We are not paying enough mind to mental illnesses

February 17, 2022 | 04:00 pm PT
Le Duy Journalist
I once had a very strange disease – heightened blood pressure, quickened heartbeats and constant sweating. I thought I was dying.

I was rushed to the hospital several times a month. Three major hospitals studied me closely, trying to find a cause for my hypertension. The most probable theory was that something was wrong with my heart, or that I had pheochromocytoma (rare tumor of the adrenal gland tissue). Ultrasound, CT scans and other diagnoses came up with nothing. Wherever I went, doctors ran the same tests to no avail.

I was trapped in this prison for months. I couldn't go to work or carry out daily activities properly. I didn't even dare to leave home on my own. There was nothing I could do to relieve myself of this misery.

One day, it struck me. What if it wasn't my body that's acting up, but my mind? So I ended up reading some stuff on neurology and decided to consult with a neurologist.

A young doctor at the Bach Mai Hospital took one look at me and said I had panic and anxiety disorder. There was no follow-up diagnosis: he wrote me a prescription and I simply recovered some months after.

Anxiety disorders are extremely common. About 1.7 percent of Americans between 18 and 54 encounter them at some point in their lives. The disorder by itself is not too strange, but the fact that three major hospitals in Hanoi failed to diagnose me is. I had to look things up on my own to diagnose my condition.

When I shared my story online, many people responded saying they have similar mental disorders and asked me for advice. Inadvertently, I became an armchair psychologist.

In truth, I simply listened to what they had to say and referred them to qualified doctors. My job was to lessen their anxiety and point them to the correct doors for help.

It baffles me how there are so many people with mental health issues, yet there are so few doctors and experts to help. According to statistics from the Bach Mai Hospital's Mental Health Department, 30 percent of Vietnamese have had at least one mental disorder in their lives, and half of them required treatment. Suicide committed because of depression claims the lives of 40,000 people a year, around half the number of cancer deaths.

The majority of the people I helped did not know what was going on with them, especially those who live in rural areas. They suffered silently on their own, thinking that it was something everyone would go through at some point in their lives.

The more fortunate ones, many living in cities, knew their mental health was not okay and looked for relief. I followed some of them to every institution we could find in an effort to learn more about Vietnam's mental healthcare system. Many ended up at neurological departments at major hospitals, like I once did, where doctors listened to their problems for a few minutes before giving them prescriptions right after.

Listening patiently

Treating mental health issues involves a lot of listening to patients' stories. But the lack of personnel and resources often push doctors to rush, causing them to miss things, important clues. Many patients have been inaccurately diagnosed. For instance depression is misdiagnosed as bipolar disorder.

This happens across both public and private healthcare sectors - doctors too busy to give mentally troubled patients a patient hearing. Many clinics I've been to were always crowded with patients and doctors too busy to give patients, especially those with mental disorders, the time the latter need.

Vietnam simply has too few mental health professionals. WHO data showed in 2014 that for every 100,000 Vietnamese citizens, there were only around 0.91 psychiatrists or psychologists, which is among the lowest ratio in the world. As a comparison, the corresponding number in Singapore is 3.48 and 12.4 in the U.S.

The doctor who diagnosed me once said students who specialize in psychology and psychiatry are considered to be "lesser" somehow than their peers focused on physical illnesses. This "stigma" is another factor in the lack of practitioners in these fields in Vietnam.

As of 2014, Vietnam had just 36 mental health hospitals with around 6,000 beds for severely ill patients. Only 600 medical facilities, most public hospitals or clinics, offer diagnostic services for outpatients with mental problems.

Things could have improved since, but the current situation doesn't seem to be so different from 2014. Over the last two years, the pandemic has added fuel to the fire, severely exacerbating mental health issues. While this is a daunting challenge, it is also an opportunity for both the public and private health sectors to rise to the occasion.

Vietnam should do more to encourage future doctors to choose specializations in neurology or psychiatry, and mental health departments could invest in and be aligned with the private sector to secure more resources. In more developed countries, neurology, psychiatry and psychology are highly rewarding careers.

Investors should also take note that mental health is increasingly becoming a social priority. Patients will seek the best facilities to place their trust in, but from what I've seen, the infrastructure and service quality in most mental health institutions we have are disappointingly subpar.

A national strategy to increase the number of mental health professionals should be a priority for Vietnam. It would save so many people from despair. I know. I have been there.

*Le Duy is a Vietnamese journalist and author. The opinions expressed are his own.

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