Development strategy of national mental hospital 2

Great exercise of Strategic Management Group 8 Page 6 INTRODUCTION Reasons for choosing the topic Health is a very important issue in improving the population quality; it is one of huma

National Mental Hospital 2

GRIGGSUNIVERSITYGLOBAL ADVANCED MASTER OF BUSINESS ADMINISTRATION PROGRAM

GRADUATION ASSIGNMENT

DEVELOPMENT STRATEGY OF NATIONAL MENTAL HOSPITAL 2

HO CHI MINH 2011

Assignment of Strategy Management Group 8

GUARRANTEE

Our group of eight including four members undertakes that our group researches graduation assignments of Master of Business Administration Programmed of Griggs University

Related theory and data in the main assignments were made by us and references come partly from sources such as books, textbooks and other reference materials in Vietnamese and English as well as from the magazines, internet The actual data is collected directly in the National Mental Hospital 2

From these data sources and basing on the approved outline, our group has completed this assignment Base the developing strategic solutions of the National Mental Hospital 2 we introduce on studied theoretical basic as well as intuition and members’ experience In addition, it was through this assignment, members of group have accumulated some valuable experience for the establishment of a practical strategy for a hospital

Assignment of Strategy Management Group 8

ACKNOWLEDGEMENT

Completing graduate assignment of Master of International Business Administration Programmed - Griggs University after nearly a half year study, our group eight sincerely gratitude to the MBA Program - Griggs University and Training & Development Human Resource Center has created more favorable conditions for us during the learning process, the group also would like to thank most profoundly to the teachers who enthusiastically taught and imparted valuable knowledge We also wish to thank the teachers who guide our group to complete this assignment

In addition, the group would like to thank tutors for their enthusiasm to support us Thanking the leadership of the National Mental Hospital 2 for these data, valuable information for this assignment

Finally, we sincerely thank to the Director where we are working and all members of the group for facilitate on the time as well as costs for us to complete the course

Please, accept our sincere and deep thanks

Implementer Group 8 - Class GaMBA01.C04

Assignment of Strategy Management Group 8

LIST OF ABBREVIATION

Matrix QSPM Quantitative strategic planning matrix

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TABLE OF CONTENTS 

Reasons for choosing the topic 6 

Research objectives 7 

Object and scope of research study 8 

Research Methodology 8 

Significance of the topic 8 

1.1 Overview of strategic management 10

1.1.1 The basic concepts of business strategy 11

1.1.2 Model of building a strategy 11 

1.1.3 Tools for building and selecting strategy 14 

1.1.3.4 Analysis of internal environment 17 

1.1.3.5 Setting business Strategy 18 

1.1.3.6 The solution to implement business strategies 18 

1.1.3.7 Evaluate the effectiveness of business strategy 19 

1.1.3.8.2 Internal factor matrix 20 

1.1.3.8.3 SWOT Matrix 22 

1.1.3.8.4 Quantitative strategic planning matrix (QSPM) 23 

1.1.3.9 Strategic management in nonprofit organizations 25 

1.2.Current status of the system of mental health care of some countries in the world and Vietnam; difficulties and challenges 25 

1.2.1. Developing countries 25 

1.2.2. Developed countries 26 

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1.2.3. The current status of the system of mental health care in Vietnam 26 

1.2.4. Difficulties and challenges of mental health treatment system in Vietnam 27 

1.3. Demand for strategic planning for the National Mental Hospital 2 28 

1.3.1. The general tendency of mental health issues 28 

1.3.2. Network of mental health care in southern provinces 29 

1.4. The need to set out a develop strategy of the National Mental Hospital 2 29 

2. The legal basis to build planning 31 

2.1. Current situation of the National Mental Hospital 2 32 

2.2.1. History and Development 32 

2.2.2. Functions and responsibilities of the hospital 32 

2.2.3. Functional divisions of the Hospital 38 

2.2.4. Clinic departments 38 

2.2.5. Subclinical departments 39 

2.2.6. Scale of beds for patients 39 

2.2.7. The situation of facilities and equipment 41 

2.2.8. Situation of budget receipts and expenses 42 

Figure II-7: Situation of budget receipts and expenses in 2010 43 

2.3. The limits and causes 49 

2.3.1. The limits 49 

2.3.2. Causes 50 

CHAPTER III 51 

HOSPITAL DEVELOPMENT STATEGY BY 2020 51 

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3.1. Development goals by 2020 51 

