Experts urge better care for depression patients

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Doctors call for improved awareness and better healthcare to tackle a rising tide of clinical depression

Patients being treated for depression at the National Mental Hospital 2 in Dong Nai Province

On Wednesday, Hang thought about ending his "boring and empty life."

"I talked about committing suicide this morning but my wife calmed me down," said the 50- year-old carpenter from Dak Nong Province.

"I suffer from sleepless nights and vomit very often. It's like a severe flu. Everything is boring. I don't want to talk to anyone," said Hang, who is being treated for depression at the National Mental Hospital 2 in Dong Nai Province.

The carpenter said he first heard about depression last year, when his symptoms became so severe he had to be hospitalized. After receiving antidepressants for six months at hospitals in Hai Duong and Hanoi, he recovered and stopped taking medicine.

Hang was admitted to the Dong Nai facility on September 3; his depression had returned. "Maybe I have been thinking too much," he said.

Hang's case is not uncommon in Vietnam.

Many hospitals have seen a rise in the number of mental health cases in recent years. Doctors are also calling for increased public awareness of the harmful consequences of clinical depression.

According to the World Health Organization, about 154 million people around the world suffer from depression.

Emerging concern

"The number of patients suffering from mental disorders, including depression, has increased in recent years," Dr. Phan Tien Si, head of the National Mental Hospital 2's Training and Scientific Research Department, told Thanh Nien Weekly. "Depression has become one of the major concerns in our modern society."

"Some ten percent of patients examined at the hospital recently have been diagnosed with depression," he said, adding that the proportion of inpatients with mental disorders has increased significantly


Si attributed the increase of depressed patients to the anxieties associated with the modern world.

"A modern person faces a number of problems every day: traffic gridlock, accidents due to that traffic, air pollution, and pressure in the working environment," he said.

Si alleged that few surveys in Vietnam have focused solely on depression. Research compiled a decade ago found that between three and six percent of the country's population suffered from the disorder.

Dr. Pham Van Tru, deputy director of the Ho Chi Minh City Mental Hospital, offered a similar analysis of the current situation.

"The number of depression patients increased as Vietnam modernized and industrialized," he told Thanh Nien Weekly. "For instance, harsher competitive environments force people to constantly improve themselves. These pressures can lead to stress and depression."

Fatal disease

Clinical depression, even in its most severe form, is a highly treatable disorder. According to Dr. Si, the earlier treatment begins, the more effective it is and the greater the likelihood that recurrences can be prevented.

"Depression can heavily affect a person's life," he said. "Victims often find they can't concentrate on work. Many personal relationships, including marriage, can also be affected," he said.

Avoiding treatment can only worsen the condition, Si said, and make problems worse. In extreme cases, untreated depression can result in suicide.

According to the HCMC Mental Hospital, one in every five cases of untreated clinical depression ends in suicide, the hospital said in a statement published on its website.

Low awareness

Dr. Si said that a majority of patients suffering from clinical depression didn't recognize their illness at first. Many sought treatment from general practitioners rather than mental health professionals.

"Incorrect diagnoses have also worsened the disease in many cases," he said, adding that many were unwilling to come to a mental hospital fearing that they would be stigmatized for life.

Dr. Jean-Marc Olivé, WHO Representative for Vietnam, said that depression "is a burning health problem in the world as well as in Vietnam" and called for better care in the community.

"In Vietnam, the prevalence of the ten most common mental diseases is about 15 percent according to the national survey conducted by National Mental Hospital in 2000," Olivé wrote, via e-mail. "Recent surveys on a smaller scale showed that mental disorders in children, in pregnant women and mothers of newborns were about 20-30 percent. Most of these cases were depression."

He also said that Vietnam's National Target Program for Mental Health was ratified in 1999- 2000 by the Government. According to Olivé, the program established a community-based mental health care model that has focused solely on addressing schizophrenia and epilepsy.

"To assist in solving the problem, last year we supported the Ministry of Health to review and revise the model following WHO recommendations. That means the model will cover all common mental disorders in the community including depression," he said.

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