and social security policies Social work services and method of social work services deployment are mostly grown up in developed countries Studies on social work services towards mental disorder-suffering children worldwide focus on problems such as needs of using services of mental disorder care from various group of mental disorder-suffering children; they should have direct and connected intervention and psychotherapy that change their life; Social workers, social work models and activities at communities take an important role in intervening and supporting mental disorder-suffering children; Associations of Social Workers and partners of policy mobilization enhance quality of mental healthcare for children; Studies on intervention measures help to improve awareness of mental disordersuffering children; Many children and teenagers with needs of mental healthcare (determined with some clinic assessment) desire to receive social work services, however there are some restrictions in receiving such services, etc 1.2 Literature review of domestic studies 1.2.1 Studies on mental disorder-suffering children Majority of findings on mental health epidemiology in Vietnamese children shows that the rate of children with mental health problems is generally in range of 13% to 20% in developing countries according to WHO studies Especially, among studies on mental disorder-suffering children, study on autism in children is one of the topics that many researchers in the world and Vietnam are interested in Specially, the search results for the word "autism" on PsyINFO are 38,250 articles, books, theses and dissertations If “autism” is limited to the name of study, there are 12,174 results Thus, it can be said that the number and topics of autism studies in the world are extremely large and diversified Autism has been being a great interest for study 1.2.2 Studies on social work services towards mental disordersuffering children Findings of some authors: Basic information about common mental disorders in children; knowledge and skills of caring and educating children and process of examination, assessment and treatment, rehabilitation for mental disorder-suffering children; Oriented recommendations on management innovation and development of social services in the most general perspective of services in Vietnam in the coming time; Recommendations on the development of a network of social services in Vietnam as services to be established and provided to people with social problems at all levels and in communities; Basic concepts, processes and tools used in social work for mental disorder-suffering people who are women and children; Multi-system therapy is currently being assessed very effective in the intervention of behavioral disorders in adolescents However, there are still not many studies clearly indicating which conditions multi-system therapy is effective The analysis results have also identified a number of affecting factors such as the child's age, family income, parents’ marital status or parents’ mental health; Basic counseling skills and some specialized counseling skills of social workers when working with autistic children's families and providing effective solutions to improve some specialized counseling skills for families of autistic children; Actual status of social service provision in public and private social CHAPTER THEORETICAL ISSUES ON SOCIAL WORK SERVICES TOWARDS MENTAL DISORDER-SUFFERING CHILDREN 2.1 Concepts 2.1.1 Concepts on social work Social work is a career, a professional work to assist individuals, families and communities to improve competence to meet needs and strengthen social functions, simultaneously impulse the social environment in terms of policies, resources and services to help individuals, families and communities settle and prevent social issues to contribute to assuring social security 2.1.2 Concepts on social work services Social work services are professional ones in the field of social work where social workers use professional knowledge, skills and methods to help individuals, families and communities improve their competence to meet needs and enhance social function performance; simultaneously impulse the social environment in terms of policies, resources and services to help individuals, families and communities settle and prevent social issues to contribute to assuring social security 2.1.3 Concepts on mental health, mental disorder 2.1.3.1 Concepts on mental health Mental health is a state of satisfaction in which an individual realizes his or her own potential, can cope with the normal stresses in life, can work actively and contribute to the community 2.1.3.2 Concepts on mental disorder Mental disorder is a group of symptoms or behaviors resulting in psychological, physiological and social dysfunction, causing difficulties and disturbances in social interaction, study and work If self-adjustment is not made, then such symptoms or behaviors exceed their limit and professional intervention is required 2.1.4 Concepts on children, mental disorder-suffering children 2.1.4.1 Concept on children At Article of the Law on Children 2016, it is stipulated “children are people of less than 16 years old” 2.1.4.2 Concept on mental disorder-suffering children 11 - Concept on mental disorder-suffering children: They are people of less than 16 years old, with a group of symptoms or behaviors resulting in psychological, physiological and social dysfunction, causing difficulties and disturbances in social interaction, study and work If self-adjustment is not made, then such symptoms or behaviors exceed their limit and professional intervention is required - Causes of mental disorder in children: Including: