Despite the high risk of mental disorders in adolescence, many young people are not receiving appropriate support and guidance from mental health professionals and the community (including family and school); they lack access to health care and education facilities (World Health Organization, 2019b). In recent years it has become commonplace for individuals to seek health information on the Internet. Several websites on mental health in different countries, such as KidsHealth.org, youthbeyondblue.com, and tamlydoisong.wordpress.com, appear to play a significant role in improving understanding of mental health and reducing symptoms of depression (Boydell et al., 2014; Duplaga & Dzida, 2013; Moock, 2014). Most adolescents in urban areas in high-income countries have access to and make use of online information on mental health, especially for disorders regarded as behavioral problems. That young people tend to turn to the Internet suggests that they are willing to seek help, and they might be prepared to cooperate with others having similar mental health problems and contribute to forming peer support networks. With the spread of the Internet, it has been recognized that it can contribute to increasing the accessibility of health care (Moock, 2014). There have been few reports, however, on combining the Internet with positive psychology for health promotion and reduction of mental health symptoms (Mitchell, Vella-Brodrick, & Klein, 2010).
Vietnam is one of the nations with the most rapidly growing use of the Internet, with a greater development than most other countries in the region. It is reported that approximately 50 million Vietnamese, or half of the population, were connected to the Internet in 2017 and Vietnam’s penetration rate (54%) was higher than the world average (46.5%) (EU-Vietnam Business Network, 2018). Two thirds of the Internet users accessed it every day, spending on average about 2 hours 20 minutes on weekdays, less at weekends. Popular places to access the Internet were at home (78%), at work (31%) and in Internet shops or cafés (25%) (Cimigo, 2011).
Previous studies in Vietnam showed that mental health problems in relation to young people should be a major concern for health authorities, schools, communities, and families (Dat Tan Nguyen, 2009; T. H. Nguyen, 2006; Tran, 2007). Of particular relevance to this study were the high levels of depression, anxiety, and suicidal ideation among secondary school students in Cantho city (D. T. Nguyen, C. Dedding, T. T. Pham, P. Wright, & J. Bunders, 2013). However, although the primary health care system in Vietnam is quite strong, primary mental health care - especially for mental health problems in children - is non-existent. Despite some progress, the service environment and response to mental health problems in Vietnam remain largely inadequate. The situation is even worse outside the major cities in remote provinces, which lack mental health services and cannot prevent or treat children’s mental health disorders (UNICEF, 2018). Stigma related to mental health is highly prevalent in Vietnam, and is recognized as one of the main factors hindering youth from approaching mental health services (van der Ham, Wright, Van, Doan, & Broerse, 2011).
In our previous studies in Vietnam, relevant stakeholders including students, teachers and school health officers had suggested that a web-based information resource on psychology and mental health could be helpful for students (Dat Tan Nguyen, Christine Dedding, Tam Thi Pham, & Joske Bunders, 2013; Dat Tan Nguyen, Christine Dedding, Tam Thi Pham, Pamela Wright, & Joske Bunders, 2013; Dat T. Nguyen, Dedding, Wright, Pham, & Bunders, 2019; Dat Tan Nguyen, Wright, Pham, & Bunders, 2020). In addition, most of the students reported that they would share their private problems and seek help from a website, if one were available.
For these reasons, it is possible that students and adolescents in Vietnam could benefit from access to information about mental health through a website, where they can remain anonymous. Since there was no existing website providing specifically mental health information aimed at that age group, we designed one, with consideration for the characteristics of teenagers and adolescents. The suckhoetre.vn (youth health) website has three main sections, providing students with information on health, on health-related skills, and a health check-up. The main contents were designed based on key topics in general health care, sexual orientation, love and relationships, drug and game addictions, reproductive health, nutrition, and skills to scope with stress in life, as mentioned by students, teachers and parents in previous studies (Dat Tan Nguyen, Dedding, Pham, & Bunders, 2013; Dat Tan Nguyen, Dedding, Pham, Wright, et al., 2013; Dat T. Nguyen et al., 2019; Dat Tan Nguyen et al., 2020). Information in Vietnamese posted on the suckhoetre.vn was translated and cited from information in both national and international websites, such as kidshealth.org website (The Nemours Foundation, 2020), Mai Huong Daycare Psychiatric Hospital website (Bệnh Viện Tâm Thần Ban Ngày Mai Hương, 2020), and Depression website (Bệnh Lý Trầm Cảm, 2020). In addition, current health status screening was integrated in the website, including the General Health Questionnaire (Sanchez-Lopez Mdel & Dresch, 2008; Zulkefly & Baharudin, 2010), the CES-D (Radloff, 1977), the Rosenberg self-esteem scale (M. Rosenberg, 1965; Morris Rosenberg, 1989), and the Educational Stress Scale for adolescents (Thai et al., 2012). Information translated into Vietnamese was checked by the researchers for accuracy and by students of Can Tho University of Medicine and Pharmacy for accessibility to young readers. The design and interface of the website were shaped by the researchers in collaboration with students of Can Tho University of Medicine and Pharmacy. The first draft version was piloted with three school health officers and ten students for feedback, to complete the website. It was launched for public use in 2016, with the aim of meeting the needs of secondary school students for information on mental health and psychological wellbeing in Cantho city.
After the website was available, we recruited secondary school students to investigate whether they appreciated the features of the website, and whether it might be a way forward to recommend to education authorities as a tool to improve students’ mental health. Until now, the website is still available for public use, but has not had regular updates on the information as it did during the study.