How do Vietnamese mental illness stigma affect people living with them?
“Mental illness is when depressed thoughts and stress deviate our mind from its normal state, which was triggered by family troubles.”
This was my closed ones’ perception of mental illness when I approached them with the question: “How do you define mental illness?”. While the response was true to a certain extent, it was an incomplete understanding of mental illnesses. In Vietnam, mental illness often does not generate rigorous discussions as the government health department’s sole focus is infectious diseases [3]. The lack of resources to improve people’s understanding of mental illness meant that the prevalence of stigma can negatively affect those who experience them.
The comprehension of mental illness in Vietnam typically involves the acknowledgment of the dangers posed by life stress. A study comparing the perception of mental illness and its help services between Vietnamese students and U.S. students discovered that Vietnamese students exhibit a stronger stigma towards individuals with mental illness [1]. Due to the belief that people with chronic mental illness are capable of violence, there was a higher agreement in isolating them from the community in Vietnamese students compared to U.S. students. Vietnamese students were also more inclined to believe that stress and emotional shock from life struggles cause mental illnesses whereas U.S. students refer to chemical imbalance as the cause of mental disorders. The same study also showed that although Vietnamese students’ understanding of the elements leading to mental illness was practical, their stigma of people with mental illness remained strong.
Vietnamese people acknowledge that the occurrence of mental illnesses is a combination of internal and external causes, and family plays a central role in their treatment [2]. A focus group research investigated further into Vietnamese perceptions of mental health suggested that depression and schizophrenia are the most identifiable mental illnesses among respondents [2]. The participants attributed depression to family problems, excessive studying and ruminating while they associated genetic, work and love with schizophrenia [2]. Additionally, they considered socially disruptive behaviors, for instance, manic laughing and wandering, as incredibly severe symptoms of mental illness. From their perspective, this type of actions must receive care from mental facilities, yet family care is adequate to treat other mental illnesses. Participants’ belief in the family’s role as the cause and treatment of mental illness reflect its significance in Vietnamese limited understanding of mental disorders.
The stigma of mental illness not only results in an unwillingness to assist people with mental disorder, but it also highlights incomplete comprehension of its definition. Stigma has been shown to prevent Vietnamese children affected by Autism Spectrum Disorder (ASD) from accessing essential services in a study investigating how their parents navigated ASD stigma [3]. ASD stigma manifests in the mainstream media’s hesitance to acknowledge ASD as a disorder (rối loạn phổ tự kỷ), rather than a disease (bệnh tự kỷ). Its reluctance to apply the term disorder (rối loạn) misrepresents calming behaviors such as constant talking and hand-waving usual for children with ASD as abnormal and socially troublesome. Thus, school and medical services may not offer them adequate support, leaving many parents of children with ASD to turn to each other for homeschooling and therapy.
People with complex mental health issues spend their lives dealing with stigma particularly from their relationships, social media, employment, and care services. The 2020 annual report on national stigma surveys Australians who had experienced mental disorders found that 70% of participants have trouble making and maintaining relationships due to stigma and discrimination [4]. Additionally, they found those who had experienced mental disorders have a tougher time applying for work opportunities, finding physical and mental support, and participating in education and training because of stigma and discrimination. Surveyees stressed the importance of education about complex mental health issues, people’s respect towards them and acceptance in support services as ways to reduce stigma. The report bears resemblances to the situation of people with mental illness in Vietnam whose fight for visibility and access to support services and education is still very much challenging.
Nonetheless, Vietnamese people’s stigma of mental illness can be deterred through anti-stigma intervention. An example of an anti-stigma intervention highlights positive aspects of people with mental illness and their treatment progress is the ethnic media project known as Tam An in the Vietnamese immigrants’ community in the U.S. [5]. By providing information about mental illness in Vietnamese, the project has increased awareness of mental illnesses and the willingness to seek psychological help in the community. The effectiveness of the campaign relies on numerous factors, such as the frequency and cultural relevance of the content, and the connection building to community members to spread the message on multiple media (i.e. social media, radio). Although the positive impact of Tam An is not quite widespread, the project can be a future model for combating stigma in Vietnam.
Photo: Tam An Family Empowerment Forum.
Despite Vietnamese’ improved awareness of mental disorders that shift to a more nuanced explanation, the stigma is still rooted in insecurity towards community disordering. Without a comprehensive resource to explain mental illness to people, the stigma will continue to negatively affect those who live with them. However, with an anti-stigma intervention that aims to spotlight the positive impacts of the psychological recovery of people with mental disorders, there will be greater sympathy for them. For the intervention to be effective, members in the community must build a commitment to raise awareness of matters relating to their mental health. Even though the community can reinforce stigma and discrimination that exclude people with mental illness, the community can also welcome them and progress their healing.
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References
[1] Kamimura, Akiko, Ha N. Trinh, Mitch Johansen, Jazmine Hurley, Mu Pye, Kai Sin, and Hanh Nguyen. “Perceptions of mental health and mental health services among college students in Vietnam and the United States.” Asian journal of psychiatry 37 (2018): 15–19.
[2] Van der Ham, Lia, Pamela Wright, Thang Vo Van, Vuong DK Doan, and Jacqueline EW Broerse. “Perceptions of mental health and help-seeking behavior in an urban community in Vietnam: an explorative study.” Community mental health journal 47, no. 5 (2011): 574–582.
[3] Ha, Vu Song, Andrea Whittaker, Maxine Whittaker, and Sylvia Rodger. “Living with autism spectrum disorder in Hanoi, Vietnam.” Social Science & Medicine 120 (2014): 278–285.
[4] Groot, Christopher, Imogen Rehm Cal Andrews Beth Hobern Rikki Morgan Hannah Green Lisa Sweeney and Michelle Blanchard. “National Stigma Report Card: Report Summary.” 2020.
[5] Han, Meekyung, Lien Cao, and Karen Anton. “Exploring the role of ethnic media and the community readiness to combat stigma attached to mental illness among Vietnamese immigrants: The pilot project Tam An (Inner Peace in Vietnamese).” Community mental health journal 51, no. 1 (2015): 63–70.
Editor: Tiên Trần & Hương Lê
Illustration: Quỳnh Theresa Đỗ