Biological causes; Personal psychological causes; social and environmental causes; Many countries around the world are facing profound economic and social changes The social structure of the community is changing due to the rapid growth and expansion of cities, migration, widening income inequality, increasing unemployment and violence All these factors are the direct or indirect causes resulting in negative effects on mental health of each individual, family and community today - Scale of assessment and screening of mental disorder in children: Currently there is not any common standard for screening, diagnosis and psychological intervention, therapy and functional rehabilitation for mental disorder-suffering children Approaches, performance processes and regulations vary from one hospital, health station, social assistance establishment of labor invalids and social affairs and private social assistance establishment to others Normally clinical psychologists, therapists, consultants, researchers will refer to the observations in children in the tables of diagnostic criteria: ICD - 10 or DSM - IV - TR (2000) to make diagnostic conclusions At some public and private social assistance establishment in Vietnam, Test Denver II and PEP R, Gars-2 scale, PSSI, GAD-7, PHQ-9 are used for screening assessment for early detection of mental disorder in children Within the scope of studies of the topic and approaching to the major of social work, principal scales of screening and assessment that have been adopted at some public and private social assistance establishments to assess and detect early mental disorder-suffering children for timely psychological intervention and therapy are mentioned hereof, such as Test Denver, PEP - R, questionnaire for SDQ mental health screening 2.1.5 Concepts on social work towards mental disorder-suffering children 12 Social work services towards mental disorder-suffering children are professional ones in the field of social work, supplied by health establishments, social assistance establishments where medical workers and social workers adopt knowledge, skills, professional methods for the field of mental health, psychology and society in order to assist individuals, families and communities to improve their competence to meet needs and enhance social function performance; simultaneously promoting the social environment in terms of policies, resources and services to help individuals, families and communities to solve and prevent social problems, ensure the implementation of the basic rights of mental disorder-suffering children and their families, contributing to assuring social security 2.2 Social work services towards mental disorder-suffering children It focuses on studying such social work services towards mental disordersuffering children as: screening, early intervention for mental disordersuffering children; consultancy and advice for families of mental disordersuffering children; connection, referral, policy support; communication and education for awareness enhancement and training 2.3 Mental disorders in children Majority of children grow up healthily in terms of mental health, however, current studies show that more children and youths cope with mental problems as compared to the figures of 30 years ago Some mental disorders in children can be treated or solved, while others may not be treated or become long-term problems Some mental disorders in children are common, but others are rare Within the scope of study, the author learns at mental disorders such as autism, attention deficit/hyperactivity disorder, emotional disturbance, depression, developmental language disorder, behavioral disorder 2.4 Difficulties and needs of mental disorder-suffering children 2.4.1 Difficulties of mental disorder-suffering children Mental disorder-suffering children copes with some difficulties: differentiation and discrimination; difficulties of integrating into the community; difficulties of accessing social care services; difficult circumstances; family’s or caregiver’s lack of knowledge and methods of care 2.4.2 Needs of mental disorder-suffering children 13 Mental disorder-suffering children have common needs like normal children However, they also have specific needs to be met and problems in an effort to relieve symptom and signs and enhance capability of integrating into the community 2.5 Theory applied to practicing the provision of social work services towards mental disorder-suffering children The perspectives of the Abraham Maslow’s demand theory and the system theory are applied to address the content of study 2.6 Factors affecting social work services towards mental disordersuffering children To successful provide mental disorder-suffering children with social work services, health establishments and providers of social work services should attention to some main affecting factors: policies, laws, providers of social work services, characteristics of mental disorder-suffering children, families of mental disorder-suffering children; service provision establishments CHAPTER ACTUALITY OF SOCIAL WORK SERVICES TOWARDS MENTAL DISORDER-SUFFERING CHILDREN IN QUANG NINH PROVINCE 3.1 Generalizing features of Quang Ninh area and objects of study Quang Ninh is a province located in the Northeast of Vietnam, covering natural area of over 617,821 ha; administrative units include 04 cities, 02 towns and 07 districts with 177 communes, wards and townships; of which there are 113 ethnic minority and mountainous communes; the population as of 2020 is over 1.2 million people Quang Ninh is home to the largest mineral deposits in our country, accounting for 90% This is an endless resource to supply raw materials for many