title: The Vietnam Multicomponent Collaborative Care for Depression Program: Development of Depression Care for Low- and Middle-Income Nations.
abstract: In this article, we discuss the Vietnam Multicomponent Collaborative Care for Depression Program, which was designed to provide evidence-based depression care services in low-resource, non-Western settings such as Vietnam. The article provides the program development background; the social, economic, and political context in which the program was developed; and the structure and content of the program and their underlying rationale in the context of rural Vietnam. Although the program was found to be acceptable, feasible, and effective in reducing depression outcomes, we did face challenges in implementation, which are outlined in this article. Key challenges included cultural factors (e.g., a lack of recognition of depression as a health-related entity amenable to professional treatment, relatively low levels of psychological mindedness useful for understanding of psychological interventions) and health system (e.g., lack of mental health specialists, overburdened health providers unfamiliar with behavioral interventions) factors. We discuss the strategies we employed to resolve these challenges and our successes and failures therein. We conclude with recommendations for others interested in implementing similar programs in low- and middle-income countries settings.
authors.affiliation: The RAND Corporation, Santa Monica, California.
authors.forename: Victoria K
authors.initials: VK
authors.lastname: Ngo
authors.affiliation: Vanderbilt University, Nashville, Tennessee.
authors.forename: Bahr
authors.initials: B
authors.lastname: Weiss
authors.affiliation: Da Nang Psychiatric Hospital, Da Nang, Vietnam.
authors.forename: Trung
authors.initials: T
authors.lastname: Lam
authors.affiliation: Khanh Hoa Psychiatric Hospital, Nha Trang, Vietnam.
authors.forename: Thanh
authors.initials: T
authors.lastname: Dang
authors.affiliation: Basic Needs Vietnam, Hanoi, Vietnam.
authors.forename: Tam
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: Vietnam Veterans of America Foundation, Hanoi, Vietnam.
authors.forename: Mai Hien
authors.initials: MH
authors.lastname: Nguyen
keywords: collaborative care; depression care; low- and middle-income countries (LMIC); primary care integration; task shifting