# Serious psychological distress among slum dwellers and unhoused people in Ho Chi Minh City, Vietnam: a pilot study

## TL;DR

This study found high rates of serious psychological distress among slum dwellers and unhoused people in Ho Chi Minh City, linked to factors like debt and labor exploitation.

## Contribution

The study provides the first prevalence estimate of serious psychological distress among housing-insecure populations in Ho Chi Minh City.

## Key findings

- 19.8% of participants experienced serious psychological distress, with higher rates among the unhoused.
- Female gender, debt, and labor exploitation were significantly associated with psychological distress.
- 68.7% of participants faced labor exploitation, and 43.7% were in debt, often from moneylenders.

## Abstract

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.