industries and exportation; Besides, tourism advantages are also prioritized for development by the province At present the number of people demanding to use social work services and disadvantageous people needing social assistance in Quang Ninh is great, of whom are mental disorder-suffering children To assure social security in Quang Ninh province, public social assistance establishments: Quang Ninh Social Work Center, Mental Health Protection Hospital, Mental disorder prevention and therapy establishment – Van Don district Health Center, 14 medical rehabilitation unit of Quang Ninh Obstetrics and Gynecology Hospital and private social assistance establishments have promoted activities of providing social work services to support mental disorder-suffering children and their families in recent times The study is performed in Quang Ninh, involved by 83 officials, doctors, social workers of public and private social assistance establishments; 110 parents and caregivers of mental disorder-suffering children who are being intervened and treated psychologically at public and private social assistance establishments in Quang Ninh 3.2 Generalizing the current situation of mental disorder-suffering children in Quang Ninh In the year of 2012 – 2013, Quang Ninh Department of Labor Invalids and Social Affair collaborated with departments, agencies and the system of social work services provision at levels and Research and Training Center for Community Development (RTCCD) in investigation, survey and screening examination with ECST, PSC, SDQ25, DSM – IV scale at 90 hamlets and streets of 90 communes, wards and townships in 14 districts, towns and cities of Quang Ninh province, in each village, households that have children at the age of 2-16, with a total of 3,656 children, including children in special circumstances As a result, out of a total of 3,656 children screened, the rate of mental disorders generally accounted for 10.1% In other words, out of every 10 children suffered from mental disorder, in which the highest rate was the group of children at age of 11-16 (accounting for nearly 17%), followed by the group of children at age of 2-5 (accounting for about 12%) 3.3 Actuality of social work services towards mental disordersuffering children in Quang Ninh province Providing social work services is an important task of health establishments, public and private social assistance establishments of Quang Ninh during intervening and assisting mental disorder-suffering children and their families Social work services in Quang Ninh is being provided by officials, doctors, social workers of public and private social assistance establishments with main services of screening, early intervention for mental disordersuffering children; consultancy and advice for families of mental disorder- 15 suffering children; connection, referral, policy support; communication and education for awareness enhancement and training Among social work services provided by public and private social assistance establishments, screening, early intervention; consulting and advice for families of mental disorder-suffering children are highly appreciated in terms of its utility and efficiency by providers of social work services and families of mental disorder-suffering children; In addition, other services of supplying basic information of mental disorder in children; connection, referral, communication, training, supplying knowledge and skills for instructing to support mental disorder-suffering children are assessed as effective in supporting psychological therapy for these children However, training, disseminating knowledge and skills of instructing support to mental disordersuffering children remain restricted; and their efficiency has not been promoted due to interval of training and content of training program, which decrease efficiency in combination of psychotherapy by officials, doctors, social workers at health establishment, social assistance establishments and parents, caregivers of these children at home to assure intervention and support with shortened duration of treatment and bring more positive results Services of connection and completion of formalities for families of mental disorder-suffering children to receive social welfares are not highly assessed due to incomplete policies, complicated formalities and hesitating psychology of beneficiary families 3.4 Actuality of factors affecting social work services towards mental disorder-suffering children in Quang Ninh province In the process of study, the obtained findings in assessing factors affecting social work services towards mental disorder-suffering children I Quang Ninh province are stated hereof Feedbacks show that there are many factors affecting the efficiency of providing social work services for mental disordersuffering children such as: factors of policies and laws; factors from social work service providers; factors from the characteristics of mental disordersuffering children; factors from families of mental disorder-suffering children; factors from social work service providing establishments, etc at different levels For the group of officials, doctors and social workers, they assess that policies, laws; characteristics of mental disorder-suffering children and their 16 families are the factors affecting mostly the efficiency of social work service provision for mental disorder-suffering children However, for the group of parents and caregivers of mental disorder-suffering children, social work service providers and their establishments are significant factors It demonstrates that disciplinary officials, doctors, social workers with intensive knowledge can recognize that the affecting