A Nationally Representative Epidemiological and Risk Factor Assessment of Child Mental Health in Vietnam

Abstract

As part of the global mental health movement’s focus on identifying and reducing international disparities, this study conducted the first nationally representative child mental health epidemiological survey in Vietnam. We assessed as risk/protective factors several family social structure characteristics (e.g., presence of grandparents, number of siblings in the home) of particular relevance to non-Western countries. Epidemiological data using the Child Behavior Checklist and the Strengths and Difficulties Questionnaire were collected at 60 sites in 10 of Vietnam’s 63 provinces selected to provide a nationally representative sample, which included 1,314 adult informants of children 6-16 years of age, and 591 children aged 12-16. Vietnamese children’s mental health functioning was reported overall to be better by approximately a third standard deviation than the international average; this international difference was particularly large for externalizing (behavior) problems as compared to internalizing (emotional) problems, suggesting that a cultural problem suppression model may be operating in Vietnam. Significant variability in mental health problems was found across provinces, emphasizing the need for nationally representative samples when conducting child mental health epidemiological surveys. Contrary to many other studies, in Vietnam higher SES was found to be a risk factor for attention/hyperactivity problems.

Incremental validity of the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ) in Vietnam

“…The general prevalence of mental health problems and disorders in youth in Asia has been reported to be in the range of 10–20% (Srinath et al, 2010), indicating a need for valid but efficient (e.g., inexpensive) psychiatric assessment tools, particularly for Asian low and middle-income countries (LMIC). In Vietnam, for example, the prevalence of significant mental health problems among children and adolescents has been estimated at 12%, similar to those reported in HIC countries (Weiss et al, 2014). Yet like most LMIC in Asia, Vietnam has highly limited mental health infrastructure, particularly in regards to children and adolescents (Weiss et al, 2012).…”

“…Data were collected over 6 months, from February to August 2013. The population/community based sample consisted of 1314 children and adolescents from 6 to 16 years of age collected in 2012 from 10 provinces in Vietnam as part of a national epidemiological study of Vietnamese child mental health (Dang et al, 2015; Weiss et al, 2014). The study was conducted by Vietnam National University and approved by their US FWA IRB (00018223).…”

Early identification and intervention services for children with autism in Vietnam

“…It is important to note, of course, that although perhaps representative of Vietnamese children actually receiving ASD services (given that there are few ASD centers outside the major urban areas we sampled; Nguyen, 2013), our sample certainly is not representative of children with ASD in Vietnam in general: Given (a) international ASD prevalence rates of approximately 1%, (b) the overall Vietnamese population of approximately 93 million, and (c) the relatively small number of sites providing ASD services in Vietnam (Nguyen, 2013), the vast majority of children in Vietnam with ASD undoubtedly are not receiving any services, early or otherwise. In regards to the representativeness of our sample more generally, the median level of education in Vietnam is about 8 th grade (Weiss et al, 2014) whereas in our sample the median education was about two years of college. The effect of both of these factors likely would be to over-estimate the quality and availability of services (Lai & Tran, 2014).…”

“…The average age of caregivers was 34 years, and 59% were female. As is typical in Vietnam (Weiss, Dang, Trung et al, 2014), the large majority (93%) of caregivers were married. Participant characteristics are reported in Table 1.…”

“…Agency directors most frequently identified facility difficulties, a lack of governmental policy, and a lack of well-trained therapists and teachers as major obstacles. In the major urban areas from which our participants were recruited, because of the rapid urbanization that Vietnam is undergoing costs of land and hence rent can be quite high (Cuong, 2011) yet median national income, which controls what typical families can pay for services, is low (Weiss et al, 2014). Thus, it is difficult for ASD centers to afford appropriate physical facilities with sufficient space, technical tools, access to outdoor spaces for play, etc.…”