3.1.1. Common goals 51 

3.1.2. The goals to 2015 51 

3.1.3. Target from 2015 – 2020 52 

3.2. Analyzing internal-external environment 52 

3.2.1. Analyzing internal environment 53 

3.2.2. Analyzing operation of the Hospital 60 

3.2.3. The matrixes select the Hospital’s strategies 65 

3.3. Strategy of the National Mental Hospital 2 in 2020 76 

3.3.1. Predicted a number of patients from 2010 – 2020 76 

3.3.2. Development strategy of expertise techniques 77 

3.3.3. Development Strategy of Human Resource 80 

3.3.4. Bed scale 80 

3.3.5. Training staff 80 

3.3.6. Science Research 81 

3.3.7. International cooperation 81 

3.3.8. Develop facilities, equipments 81 

3.4. Solution – Proposal 82 

3.4.1. Solutions 82 

3.4.2. Proposal - Suggestion 88 

CONCLUSION 90

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LIST OF CHARTS

Chart I-1 Comprehensive strategic management model 14

Chart I-2 Strategic planning process 15

Chart I-3 Porter 5 competitive forces model 17

Chart I-4 Matrix of external factors 20

Chart I-5 Matrix of internal factors 21

Chart I-6 SWOT Matrix 22

Chart I-7 QSPM Matrix 24

Chart II-1 The National Mental Hospital 2 organizes free health examination and medicines 36

Chart II-2 Daigram Presenting real bed scale against plan from 2005 - 2010 41

Chart II-3 Situation of budget receipts and expenses in 2010 43

Chart II-4 Receipt situation from the budget from 2005 -2010 44

Chart II-5 Budget structure to 2010 46

Chart II-6 The amount of patient examination and treatment from 2005- 2010 48

Chart II-7 Structure of in-patents and out-patents in 2010 48

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LIST OF TABLES

Table II.1 Number of employees and staffs at the Hospital 37

Table II.2 Fluctuation in number of beds 40

Table II.3 Medical equipment of the Hospital 42

Table II.4 Budget revenue 43

Table II.5 Budget expenditure of the Hospital for the period 2005-2010 45

Table II.6 Budget revenue-expenditure balance for the period 2005-2010 46

Table II.7 Real situation of health examinations for the period 2005-2010 47

Table III.1 Matrix of external factors 65

Table III.2 Matrix of internal factors 66

Table III.3 SWOT Matrix 67

Table III.4 QSPM Matrix for S/O cooperative strategy group 71

Table III.5 QSPM Matrix for S/T cooperative strategy group 72

Table III.6 QSPM Matrix for W/O cooperative strategy group 73

Table III.7 QSPM Matrix for W/T cooperative strategy group 74

Table III.8 Forecasting number of patients for the period 2011-2020 by extrapolation method 77

Table III.9 Human resource 81

Table III.10 Estimate capital requirement for the period 2011-2015 85

Table III.11 Estimate requirements of investment capital for the period 2011-2015 86

Table III.12 Estimate budget revenue for the period 2011-2015 86

Table III.13 Balance financial revenue and expenditure for the period 2011-2015 87

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INTRODUCTION Reasons for choosing the topic

Health is a very important issue in improving the population quality; it is one

of human development strategies in every country around the world According to

status, but a completely relaxed state in terms of physical, mental and social.” Being

social, community activities So, to develop our country, we must first to pay attention to health factors, make our people centered

The great development of science technology entailing cultural changes has affected spiritual relationships between people and people Therefore, mental health is becoming a more important issue in modern society

health professionals in Viet Nam, with only 10 common mental illnesses including schizophrenia, depression, epilepsy, anxiety disorders, intellectual decline in the

adolescents, mental disorders due to drug, there has already been 14.9% of the population suffered these diseases

