Mental disorders may affect one out of four people during their lives (Kessler et al. 1994
; Hwu et al. 2007
). These disorders include unipolar depressive disorders, bipolar affective disorders, schizophrenia, alcohol and drug use disorders, obsessive and compulsive disorders and panic disorders (World Health Organization 2001
). They change the functioning and thinking processes of the individual and often reduce his social role and productivity in the community. Because mental illnesses are disabling and may last for many years, they also place a huge burden on the emotional and socio-economic capacity of the family members who care for the patient (World Health Organization 2001
). The global burden of disease of mental illness is high and is expected to rise (Mathers and Loncar 2006
). At present, anxiety and mood disorders are the most common mental problems worldwide (WHO World Mental Health Consortium 2004
) and it has been predicted that unipolar depressive disorders will be the second leading cause of burden of disease in 2030 (Mathers and Loncar 2006
). Most people suffering from mental health problems live in developing countries, where they often do not receive the treatment they need even though it may be available and generally inexpensive (Patel et al. 2006
). In these countries, mental illness is more often associated with stigma than in more developed countries (World Health Organization 2001
). Up to today, mental health remains a neglected topic. Interventions aimed at decreasing the burden of mental disease are limited, especially in low and middle-income countries (Jacob et al. 2007
As a consequence of rapid demographic and socioeconomic changes, Vietnam is in an epidemiological transition. There is a double burden, with decreasing but still high rates of infectious diseases along with increasing rates of non-communicable diseases including mental disorders (Giang 2006
). The burden of mental health problems is high and appears to be rising, but the health system still pays little attention to mental health. Access to mental health care is limited and few health policies address mental health (Harpham and Tuan 2006
). For a long time the national plan of action focused only on the treatment of schizophrenia and epilepsy in hospitals. Although epilepsy is a neurological disorder, it is often (as is the case in Vietnam) treated in mental health care settings by psychiatrists because people with epilepsy often have considerable psychiatric comorbidity and share many of the same problems with the mentally ill regarding training, planning of services and treatment (Giel and Harding 1976
; Mbuba and Newton 2009
). Since 2004, the national plan proposed to incorporate screening for mental illness among women and children to implement early detection and treatment.
Research on mental health in Vietnam is limited and few studies have been published about the prevalence of mental disorders. Fisher et al. (2004
) found that 33% of the women attending general health clinics in Ho Chi Minh City were depressed after giving birth and 19% of them explicitly acknowledged suicidal thoughts. Giang (2006
) found a prevalence of 5.4% of mental distress in a rural area in Vietnam. Only 42% of those people, however, received treatment for their problems and only 5% sought treatment at official mental health facilities. Help-seeking behavior of the Vietnamese is influenced by Vietnamese concepts of mental illness and health, which are based on a mix of traditional and modern beliefs (Nguyen 2003
; Phan and Silove 1999
). Information is lacking on the perceptions about mental health and help-seeking behavior in Vietnamese communities. The aim of this study was therefore first to describe the perceptions of community members, family members of patients with mental illness and health workers in an urban setting in Vietnam about mental health and about appropriate help-seeking behavior, then to explore the relations between these perceptions.
Jorm et al. (1997
, p.182) introduced the term ‘mental health literacy’ and define it as “knowledge and beliefs about mental disorders which aid their recognition, management and prevention”. Mental health literacy includes the ability to recognize specific disorders; knowing how to seek mental health information; knowledge of risk factors and causes, of self-treatments, and of professional help available; and attitudes that promote recognition and appropriate help-seeking. The Health Belief Model (Rosenstock et al. 1988
) attempts to predict health behavior by focusing on attitudes and beliefs. Relevant components of the Health Belief Model are ‘perceived severity’ and ‘perceived barriers’. The factors addressed by these two models reflect important aspects of perceptions of mental health, perceptions of help-seeking behavior and the relation between them. Together, the aspects from the two models form a conceptual framework along which the methods and analyses were structured.