factors of the social work services are policies and problems the children and their families are coping with On contrary on the side of parents, they realize that the affecting factors are social work service providing establishments and medical workers who direct psychotherapy for the children It is demonstrated that policies, officials, doctors, social workers who directly apply psychotherapy to the mental disorder-suffering children, have good qualification and spend much time on dealing with the children are factors boosting up and affecting profoundly the efficiency of assistance service provision 17 CHAPTER EXPERIMENTING THE TRAINING, DISSEMINATING KNOWLEDGE AND SKILLS, INSTRUCTING TO ASSIST MENTAL DISORDER-SUFFERING CHILDREN FOR PARENTS AND CAREGIVERS 4.1 Grounds for experimenting - From the findings on the actuality of social work services provided to mental disorder-suffering children and their families, some restricted social work services are chosen by the author for experimenting the effect of enhancing efficiency of social work service provision - Some social work services are restricted due to the fact that parents and caregivers of mental disorder-suffering children have not knowledge and skills to care for mental disorder-suffering children, especially fail to instruct to support mental disorder-suffering children at home - One of factors affecting significantly the intervention and improvement rate of mental disorder-suffering children is the collaboration in instructing for assistance towards mental disorder-suffering children at home by their parents and caregivers, apart from the treatment periods at the health establishments or social assistance establishments - Among proposals of officials, doctors, social workers, parents and caregivers of the children: it is required to have training courses for parents and caregivers of mental disorder-suffering children to obtain knowledge and skills for instructing to assist mental disorder-suffering children - Parents’ and caregivers’ needs of being trained, equipped with in-depth knowledge and skills to instruct and support mental disorder-suffering children are great because of the effectiveness of this activity Besides, most parents and caregivers attended several training courses in the past, but not regularly and the knowledge did not satisfy their expectations - According to assessment of families of mental disorder-suffering children, training courses for parents’ and caregivers’ knowledge and skills of instructing to assist mental disorder-suffering children were performed but not regularly; 100 families of mental disorder-suffering children recognized that they sometime attended a training courses held by health establishments and social assistance establishments in Quang Ninh, which provided them with 18 knowledge and skills to instruct and assist mental disorder-suffering children; Another issue is that such training courses just offered the most basic knowledge on mental health but did not focused on so intensive content that parents or caregivers can instruction and assist their mental disorder-suffering children at home This indicates that, currently the training courses is not really paid attention and organized on a regular and intensive basis to support their families, while as mentioned above, officials, doctors, social workers and the children’s families all consider this activity important in the process of intervention and support for mental disorder-suffering children to solve difficult problems - The results of the survey on the needs to be trained and equipped with knowledge and skills to instruct and assist mental disorder-suffering children for parents and caregivers 4.2 Design of experimenting - Objective of experimenting: Experimenting a training program for enhancing knowledge and skills for instructing and assisting mental disordersuffering children for their parents and caregivers - Hypothesis of experimenting: At present, parents and caregivers of mental disorder-suffering children in Quang Ninh are still restricted in some knowledge and skills for instructing and assisting these children Such knowledge and skills can be enhanced through training courses for them - Objects of experimenting: 10 parents and caregivers of mental disordersuffering children in Ha Long city are chosen from those whose children are under psychotherapy and rehabilitation at Quang Ninh Obstetrics and Pediatrics Hospital, Van Don Health Center, Social Work Center and private social assistance establishments - Time and location of experimenting: From June 2018 to November 2018 at Quang Ninh Social Work Center - Method of performance + Objective of the method: Training courses for enhancing knowledge and skills of instructing and assisting mental disorder-suffering children are organized for their parents and caregivers in 02 sessions, 03 days each time 19 + Content of the method: Specialists are invited to offer knowledge and skills for instructing and assisting mental disorder-suffering children at home to their parents and caregivers 4.3 Steps and contents to be experimented Step 1: Prepare and set up an experimenting program Step 2: Pre-experimenting estimation Step 3: Training Step 4: Post-experimenting estimation and completing 4.4 Experimenting results - Results of experimenting indicate that its hypothesis is right Upon the experimenting, knowledge about mental disorder in children, performance of skills of instructing and assisting the children were profoundly changed; majority of parents and caregivers of mental disorder-suffering children acquired knowledge and performed skills rather well; no one at bad rate; and the average rate significantly reduced - Analysis of 02 typical cases illustrating the experimental results: After the training, Ms M and Ms V has had very positive changes although at different levels, this is a good thing for parents whose children are suffering from mental disorder like Ms M and Ms V It will open the direction of intervention and support for mental disorder-suffering children with close coordination between screening, assessment and psychotherapeutic interventions by professional social workers working at health establishments, social assistance establishments; Rehabilitation at a specialized hospital and methodical guidance and support of parents at home; joining associations and clubs with similar circumstances to exchange and share experiences to support each other to solve difficulties, towards rehabilitation and social integration for mental disorder-suffering children 4.5 Effects and learned experiences about the experimented intervention model - Effects: The experimented intervention model for training, disseminating knowledge and skills for instructing and assisting mental disorder-suffering children for 10 parents and caregivers of these children for days at Quang Ninh Social Work Center has indicated positive results from participants, which shall help the provision of social work services towards mental disorder- 20 suffering children, direct to enhance efficiency of providing social work services in Quang Ninh in coming time Its results actively affect mental disorder-suffering children, their parents and caregivers, the service providers and providing establishments This is an important basis for public and private social assistance establishments to consult competent authorities in promulgating specific policies and regimes for providing assistance services to mental disorder-suffering children - Learned experiences: The author realizes that it is an effective experimenting model for providing social work services to mental disordersuffering children With such steps, content of experimenting and results, it shall contribute to enhancing efficiency of supporting mental disorder-suffering children, it is very essential model However, it is realized that there are shortcomings occurred during experimenting, which relate to parents, caregivers of mental disorder-suffering children, the training program, method of organizing, etc These are valuable experiences that are hopefully useful for candidates, lecturers and scientists working in the field of social works and mental health 21 CONCLUSIONS AND RECOMMENDATIONS Conclusions 1.1 Theoretical studies demonstrate that social work services are professional ones in the field of social work, provided by health establishments and social assistance establishment where officials, doctors, social workers apply their knowledge, skills and professional methods of mental health, psychology and society to help individuals, families and communities to enhance competence to meet demand and strengthen social function performance; while impulsing the social environment in term of policies, resources and services to help individuals, families and communities settle and prevent social issues; ensure to perform basic rights of mental disordersuffering children and their families; contribute to assuring social security 1.2 Within the scope of study, it mentions some mental disorders: autism, attention deficit/hyperactivity disorder, emotional disturbance, depression, developmental language disorder, behavioral disorder 1.3 The social work services being provided in Quang Ninh by public and private health establishments and social assistance establishment are mainly screening, early intervention for mental disorder-suffering children; consultancy and advice for families of mental disorder-suffering children; connection, referral, policy support; communication and education for awareness enhancement and training Of which, screening, early intervention for mental disorder-suffering children; consultancy and advice for families of mental disorder-suffering children are highly appreciated by officials, doctors, social workers and families of mental disorder-suffering children in terms of utility rate and efficiency In addition, other services of supplying basic information of mental disorder in children; connection, referral, communication, training, supplying knowledge and skills for instructing to support mental disorder-suffering children are assessed as effective in supporting psychological therapy for these children However, training, disseminating knowledge and skills of instructing support to mental disorder-suffering children remain restricted; and their efficiency has not been promoted due to frequency of training and content of training program, which decrease efficiency in combination of psychotherapy 22 by officials, doctors, social workers at health establishment, social assistance establishments and parents, caregivers of these children at home to assure intervention and support with shortened duration of treatment and bring more positive results Services of connection and completion of formalities for families of mental disorder-suffering children to receive social welfares are not highly assessed due to uncompleted policies, complicated formalities and hesitating psychology of beneficiary families 1.4 Currently in Quang Ninh province, social work services towards mental disorder-suffering children are encountering factors such as: policies, laws; providers of social work services; characteristics of mental disordersuffering children; families of mental disorder-suffering children; service provider’s establishments, etc at different level For the group of officials, doctors and social workers, they assess