While the needs of people and society are increasing, our country’s medical sector can not catch up with society's development, especially in improving the quality of medical care in mental health field To facilitate the medical care in general and mental health care in particular and to meet the needs of society, on February 23, 2005 Politburo issued Resolution 46-NQ-TW emphasizing

on the need of innovating and perfecting the health system towards equity, efficiency and development

Strengthening and perfecting the local health system in terms of facilities,

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equipment and personnel to create favorable conditions for all citizens to be protected and improve their health with better quality, along with economic- social development of the country In particular, the

National Mental Hospital is the first Hospital in Dong Nai health sector which

be autonomy of finance by the Government as other revenue-generating hospitals

On this basis, the Hospital has agreed with two goals and three solutions of the

providers Such hospitals are viewed as a special enterprise, specializing in providing guidance services, prevention and treatment of diseases related to mental;

fees and other revenue sources That is, Central Mental Hospital 2 should have the appropriate financial solutions to develop and provide better medical services and mental treatment satisfying the social needs

In that situation, the National Mental Hospital 2 needs to define a strategy for

in psychiatric industry in the South, with modern facilities and equipment and a contingent of scientific and technical staffs on par with advanced countries in the region To contribute to realizing this goal, our group decided to do the research project: “Strategy to develop National Mental Hospital 2 up to 2020”

Research objectives

The objectives of the research are:

- Summarizing theoretical basis of strategic planning;

- Analyzing and evaluating the activities of the National Mental Hospital 2 recently as well as the factors affecting the operation of the hospital;

- Comprehensively assessing the current operational situation of the

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Object and scope of research study

- Object: The National Mental Hospital in Dong Nai 2;

- The scope of research: Main activities in the National Mental Hospital 2

The research experiments the following methodologies:

- Using the method of dialectical materialism, historical materialism, the description method, statistical analysis, synthesis, comparison, etc and apply knowledge from several subjects in business administration major;

- Materials used: a textbook on business management, marketing management, the documents of the National Mental Hospital 2, Department of Health, health economics journal, The Sai Gon Economy, newspapers, year books and other related magazines, the Internet, etc

Significance of the topic

- Scientific significance:

3 In the market economy, business strategy is crucial to the success or failure of the business To survive and develop, first the enterprise needs to have

a good business strategy and performance;

3 There are many approaches to building a business strategy for any business The study has a scientific significance; that is, it has synthesized theories

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from various sources to build a business strategy in a most basic way, easy to understand, easy to use

- The practical meaning:

3 It is shown that in a developed society, people are increasingly under pressure of study and work, environment is increasingly polluted by noise,

physiological illness, and mental illness are also more complex (The fact that the paranoia, mental illness frequently happened for groups of students in recent times has been a convincing proof for that)

3 National Mental Hospital 2 is the Hospital governed by the State, under the direct management of the Ministry of Health, the research will analyze, identify strengths and weaknesses of the hospital, and determine the challenges

in the present and future as a basis for the hospital leaders to plan development strategy;

of reference, quite well in quantifying the influence of these factors has and will impact the business

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CHAPTER I THEORETICAL BASIS 1.1 Overview of strategic management

Concept of “strategy” appeared very early in the study of wars in the history The earliest definition of Strategy is seen as of the Greek historian Xenophon in the 6th century Also in this period, Sun Tzu - a Chinese military theorist also wrote “The Art of War” to discuss military strategy

It is not until the middle of the 20th century, research of strategy and strategic

success of economic groups in the United States before and during World War 2; and today’s administrators, economists as Michael E Porter, Fred R David,

approaches to strategic management in business Here are a few different definitions of strategy:

- “Strategy is the determination of goals, long-term fundamental purpose

of organization and the application of a sequence of actions as well as the allocation of resources necessary to realize this objective” - Chandler (1962);

- “Strategy is the coordinative force between organizations and environment: a consistent pattern of organizational decision chain in line with the environment” - Mintzberg (1979);

