Since the time that VNU was first founded 100 years ago, there have been many changes in the world that have affected education. There is much more knowledge to teach and to share with our students, there is much more that students must learn in order to become productive citizens, and there are new teaching methods and technologies that we must understand how to use. These are all positive developments. But there are also new challenges that students, and their teachers, and society face that we did not face 100 years ago, challenges that are not so positive.
In the West, in the field of Special Education, these challenges are often called "Emotional and Behavioral Problems". In Psychology, they are called "Psychopathology," and more generally in the United States we call them "Mental Health Problems". In Vietnam they may be called Tệ nạn xã hội, or social evils.
There is a reason why in the United States we call them mental health problems. They are health problems because they are problems in the body caused by a combination of biological and environmental factors. They are called mental health problems because they involve the brain, and thus influence our behavior and emotions.
Today, students face a number of mental health challenges that they did not face when VNU was founded 100 years ago. These can include depression and anxiety and suicide, and delinquency and violence. The mental health problem that I am going to spend most of my time talking about today is drug abuse.
The reason I have chosen to talk about drug abuse today is because, as we all know, it has many negative effects. Many of these effects are on the individual person using the drugs. Students who use drugs do not do well in school, using drugs can cause a large number of health problems, and using drugs causes financial problems for the individual.
Using drugs also creates problems for society. People who use drugs often do not fulfill their social roles as parents, or as children. More generally, people who use drugs often are uninvolved in normal society, and do not become productive members of society, and they may become involved in crime.
I know in Vietnam, drug abuse is generally considered a Tệ nạn xã hội or social evil because of the serious harm it does to society. This is logical, because of the great harm the drug abuse does to society. But thinking of it only as a social evil may have limitations, because conceptualizing drug abuse as a mental health problem, or as a social evil, has important implications for how we think about and attempt to deal with drug abuse.
The most basic difference is how we think about the person who is abusing drugs. If we see drug abuse as a social evil, then we see the person who is abusing the drugs as someone who is committing a social evil, and we see this person as a bad person. However, if we see drug abuse as a mental health problem, then we see the person as ill. Their behavior, the drug abuse, is illegal but the person themselves is ill, not necessarily bad.
There are consequences that result from how we view drug abuse, if we see drug abuse as involving a bad person, or an ill person. The first consequence is that if we someone as a bad person, then it probably is inevitable that they are going to do bad things. Bad people do bad things. On the other hand, if we see drug abuse as involving illness, then it may be possible to prevent or avoid drug abuse using medical or psychological approaches.
Second, if we think of drug abuse as involving bad people, it is very difficult to change. We sometimes can control bad people’s behavior, but it is very difficult or impossible to change or make a bad person into a good person. But if we view drug abuse as involving an illness, then we see that drug abuse is changeable, because we can change the circumstances or situations that cause it.
And finally, if we think of drug abuse as involving bad people, then we view drug abuse as a crime, and we respond with punishment. But if we view drug abuse as a mental health problem, then we view it as an illness and provide treatment. Of course, there must be legal consequences. But this is not the only way to intervene, there must be scientifically-based treatment as well as consequences.
In the U.S., it is well known that people who abuse drugs who are sent to prison continue to use drugs: Punishment alone does not change drug addicts’ behavior. On the other hand, in the U.S. if people who abuse drugs receive appropriate treatment, over 70% of them can stop or significantly reduce their use of drugs. So providing treatment is much more effective in reducing drug use than only providing punishment. Thus, while drug abuse is a social evil that hurts society, understanding it only as a social evil does not help us to develop with effective ways to deal with it.
In order for treatment to be effective, we must understand what the causes of a problem are. In Western countries, there has been a great deal of research about why people use and continue to use drugs. Right now, I would like to talk briefly about some the reasons why people in the West use drugs.
One reason that people sometimes use drugs is to reduce stress, anxiety or depression. We all face stress and anxiety in our lives, and we each come up with our own way of coping with this stress. I like to read or take walks to reduce stress in my life. Unfortunately, some people turn to using drugs and alcohol to cope with the stress in their lives, either because they don’t know other ways to cope with their stress, or because their level of stress or anxiety or depression are too intense for them to manage any other way. Instead of going to a doctor to get medication to help with their condition, they try to medicate themselves with drugs or alcohol.
For example, one man with whom we have worked in Vietnam became addicted to drugs because his wife divorced him and wouldn’t let him see his children. So he became very depressed and began using drugs to reduce his sadness and depression. There are ways that doctors and psychologists can successfully treat depression, but unfortunately, this man did not use them, and turned to drugs instead.
