Viet Nam's policymakers respond to research findings on mental health

Policymakers in developed countries are increasingly using scientific evidence to formulate government policies on health care. Health professionals argue that policies based on evidence provide far better care for patients and value for money than their predecessors. Should developing countries be following suit?

LondonSouth Bank University, together with the Research andTraining Centre for Community Development, Hanoi, looked at whethergovernment officials in Viet Nam used medical evidence in order to formulatemental health policy.

VietNam has high levels of mental illness. One study found that 33 percent of womenattending health clinics in Ho Chi Minh City were depressedand 19 percent had contemplated suicide. A national survey found that 20percent of children suffered from depression. Despite these figures, there wereno policies in place until recently for the care of the mentally ill. Theexception was patients suffering from severe mental illness, such asschizophrenia and epilepsy. These patients were cared for in hospital.

In2004, the Research and Training Centre for Community Development presented itsfindings on mental illness to members of the National Assembly. The meeting washeld outside the capital to prevent senators from returning to their regularduties. Shortly afterwards, the Research and Training Centre presented itsfindings to the government body devoted to the needs of families (the NationalCommittee for Population, Families and Children). This event was timed to feedinto the new five year plan.

Foursenior officials were interviewed in 2005 to discover if mental health was tobe addressed in government policy; if so, why it had been included; and ifscientific evidence had influenced the process of decision-making.

Thestudy found that the Research and Training Centre’s efforts to influence policy weresuccessful despite the fact that there was not yet broad-based support forpolicy change. Neither was there a Communist Party official backing the newpolicy. The study found that:

• The scientific evidencewas released at a good time: it coincided with the planning cycle.
• The Research and TrainingCentre already had good links with government. It had worked withgovernment officials on previous occasions, providing information onmalnutrition amongst women and children.
• Government policymakers regardedthe scientific evidence as reliable.

Thenew five year plan will include screening women and children for mental illnessin order to catch and treat it at an early stage. A health programme aimed atcaring for mentally ill patients within the community will be piloted. The existenceof the National Committee was beneficial because it was able to look at theneeds of women and children from a wider perspective rather than from a narrowdepartmental approach. In order for politicians and civil servants to basetheir policy decisions on scientific evidence the study suggests that:

• The scientific researchshould be thorough and reliable.
• The information needs tofit in with existing political pressures: for example, it should be providedat a time when policy change is taking place.
• The researchers should haveestablished links with the policymakers.