VietNamNet Bridge – Twenty-year-old Le Van Son was recently washing his customers' motorbikes with enthusiasm. His ability to move so quickly, soaping, cleaning and drying the motorbikes made it heard for many people to believe that he once suffered from depression.

Washing motorbikes is a normal activity for most people but it is a remarkable achievement for Le Van Son who is recovering from depression. Community-based support methods have helped him stabilise his mental state and integrate with the society.

"My crisis started at 17 when my parents divorced," he said. "There were mornings when I woke up and saw black and blue scratches on my arms and legs. My father told me I hurt myself, but I didn't remember anything."

Following his parents' divorce, Son lived with his father in Thuong Tin District while his younger sibling went to live with his mother in a different town.

Son spent his days huddled in the corner of his house. Noises frightened him and even voices, including laughter. The only time he ever left the house was when he went to the game shop.

"I hated myself and always felt tired and fidgety," he recalled.

Son was later brought to Ha Noi's National Psychiatric Hospital No1, where he underwent treatment for mental illness, using a method called community-based support.

Cao Thi Vinh, head of the Examination Ward of the hospital, said that nowadays young people are extremely vulnerable to depression due to family shocks, such as divorce.

"They could feel discouraged and powerless," she said. "Later, stress in life, like failures at work or in love can push them further into depression."

In addition to medicine, doctors have increased their use of psychiatric rehabilitation, which gives patients social support in order to help them better integrate with society.

Viet Nam first began using this new approach for treating mental health in 1999. The programme was implemented at National Psychiatric Hospital No 1 in Ha Noi and National Psychiatric Hospital No 2 in HCM City.

Patients are grouped together under the care of psychiatric doctors who talk with the patients and then determine the therapy necessary for treating their mental disorders, such as art-therapy, music-therapy or sometimes even the use of gardening as therapy.

Once a patient's condition stabilises, they can return home to continue their treatment by way of monthly check-ups with doctors.

Even though there has been no scientific research to substantiate the effectiveness of using psychiatric rehabilitation, Vinh believes that at least 70 per cent of the patients suffering from depression can recover completely.

"In fact, many families become poor after years of paying for hospital treatments. If they know how to help in the care of their loved ones at home, then the expense of that treatment will be much less," she said.

However, late diagnosis remains a significant problem when it comes to treating patients with mental disorders; there is also an insufficient number of rehabilitation centres and hospitals for treating the mentally ill.

According to statistics from the Ministry of Labour, Invalids and Social Affairs (MOLISA), there are currently about 9 million people suffering from mental diseases, which is nearly 10 per cent of the population. Only 5 percent of these people receive treatment at one of the 26 mental hospitals and centres located in 20 cities and provinces across the country.

This 5 per cent figure is partly due to families who try to hide another family member's mental illness in order to avoid embarrassment and other social stigmas, experts say.

The labour and social affairs ministry forecasts that the number of people suffering from mental disorders could reach 10 million by 2020 due to factors such as the economic downturn, natural disasters and environmental pollution.

Nguyen Van Hoi, deputy director of MOLISA's Social Protection Administration, said that the limited number of hospitals and centres specialising in the treatment of mental health obviously cannot meet the demand.

Additionally, many of the existing centres do not meet sufficient standards of mental health care.

Regulations state that hospitals should provide patients with at least 8 square meters of room space during their hospital stay and treatment. However, only 40 per cent of the 26 hospitals meet this regulation.

Hoi said the regulation was aimed at requiring hospitals to provide the space necessary for the social support of patients, such as vocational training or consultancy meetings.

Two years ago, the Government approved a community-based social assistance and rehabilitation project for people with mental disorders. Also known as Project 1215, it is in effect from 2011 to 2020.

The project is designed to get corporations, families and communities to support people with mental disorders and to help these people integrate with society.

By 2020 the project aims to have more than 62 social protection centres upgraded and an additional 20 centres built nationwide. In order to ease the overcrowding of hospitals, community medical stations will also receive nurses and other staff trained to deal with mental disorders.

The families of the patients will also receive consultancy from doctors and nurses in order to allow the families to treat patients at home and in their communities.

Over the past two years, the project has also set up software to conduct training and to monitor mentally ill patients in hospitals and social protection centres.

Nguyen Thi Y Duyen, a specialist at the United Nations Children's Fund (UNICEF), said that Project 1215 created a good foundation to set up a system of community-based social assistance and rehabilitation for mental health patients, something that was still not popular in the country.

UNICEF is working with partners, such as the Centre for International Mental Health and the Melbourne University to conduct a project called the Viet Nam Mental Health Consortium to improve the system of mental health care in the country.

Among the priorities include in the project, there is a plan to develop a workforce and give them professional training in mental healthcare and to expand other community-based support models.

It is hoped that these efforts are enough to bring patients suffering from mental disorders, such as Son, back into the community.

After two months at the hospital, Son is now a happy worker at his father's motorbike washing shop.

"My customers often smile at me and I feel much better," he said.

He earns about VND300,000 (US$14) per month and occasionally plays badminton with his father during free time – a common activity, but for someone who used to be so fearful of their surrounding environment, a remarkable sign of progress and recovery.

Source: VNS