A second reason people sometimes use drugs is because they have friends who use drugs, or because of peer pressure. Sometimes young people use drugs so that they can fit in with their peers. In most cultures, adolescence is a time of life when people began to develop close relationships with people outside their family. Most young people find peers who are socially healthy. Unfortunately, however, some young people become involved with peers who are not so socially healthy, perhaps because they are not very successful studying at school, or because they lack the social skills to make friends with other adolescents. Or there may be other reasons why the adolescent cannot make friends with socially healthy peers. But adolescents who use drugs will always accept anyone into their group, as long as they are also using drugs. So when an adolescent cannot find a peer group to belong to, a drug abusing peer group will always accept them, and some adolescents unfortunately may turn to such peer groups.
For example, one teenager who was lacking in self-confidence went to a party where other teenagers were using drugs, and they asked him to try using drugs. He wanted to say "no" but he was afraid that his friends would laugh at him, so he began using drugs. We hope that our children will be strong and smart enough to say "no" but unless we help them, they may not be. Because adolescents are not yet able to think like adults, they sometimes cannot understand the consequences of using drugs, even one time. We need to give them guidance so they will understand why to say "no".
Sometimes people begin using drugs because they have parents who use drugs or alcohol. Sometimes we parents can be poor role models. Even alcohol is a drug, in fact it is an addictive drug, and if parents drink too much, this tells their children that it is okay to use drugs to influence their behavior.
For example, sometimes in the United States, when people come home from work, if they have had a difficult day, they may several drinks to relax. But if children see this, they learn that it is okay to use drugs to cope with stress.
Another way that parents can sometimes influence their children can be when parents are too busy to fulfill normal parental roles: Nowadays, we can be very busy with life, dealing with the many demands of our careers and work, trying to do our best to help our organization or our company. Sometimes, we parents can become so busy that we do not save enough time for our family. And then we feel guilty because we are not spending enough time at home with our family, so we become too lenient with our children and do not monitor what our children do.
In the United States, one of the best predictors of whether an adolescent will use drugs is whether the parents and children eat dinner together in the evening. It is not that the act of eating dinner together prevents drug abuse, but rather that parents who spend time with their children and know what is happening in their lives prevent their children from using drugs. We need to give our children some freedom as they get older but we also need to know what they are doing in their lives. Even when our children are more independent, they still need our guidance. It is like the Vietnamese saying, Tù do trong tay.
Finally, some people turn to drugs because they are bored, because they don’t have a job or anything that keeps them interested. Or for some people, they have a higher need for excitement but cannot find socially acceptable ways to find excitement.
For example, sometimes when we parents are spending so much time working at our company or agency, we try to make up for this by giving our children too much or making things too easy for them, we give them a car or motorbike and money without our children having to earn it. This also can cause children to use drugs, when life is too easy, children may turn to drugs because using drugs presents an exciting challenge.
Finally, I would like to say that although these are some reasons why people use drugs, in the end we all have responsibility for our own behavior. In fact, that is an important part of treatment for drug abuse, helping the person take responsibility for their own behavior. They must understand the negative effects of their choices on themselves, on their families, and on society.
For the last part of my talk, I would like to briefly mention two of the collaborative projects in which we have been involved in Vietnam. Our primary interest has always been in children’s mental health. We, like most people, see children as the future of a country. However, in the United States as in many other countries, children often have large unmet needs, in particular in regards to mental health. But we know that if we address their mental health problems early on, then even children with serious problems can become productive members of society.
So our first project was to develop a training model for children’s mental health research in Vietnam. We focused on research training because without research, we cannot know whether or not the treatments that we provide actually are useful. In fact, in the United States, for several decades we spent billions of dollars a year on treatment programs for children’s mental health problems. But when we finally conducted research to determine whether the programs actually were effective, we found that they were not effective. So we wasted huge amounts of money because we did not conduct research on the mental health programs. Sometimes even though a program seems like it is or should be effective, the results of research tell us that it is not really improving people’s lives.
Our primary Vietnamese collaborators in this project were Dr. Hoàng Cẩm Tú from the National Institute of Pediatrics, and Dr. Ðặng Bá Lãm from the National Institute for Educational Development. Over the course of three years, we considered a variety of different training models but ultimately we decided the best way to develop a training system for children’s mental health research would be to establish a Ph.D. training program in clinical psychology in Vietnam.
After more discussion, we decided that the most natural and the best place for this program would be in Dr. Mü Léc’s Faculty of Education here at VNU. We have submitted a request to the U.S. National Institute of Health for financial support for this program, and we should know in about two months whether or not they will approve our request.
The second and last project I’ll mention involves developing a treatment program for drug addiction in Danang. The purpose of this project was to establish a drug treatment program based on scientific principles, because if a program is based on science and research, then it is more likely to be effective. Our primary collaborators on this project in Danang are Dr. Phan Ngoc Ha and Dr. Lam Tu Trung at the Danang Psychiatric Hospital. We have been working on this project for about five months, and so far are very pleased with the results. ¨