- “Strategy is a pattern or plan to integrate the major objectives, policies, and action sequences into a cohesive whole” – Quinn (1980);

- “The strategy is the difference It is a selection of a series of different activities to create unique value” - Michael E Porter (1996);

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- “Strategy is the means to achieve long term goals” - Fred R David (2003);

- “Strategy is for long-term and directing management to ensure the completion of long-term goals, the primary purposes of the organization” - Rudolf Grunigand Richard Kuhn (2003);

Thus, although there are many approaches and different definitions, a business strategy always includes the following contents:

- Identify the basic and long-term objective of the organization;

- Give the general action plan

- Select the action plan, implementation and allocation of the resources to accomplish these goals

1.1.2.1 The types of business strategy

From a level standpoint, an organization has at least 3 levels of strategy as following:

- Firm-level strategy: Often aims at basic, long-term goals, so there are many types of strategies at firm-level with different names According

to Fred R David, there are 14 kinds of basic strategies at the company level, which are classified into four groups as follows:

Integrated strategy group

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advantage and different positioning strategies which can be used in the industry According to Michael E Porter, at the business unit-level, there have been three general competitive strategies:

Leading cost strategy (low price and best price)

Product differentiation strategy

Focusing strategy

- Functional strategy (or operational strategies) is the strategies that

effectively implemented, using components in terms of necessary resources,

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people and skills Functional strategy is the strategy of functions such as marketing, finance, human resource, etc These strategies help improve the performance of the organization and support for the effective implementation of business unit-level and firm-level strategies

In the globalize environment with fierce competition, from the business standpoint, boundaries between countries have been largely overshadowed, thus appear a fourth level of strategy, that's global strategy

Strategic management process consists of three phases:

establishing business tasks, performing investigations to determine the negative factors inside and outside, working out long-term goals and selecting alternative strategies Sometimes forming stage is called “strategic planning”;

- Implementation phase is the action phase of strategic management This phase’s task is to mobilize staff and administrators to implement the set-out strategy There are three basic activities, which are to establish annual goals, make policy, and allocate resources;

- Strategy assessment phase: the final stage of strategic management is to evaluate the strategy Three main activities of this phase are: (i) review the factors which are the basis for the current strategy, (ii) measuring achievement, and (iii) make adjustments

Fred R David showed a comprehensive strategic management model as in Chart 1 In which, strategic planning phase includes the following steps: defining the vision, mission, strategic goals, then analyzing the external environment to identify opportunities and risks, analyzing the internal

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thereby determining business goals and establish long-term goals and selecting strategies for implementation Strategy implementation phase will include the distribution of resources to make the annual goals and policies The last phase is the measurement and evaluation of the implementation strategy

1.1.3.1 Planning business strategy

According to Fred R David, the strategic planning process includes three stages: input stage, combination stage and decision stage as Chart I-2

Allocate  resources

Reset business goals

Analyzing internal  environment to  determine  strengths and 

Select strategies

to implement

Set out  policies

Strategic planning Implementation Evaluation

Measureme

t and evaluative

of the implementa

Set out long-term goal

Set out annual goals

Chart I-1: Comprehensive Strategic Management Model

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Chart I-2: Strategic Planning Process

1.1.3.2 Selecting mission and major objectives

This is the first step in the process of strategic management, mission and main

strategies Mission presents the reasons for existence of the enterprise and indicated what it would do Every business should have a certain mission

The main goal of business is to determine what businesses expect to meet within the medium and long term; is the destination that the organization aims toward, it is the basis of the first and foremost important to build business strategies The mission of the organization is generic, and objective

is specification of the mission

The objective is built on the basis of the organization mission, and

external-Phase 1: Input stage

Boston consulting group Matrix (BCG)

Matrix of internal- external (IE)

Major strategy Matrix

Phase 3: Decision Phase

Quantitative Strategic Planning Matrix (QSPM)

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internal environmental factors The goals must be consistent with objective and subjective conditions

The purpose of analyzing the external environment is to develop a portfolio of

and the threats that the organization should be avoided to reduce the risk from the external environment There are many different external environmental factors (macro environment and micro environment), the analysis of external environment just limited to the factors that influence the organization

