The Vietnam Multicomponent Collaborative Care for Depression Program

Development of Depression Care for Low- and Middle-Income Nations

Published In: Journal of Cognitive Psychotherapy, v. 28, no. 3, 2014, p. 156-167

Posted on on January 01, 2014

by Victoria K. Ngo, Bahr Weiss, Trung Lam, Thanh Dang, Tam Nguyen, Mai Hien Nguyen

Read More

Access further information on this document at Springer Publishing Company

This article was published outside of RAND. The full text of the article can be found at the link above.

Research Questions

  1. Was the Vietnam Multicomponent Collaborative Care for Depression Program, piloted in rural Vietnam, feasible, acceptable to patients, and effective?
  2. What lessons does the program offer for implementing similar programs in low- and middle-income countries?

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.

Key Findings

  • Treatment acceptability was high: more than 90% of patients offered treatment accepted it.
  • More than 70% of patients completed treatment.
  • The program significantly reduced depression and anxiety.
  • Successful implementation required overcoming substantial social, cultural, and political challenges.


  • Developing evidence of program success helps to generate both local and national-level support.
  • Strong community partnerships that fostered trust, openness, and commitment were critical to development of the program.
  • Successful program implementation also requires the leadership of local partners, engaging all levels of the health care system in advance, and establishing linkages across service sectors.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.