Huong T. Chu, Senior Project Officer, Coordination and Knowledge
Rachel S. Coley, Technical Advisor & Project Manager, EpiC Vietnam
Dr. Lopa Basu, Senior HIV and TB Advisor, USAID/Vietnam

Featured Image: Dr. Duong Duy Khoa spoke about his own mental health challenges while working in the COVID-19 frontline response during an EpiC-supported webinar. “[After some time working in a mobile health clinic], I just started thinking “What am I doing? Does my work mean anything?” The scariest moment was when I started to be afraid of picking up the phones or afraid when the phone rang. It felt like as soon as the phone rings, I had to respond immediately. There is no time to wait because there is an emergency on the other side of the phone.”

In early 2022, healthcare workers in Vietnam were feeling the pressure, pain, and fatigue of a prolonged stressful work environment due to COVID-19. Several members of the workforce quit their jobs, and those remaining struggled to manage their workload. For some, daily exposure to potential infection, as well as severe illness and death among patients, had a negative impact on their own health and wellbeing. Yet, there was little support available for healthcare workers and insufficient awareness of the importance of mental health support. In fact, there are only 0.91 psychologists per 100,000 people in Vietnam, compared to 3.48 in Singapore and 12.4 in the United States.[1]

USAID/Vietnam and the EpiC project recognized that any program designed to improve COVID-19 clinical care had to consider the needs of caregivers, focusing on mental health support as the backbone for providing quality health services to patients and families. In response, EpiC developed a mental health support package to complement clinical case management and infection prevention and control trainings.

Implementing a Mental Health Support Package

Understanding the importance of academic partnerships for knowledge sharing, EpiC partnered with the Ho Chi Minh City University of Medicine and Pharmacy because of their strong team of psychologists and social workers. EpiC focused on provinces around Ho Chi Minh City, the region that experienced the most severe COVID-19 burden and had the most reports of healthcare worker burnout. The mental health support package focused on: 1) training on common mental health challenges, 2) skill-building workshops, and 3) group and individual counseling. The project also ran a webinar on mental health among healthcare workers that reached more than 5,000 individuals.

Training

EpiC funded the Ho Chi Minh City University of Medicine and Pharmacy to run three two-hour trainings, each covering the same content, for doctors, nurses, and hospital administrators. Seventy-eight people participated in the trainings, and a post-training evaluation found that 95 percent would welcome more training on these concepts. 

Workshops

As the project was not originally intended to provide sustained mental health support, workshops were designed to build the skills of healthcare workers to prioritize self-care and self-compassion as a coping tool. Ms. Nguyen Gia Hoang, a licensed clinical social worker and self-compassion expert, ran twelve hour-long virtual workshops on six topics to help attendees:

  • Articulate the key principles and benefits of mindfulness in daily life, practicing mindfulness during meals and periods of rest
  • Utilize mindfulness to maintain a healthy work-life balance
  • Recognize the importance of a healthy work environment, social connections, maintaining contact, and a balanced diet

Reflections from workshop participants

“I want to learn so that I can keep myself, my family, and my patients well.”
“These sessions have made me realize that I need to take better care of myself.”

Counseling

Those in need of an in-depth conversation could access individual or small group counseling provided by a local licensed clinical social worker or psychiatrist. During each group counseling session, participants shared their experiences, learned from one another, and provided peer support. In individual sessions, counselors dove into more personal concerns and needs. In both formats, counseling aimed to:

  • Expose and familiarize healthcare workers with counseling core concepts
  • Provide a safe space for them to share their experiences
  • Help participants identify and understand their own personal needs
  • Learn how to prioritize self-care through mental health support to strengthen personal resilience

Results and Lessons Learned

In less than two months, EpiC provided more than 30 counseling sessions, six hours of training, and 12 skill-building workshops. Through this process, EpiC identified several valuable lessons for application in future programming:

  • It was difficult to recruit participants for mental health trainings concurrent to other project training efforts. In the future, EpiC will focus on building knowledge about mental health alongside person-centered skill-building and counseling efforts.
  • The lack of awareness of counseling and its benefits made it difficult to recruit and arrange counseling sessions. Yet individuals who attended these sessions found them valuable. Among 91 participants who participated in either individual or group counseling, 99 percent expressed interest in having more support in the future.
  • Some people were hesitant to participate in skill-building workshops. We believe this is due to their lack of self-care knowledge and behavior. However, after completing the workshops, participants were satisfied with what they learned. Among 101 participants, 95 percent wanted more similar support in the future.
  • The potential need for mental health support among Vietnamese health care workers expands far beyond the project’s reach and available resources. Therefore, EpiC Vietnam is pivoting to focus on documentation of mental health challenges and needs among healthcare workers for potential additional support by international and national authorities. This documentation will take place over the next few months.

Conclusion

As the world adapts to an endemic response to COVID-19, increased awareness of the importance of both mental and physical health to increase quality of life and care among healthcare workers remains critical to sustain a strong health workforce. Despite the limited scope of EpiC Vietnam’s mental health activities, positive feedback among beneficiaries indicates substantial need remains unmet. EpiC will continue to work closely with USAID/Vietnam to understand and amplify the needs of healthcare workers in its COVID portfolio. The project is already providing similar support within the HIV portfolio to promote a resilient health workforce which can better serve patients and families in Vietnam.

Additional Resources:

View a 5-minute highlight clip with English subtitles from the EpiC Vietnam Mental Health for Healthcare Workers webinar.

[1] According to a World Health Organization Survey from 2014.