External environment includes:

- Economic environment;

- Political and legal environment;

- Cultural and social environment;

- Demographics and geographic environment;

- Technology environment;

- Global Environment

Micro environment: is the competitive environment or industry environment

It is the environment which sticks to the company, majority of company’s activities are in this environment

Michael E Porter, a professor of business strategy of Harvard University has presented a Five Competitive Forces model as follows:

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Chart I-3: Porter’s model of 5 Competitive Forces

1.1.3.4 Analysis of internal environment

In each organization, there are always different strengths and weaknesses in business units Strengths and weaknesses in internal environment combining with opportunities and threats in external environments and the mission are the basics for setting objectives and strategies of the organization

Factors of internal environments include:

- Finance: includes elements of financial capacity, financial management, financial accounting, etc

- Management: includes all management activities to ensure that the business

resources management, production management, quality control, material management, financial management, sales management, etc

- Marketing: marketing is described as a process of identifying, forecasting, setting and meeting the needs of buyers for products and services Marketing

Potential  competitors

Competitors in the  industry

Substitutes 

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markets, distribution systems, sales service, etc

- Human Resources: Human resources play an important role to the success of the organization Even though a business strategy is sound, but it will not

be effective without people working effectively Personnel include factors such

as organizational structure of human resources, quality of human resources and policies to maintain and develop human resources, etc

- Management and production operations, including all activities to

processes and operations include designing manufacturing process, selection

of production line technology, production scale, site selection, floor layout, product quality, service, production price, etc

1.1.3.5 Setting business Strategy

Based on the objectives of the enterprise, the elements of the external-internal environment to set business strategy consisting of the following contents:

- Identify and select opportunities that can help companies achieve business objectives;

- Selecting target markets;

- Selecting products or services supplied to the target market;

- Develop marketing-mix strategies to market chosen products and services: Product strategy, pricing strategy, distribution strategy, and promotion strategy

1.1.3.6 The solution to implement business strategies

management, human resources, finance and so on That is the arrangement,

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sorting of company resources to successfully implement the chosen business strategy, namely:

- Arrange organizational structures appropriately;

- Distribute, maintain and develop human resource;

- Allocate financial resources;

- Develop model of effective and logical production management and operations

1.1.3.7 Evaluate the effectiveness of business strategy

Evaluation of a business strategy to see whether it is effective or not is very important A business strategy is effective when it fits with the reality of the business and economic-social situation, as well as it can make the most use of opportunities to achieve the proposed objectives The evaluation of business strategy includes the following steps:

- To review and examine the suitability of the business strategy before implementation;

- Evaluate results of business activities in each stage of executing business strategy, in order to detect flaws, defects of the strategy, so that we can have on time adjustment or amendment

1.3.8 Matrices to choose a business strategy

1.1.3.8 1 Matrix of external factors

- The construction of the matrix to evaluating external factors will help us summarize and quantify the influence of outside environmental factors to the enterprise, which affects the business activities of enterprises, including opportunities and challenges to business;

- To build the matrix we have to draw up a list containing all the external

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factors that affect the activities of the organization Assessing the importance

of each factor and weighting them by the score, the sum of the weights

of all elements equals to 1 The classification shows the corresponding importance of these factors for success in the business of the enterprise;

- Evaluating the importance of each factor by sorting the elements from 1 to

response; 3 are above average, 2 are average and 1is the lowest These levels are based on strategy performance of the organization;

- Next is to determine the number of points about the importance of each factor by multiplying the critical levels corresponding to the point’s classification Then, add the total number of critical points for each variable to determine the total number of points important to the organization; highest and the lowest is 4 to 1 and averaged 2.5 points;

- If the total important points are 4, it shows organizations are taking advantage of external opportunities and better control or minimize the threats from outside of the company If total score is 1, indicating the organization did not seize the opportunity and can not reduce the threat from the outside environment

