DOI: 10.3886/e129121v1
title: Mental Health Literacy at the Public Health Level in Low and Middle Income Countries: An Exploratory Mixed Methods Study in Vietnam

description: Purpose Mental health literacy (MHL) is key for mental health development, particularly in low-and-middle-income countries (LMIC) where mental health resources are limited. MHL development can be thought of as occurring at two levels: the individual person level (via direct contact, with specifically-targeted individuals), and the public health level (via indirect contact through public media, targeting the general public). Each approach has advantages and disadvantages. <br> <br>Methods The present mixed methods study assessed the status of and best approaches for development of mental health literacy in the Southeast Asian LMIC Vietnam. Because there has been relatively little discussion of MHL development at the public health level, this assessment focused on the public health level, although not exclusively. Because mental health professionals generally have the most in-depth understanding of their mental health system, study participants were 82 Vietnamese mental health professionals who completed a quantitative survey, with 48 participating in focus groups. <br> <br>Results Most of the professionals viewed MHL in Vietnam as low or very low, and that it was difficult or very difficult for the general public to find effective mental health services. Main barriers underlying these problems and more generally for developing MHL in Vietnam identified in the focus groups were: (a) misinformation in the media regarding mental health and mental illness; (b) lack of licensure for non-medical mental health professionals (e.g., psychologists; social workers); (c) lack of interest in mental health from upper-level leadership. <br> <br>Conclusions To the best of our knowledge, this is the first study assessing professionals’ perceptions regarding mental health literacy at both the public health and individual-person levels. Although sampling was restricted to Vietnamese professionals, results may provide initial preliminary guidance for other LMIC considering mental health literacy development at multiple levels.
description: Response Rates: 100%
description: The goal of the sampling frame was to identify mental health and education professionals with interest and understanding of mental health literacy and the challenges of mental health literacy development at public health level. That is, the goal of the sampling frame was not to obtain a random sample of the general population nor a random sample of mental health professionals, but rather to obtain a sample of mental health professionals actively involved in the professional community and interested in mental health literacy, thus most likely to have an understanding of mental health literacy in Vietnam. Consequently, the study design was structured to recruit participants at the 5th International Conference on Child Mental Health in Hanoi, Vietnam, in October 2019. During one section of the meeting, participants were invited to participate in a session on mental health literacy or a session on developmental disabilities, allowing participants to self-select for interest and background in mental health literacy. Participants selecting the former session were introduced to the study and those interested reviewed and signed the consent form. Participants could decide to take part in either or both sections (quantitative, qualitative) of the study. Of the 85 Vietnamese professionals participating in this portion of the conference, 82 (88% female, mean age=34 years) completed the quantitative survey; 39% were practicing psychologists, 23% mental health researchers, 17% school counselors, and 11% medical staff (MD or nurses), with a median of nine years working in their field. Forty-eight of these individuals choose to participate in the focus groups, which lasted slightly more than one hour.