This article summarises the development of mental health legislation in Singapore in three distinctive periods: pre-1965; 1965–2007 and 2007 onwards. It highlights the origin of mental health legislation and the relationship between mental health services and legislation in Singapore. The Mental Health (Care and Treatment) Act 2008 and Mental Capacity Act 2008 are described in detail.
This study examined the ethnic differences in stressors, risk, and protective factors among people who attempted suicide in Singapore. A retrospective chart review of 626 attempted suicide cases at a hospital in Singapore between 2004 and 2006 collected information on diagnosis according to DSM-IV-TR criteria. Chi-square tests was used to compare the sociodemographic characteristics, stressors, risk factors, and protective factors among Chinese, Malay, Indian, and other ethnic groups. Logistic regression was used to determine the odds ratios of having two or more stressors, risk factors, or protective factors for the four ethnic groups. Women were more likely than men to attempt suicide, although they also were more likely to have two or more suicide protective factors than men. In general, older people were more likely to have two or more suicide risk factors than the younger groups. Ethnic differences were found in history of psychiatric illnesses and unemployment among the risk factors, and for most of the protective factors, but none of the stressors. Indians were more likely to have two or more protective factors than were Chinese (OR of 7.74, 95% CI [1.04, 8.72]. Future suicide prevention programs should target young adults and strengthen the protective factors among different ethnic groups.
Bach Xuan Tran,1–3 Victoria L Boggiano,4 Long Hoang Nguyen,5 Carl A Latkin,2 Huong Lan Thi Nguyen,6 Tung Thanh Tran,6 Huong Thi Le,1 Thuc Thi Minh Vu,7 Cyrus SH Ho,8 Roger CM Ho9 1Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 3Vietnam Young Physicians Association, Hanoi, Vietnam; 4Berkeley School of Public Health, University of California, Berkeley, CA, USA; 5Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; 6Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam; 7Department of Immunology and Allergy, National Otolaryngology Hospital, Hanoi, Vietnam; 8Department of Psychological Medicine, National University Health System, Singapore; 9Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Background: Media representation of vaccine side effects impacts the success of immunization programs globally. Exposure to the media can cause individuals to feel hesitant toward, or even refuse, vaccines. This study aimed to explore the impact of the media on beliefs and behaviors regarding vaccines and vaccine side effects in an urban clinic in Vietnam.Methods: A cross-sectional study was conducted in an urban vaccination clinic in Hanoi, Vietnam from November 2015 to March 2016. The primary outcomes of this study were the decisions of Vietnamese subjects after hearing about adverse effects of immunizations (AEFIs) in the media. Socio-demographic characteristics as well as beliefs regarding vaccination were also investigated. Multivariate logistic regression was used to identify factors associated with subjects' behaviors regarding vaccines.Results: Among 429 subjects, 68.2% of them said they would be hesitant about receiving vaccines after hearing about AEFIs, while 12.4% of subjects said they would refuse vaccines altogether after hearing about AEFIs. Wealthy individuals (OR=0.41; 95% CI=0.19–0.88), and those who displayed trust in government-distributed vaccines (OR=0.20; 95% CI=0.06–0.72) were less likely to display hesitancy regarding vaccination. Receiving information from community health workers (OR=0.44; 95% CI=0.20–0.99) and their relatives, colleagues, and friends (OR=0.47; 95% CI=0.25–0.88) was negatively associated with vaccine hesitancy, but facilitated vaccine refusal after reading about AEFIs in the media (OR=3.12; 95% CI=1.10–8.90 and OR=3.75; 95% CI=1.56–9.02, respectively).Conclusion: Our results reveal a significantly high rate of vaccine hesitancy and refusal among subjects living in an urban setting in Vietnam, after hearing about AEFIs in the media. Vietnam needs to develop accurate information systems in the media about immunizations, to foster increased trust between individuals, health care professionals, and the Vietnamese government. Keywords: vaccination, Vietnam, media, mass media, health literacy
Background: This study aimed to compare the severity of psychological impact, anxiety and depression between people from two developing countries, Iran and China, and to correlate mental health parameters with variables relating to the COVID-19 pandemic. Although China and Iran are developing countries based on the World Bank's criteria, these two countries are different in access to resources and health care systems. We hypothesized that Iranians would show higher levels of depression, anxiety and stress as compared to Chinese. Methods: This study collected information related to the COVID-19 pandemic including physical health, precautionary measures and knowledge about the pandemic. We also used validated questionnaires such as the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21) to assess the mental health status. Results: There were a total of 1411 respondents (550 from Iran; 861 from China). The mean IES-R scores of respondents from both countries were above the cut-off for post-traumatic stress disorder (PTSD) symptoms. Iranians had significantly higher levels of anxiety and depression ( p < 0.01). Significantly more Iranians believed COVID-19 was transmitted via contact, practised hand hygiene, were unsatisfied with health information and expressed less confidence in their doctors, but were less likely to wear a facemask ( p < 0.001). Significantly more Iranians received health information related to COVID-19 via television while Chinese preferred the Internet ( p < 0.001). Conclusions: This cross-country study found that Iranians had significantly higher levels of anxiety and depression as compared to Chinese. The difference in reported measures between respondents from Iran and China were due to differences in access to healthcare services and governments' responses to the pandemic.
