Murakami Hitoshi, Linh Nguyen Thuy, Fujita Masami, Thuy Lam Ngoc, Phuc Nguyen Hong, Huong Kieu Thi Mai, Anh Le Tuan, Mai Pham Thi Ngoc, Oanh Khuat Thi Hai
Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
Trop Med Health. 2025 Apr 14;53(1):53. doi: 10.1186/s41182-025-00729-1.
Mental health is reported to be a significant issue among slum dwellers and unhoused (homeless) individuals worldwide, particularly those facing housing instability. Ho Chi Minh City, the largest city and industrial hub of Vietnam, has a substantial population experiencing housing instability, although its exact scale has rarely been accurately measured. This study aimed to estimate the prevalence of serious psychological distress among slum dwellers and unhoused individuals in Ho Chi Minh City and to identify factors associated with serious psychological distress.
A cross-sectional survey involving 415 individuals experiencing housing instability, including 383 slum dwellers and 32 unhoused individuals, was conducted between November 2023 and April 2024. Data were collected using a structured questionnaire incorporating the 6-item version of the Kessler Psychological Distress Scale (K6).
The overall prevalence of serious psychological distress was 19.8%, with 18.5% among slum dwellers and 34.4% among unhoused people. Multiple logistic regression analysis revealed significant associations between serious psychological distress and female gender (adjusted odds ratio = 3.086, p < 0.001), labour exploitation (adjusted odds ratio = 1.914, p = 0.046), and debt (adjusted odds ratio = 3.109, p < 0.001). Notably, 68.7% of the participants reported experiencing some form of labour exploitation, which commonly included contract rejections, forced overwork, wage theft, and physical or verbal abuse. Furthermore, 43.7% of the participants were in debt, with 38.6% borrowing from moneylenders.
The prevalence of serious psychological distress among individuals with unstable housing in Ho Chi Minh City was significantly higher than that of the general population, highlighting the urgent need for mental health interventions targeted at this population. Those with serious psychological distress frequently faced both labour and economic exploitation, without sufficient social protection. In terms of labour exploitation, policy interventions, particularly from an occupational health perspective, are necessary. To address economic exploitation through debt, given the prevalence of loan sharks, efforts to crack down on predatory lending and promote financial inclusion are essential.
据报道，心理健康是全球贫民窟居民和无家可归者中的一个重大问题，尤其是那些面临住房不稳定的人群。胡志明市是越南最大的城市和工业中心，有大量人口面临住房不稳定问题，尽管其确切规模很少得到准确衡量。本研究旨在估计胡志明市贫民窟居民和无家可归者中严重心理困扰的患病率，并确定与严重心理困扰相关的因素。
在2023年11月至2024年4月期间，对415名面临住房不稳定的个体进行了横断面调查，其中包括383名贫民窟居民和32名无家可归者。使用包含凯斯勒心理困扰量表（K6）6项版本的结构化问卷收集数据。
严重心理困扰的总体患病率为19.8%，其中贫民窟居民为18.5%，无家可归者为34.4%。多元逻辑回归分析显示，严重心理困扰与女性性别（调整后的优势比=3.086，p<0.001）、劳动剥削（调整后的优势比=1.914，p=0.046）和债务（调整后的优势比=3.109，p<0.001）之间存在显著关联。值得注意的是，68.7%的参与者报告经历过某种形式的劳动剥削，常见的包括合同拒绝、强迫加班、工资盗窃以及身体或言语虐待。此外，43.7%的参与者负债，其中38.6%向放债人借款。
胡志明市住房不稳定个体中严重心理困扰的患病率显著高于一般人群，凸显了针对该人群进行心理健康干预的迫切需求。那些有严重心理困扰的人经常面临劳动和经济剥削，且缺乏足够的社会保护。在劳动剥削方面，政策干预是必要的，特别是从职业健康的角度来看。鉴于高利贷的盛行，为解决因债务导致的经济剥削问题，打击掠夺性放贷和促进金融包容性的努力至关重要。