that policies, laws; characteristics of mental disorder-suffering children and their families are the factors affecting mostly the efficiency of social work service provision for mental disorder-suffering children However, for the group of parents and caregivers of mental disorder-suffering children, social work service providers and their establishments are significant factors It is demonstrated that policies, officials, doctors, social workers who directly apply psychotherapy to the mental disorder-suffering children, have good qualification and spend much time on dealing with the children are factors impulsing and affecting profoundly the efficiency of assistance service provision 1.5 Applying the measure of experimenting through training: Training courses for disseminating knowledge and skills of instructing, assisting mental disorder-suffering children for their parents and caregivers are performed with participation of 10 parents and caregivers of mental disorder-suffering children in Ha Long city, lasting days for sessions, where instructions are made by Dr Nguyen Thi Kim Quy and supported by officials, social workers of Quang Ninh Social Work Center The training program covers supplying knowledge about mental disorder-suffering children, screening and detection, instructing and assisting mental disorder-suffering children; Observing sample cases (via video where learner and lecturer play roles) and practicing towards mental disorder-suffering children; Organize training in instructing skills to help 23 mental disorder-suffering children in class and in psychotherapy rooms at the Quang Ninh Social Work Center As the results, parents’ and caregiver’s knowledge about mental disorder-suffering children’s problems and skills of instructing and assisting mental disorder-suffering children are improved 1.6 The findings of two typical cases about caregivers of mental disordersuffering children clarify manifestation, efficiency of providing social work services to mental disorder-suffering children and their families at various grades and aspects, obtain practical information to support the findings With the above mentioned results, it is affirmed that the findings are appropriate with the hypothesis introduced in the dissertation and its tasks are solved Recommendations Basing on the findings of the dissertation, in order to promote efficiency of providing social work services to mental disorder-suffering children and their families in Quang Ninh province in the coming time, specific solutions are recommended for policy-making agencies (the government, the Ministry of Labor Invalid and Social Affairs, the Ministry of Health and relevant ministries and agencies; People’s Council, People’s Committee of Quang Ninh province); health establishments, social assistance establishments; schools; officials, doctors, social workers; parents and caregivers of mental disorder-suffering children To perform such recommendations and contribute new findings to the development practice of social work services towards mental disorder-suffering children in Quang Ninh province, some solutions for performance are also suggested by the author 24 LIST OF PUBLISHED WORKS OF THE AUTHOR “Actuality and services of supporting mental disorder-suffering children in Quang Ninh province: sharing the findings and recommendation”, International scientific conference of “Social work with women and children: Experience of some nations”, Vietnam Education Publishing House, publishing registration no 3749-2016/CXBIPH/3-1379/GD, ISBN: 978-604-0-09664-7, November 2016, p 293-301 “Model of providing social work services of Quang Ninh Social Work Center”, Scientific conference of “Social work with teenagers and youths in Vietnam in terms of integration and development”, Youth Publishing House Publishing registration number: 4514-2016/CXBIPH/27-174/TN, December 2016, p 47-56 “Social work services provided to mental disorder-suffering children and their families (from the practice of Quang Ninh Social Work Center)”, International scientific conference “Social work with families and children", Publishing House of Vietnam National University, Ho Chi Minh City Publishing registration number: 2310-2016/CXBIPH/06-147/HCMC, ISBN: 978-604-73-4461-1, quarter III of 2016, p 351-360 “Literature review on social work towards mental disorder-suffering children”, Journal of Education and Society, publishing permit No 1690/CBC-BCTU dated November 17, 2018 – the Authority of Press, the Ministry of Information and Communications, ISSN: 1859 - 3917, August 2018, p 346-352 “Awareness about mental disorders in children”, Journal of Education and Society, publishing permit No 1392/CBC-BCTU dated November 6, 2018 – the Authority of Press, the Ministry of Information and Communications, ISSN: 1859 - 3917, November 2018, p 275-277 "Model of mental disorder-suffering children care in Quang Ninh", Journal of Education and Society, publishing permit No 1392/CBC-BCTU dated November 6, 2018 - the Authority of Press, Ministry of Information and Communications, ISSN: 1859 - 3917, November 2018, p 292-297 ... Restriction on location of study: The study is implemented at some agencies in Quang Ninh: Quang Ninh Social Work Center; Van Don district Health Center; Quang Ninh Obstetrics and Pediatrics Hospital;... Social Affairs in 2019, in Quang Ninh there were about 319,807 children at age of 016 With the survey statistics of Quang Ninh Center for Social Work obtained for implementing the province-level scientific... Quang Ninh province? 2.4 Hypothesis of study (1) At present there are some social work services for intervening and supporting mental disorder-suffering children being implemented in Quang Ninh,