Since the initial phases of the COVID-19 outbreak, international recommendations for disease control have been readily available. However, blind implementation of these recommendations without grassroot-level support could result in public distrust and low adherence. This study evaluated the use of a public health priorities survey to rapidly assess perceptions of local health workers. A cross-sectional study using a web-based survey was conducted among 5,847 health workers and medical students from January to February 2020 to evaluate the level of prioritization of various public health measures. Measures with the highest levels of prioritization were "Early prevention, environmental sanitation, and improvement of population health" and "Mobilization of community participation in disease control," which were concordant with policies implemented by the Vietnamese government. This study also demonstrated a high level of internal validity among survey items and shared ranking of priorities among all occupational groups. The use of this public health priorities survey was found to be effective in identifying priorities as identified by grassroots health workers to provide real-time feedback to the national government. However, future iterations of this survey should consider limiting the use of each prioritization score to ensure that responses represent the reality of source limitations and consider focusing on medical professionals and community workers due medical students' limited experience with Vietnam's healthcare infrastructure.
Long Hoang Nguyen,1 Bach Xuan Tran,2–4 Cuong Duy Do,5 Chi Linh Hoang,6 Thao Phuong Nguyen,2 Trang Thi Dang,2 Giang Thu Vu,7 Tung Thanh Tran,7 Carl A Latkin,3 Cyrus S Ho,8 Roger CM Ho9 1Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; 2Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; 3Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; 4Vietnam Young Physician Association, Hanoi, Vietnam; 5Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam; 6Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh city, Vietnam; 7Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam; 8Department of Psychological Medicine, National University Hospital, Singapore, Singapore; 9Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Background: The escalation of dengue fever (DF) cases in recent years and the occurrence of a large-scale DF outbreak in 2017 underline the importance of dengue vaccines in Vietnam. Given the potential benefits of the dengue vaccines and the need for copayment by the private sector, this study aims to evaluate the willingness to pay (WTP) for the dengue vaccines in patients with DF in Northern Vietnam. Methods: A cross-sectional study was conducted on 330 in-and-out patients with DF admitted to the Bach Mai Hospital. We used the contingent valuation method to evaluate the WTP for dengue vaccines. Socioeconomic and clinical characteristics were also investigated. Multivariate interval and logistic regression models were used to estimate the average amount of WTP and identify the factors associated with the WTP. Results: Around 77.3% patients were willing to pay an average amount of US$ 67.4 (95% CI=57.4–77.4) for the vaccine. People of higher ages, those having health insurance, those traveling in the past 15 days or suffering from anxiety/depression were less likely to be willing to pay for the dengue vaccine. However, people having a longer duration of DF or having problems with mobility were positively associated with WTP for the dengue vaccine. Patients educated to more than high school levels (Coeff.=31.31; 95% CI=3.26–59.35), those in the richest quintile (Coeff.=62.76; 95% CI=25.40; 100.13), or those having a longer duration of the disease (Coeff.=6.18; 95% CI=0.72–11.63) were willing to pay a higher amount. Conclusion: This study highlights a relatively high rate and amount of WTP for the dengue vaccine among patients with DF. Psychological counseling services as well as educational campaigns should be undertaken to improve the WTP for the vaccine. Moreover, government subsidies should be given to increase the coverage of the vaccine in the future, especially for the poor. Keywords: dengue, vaccine, willingness to pay, contingent valuation, Vietnam
Understanding the predictors of health conditions and exposure to secondhand smoke among children is necessary to determine the severity of the issues and identify effective solutions. Despite the significant prevalence in smoking and child exposure to secondhand smoke, there have been only a few studies focusing on this area in Vietnam, and thus the current study aims to fill in this gap. The questionnaires of 435 children aged between 0 and 6 and their caregivers, who agreed to participate in the research, were collected at the Pediatric Department of Bach Mai hospital, Hanoi, in 2016. Multivariable logistic regression was employed to identify factors associated with perceived health status and exposure to secondhand smoke among children in the last 24 h and the last 7 days from the date of the survey. Our study found that 43% of the respondents had smokers in the family, and 46.4% of children were exposed to passive smoking in the last 7 days. Urban children were most frequently exposed to passive smoking at home and in public, whereas in the rural area, the home and relatives' houses were the most common places for exposure. Compared to children whose caregivers were farmers, children of non-government workers were more likely to be exposed to passive smoking in the last 7 days. Moreover, children in a family having smoking rules and no smokers were less likely to be exposed to passive smoking in the last 24 h and 7 days than those living in a family allowing smoking and having smokers. In conclusion, our study shows that the government needs to implement better public smoking monitoring and encourage caregivers to implement smoke-free households or smoking rules in their houses.