Chart I-4: External factor matrix

List of external factors

- Total

1.1.3.8.2 Internal factor matrix

- Building of Internal Factor Evaluation Matrix will help us summarize and

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- Evaluation of key level of each factor is implemented by classification factors from 1 to 4 Among them, level 4 is the level that the organization has the best reaction; 3 are above average, 2 averages and 1 the lowest These levels are based on strategic effect of the organization;

- Next is to determine score of the importance of each factor by multiplying the key levels with corresponding score of classification Then, make sum of key score for each variable to determine the total key score of for the organization; the highest is 4 and the lowest 1, and average 2.5 points;

- If total key score is 4, it shows that the organization have many strong points; and may well overcome the weaknesses Conversely, if the total score is 1, it indicates that the organization has no strong point and has too many weaknesses that can not be overcome

Chart I-5: Internal factor matrix

List of internal factors

- Total

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1.1.3.8.3 SWOT Matrix

SWOT matrix allows us to proceed to the evaluation of strengths and weaknesses of the organization and to estimate opportunities and threats of external environment of the organization Since then, a combination of factors between the environmental situations with the ability of the organization shall be made into business strategies We have SWOT matrix table as follows:

Chart I-6: SWOT Matrix

STRONG (S)

Combination S-O Promote internal strengths

to take advantage of opportunities

Combination S-T Promote internal strengths

to avoid external threats

WEAK (W)

Combination W-O Overcome weaknesses inside to take advantage

of opportunities

Combination W-T Overcome weaknesses inside to avoid external

threats SWOT matrix will enable us to form four types of strategies:

- Strength strategies – Opportunities (S-O): To promote internal strengths to take advantage of opportunities;

- Weakness strategies – Opportunities (W-O): To overcome internal weakness to take advantage of opportunities;

- Strength strategies – Threat (S-T): To promote internal strengths to avoid external threats;

- Weakness strategies – Threat: (W-T): To overcome internal weakness to

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avoid external threats

1.1.3.8.4 Quantitative strategic planning matrix (QSPM)

- Matrix QSPM is aimed to evaluate and rank strategic plans, from which we have foundation to select the best strategy for the company;

- The matrix uses all information, data from the above mentioned matrixes, including IFE, EFE, competitive image matrix, SWOT Matrix,

In order to develop and form a QSPM matrix, it’s a need to go through the following six steps:

Step 1: Make a list of the firm’s key external opportunities/threats (preferably minimum of 10 factors) and internal strengths/weaknesses (preferably minimum of 10 elements) in the left column This information should be taken directly from the EFE Matrix and IFE Matrix

Step 2: Assign weights to each key external and internal factor These weights are identical to those in the EFE Matrix and the IFE Matrix

Step 3: Identify alternative strategies that the organization should consider implementing Group the strategies into mutually exclusive sets if possible

Step 4: Determine the Attractiveness Scores (AS), defined as numerical values that indicate the relative attractiveness of each strategy in a given set of alternatives Attractiveness Scores are determined by examining each key external

or internal factor, and considering the affect of this factor to the choice of strategies being made Attractiveness Scores should be assigned to each strategy to indicate the relative attractiveness of one strategy over others, considering the particular factor The range for Attractiveness Scores is 1 = not attractive, 2 = somewhat attractive, 3 = reasonably attractive, and 4 = highly attractive If the respective key factor has no effect upon the specific choice being made, then do not assign Attractiveness Scores to the strategies in that set and left that row blank;

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Step 5: Compute the Total Attractiveness Scores (TAS) Total Attractiveness Scores are defined as the product of multiplying the weights by the Attractiveness Scores in each row The Total Attractiveness Scores indicate the relative attractiveness of each alternative strategy, considering only the impact of the adjacent external or internal critical success factor The higher the TAS is, the more attractive the strategic alternative (considering only the adjacent critical success factor)

Step 6: Compute the Sum Total Attractiveness Score Calculate the Total Attractiveness Score for each strategy The Sum Total Attractiveness Scores reveal which strategy is most attractive in each set of alternatives

Chart I-7: QSPM Matrix

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strong, 4 – The strongest

PSQM matrix has many advantages of help combine appropriate internal and external factors into the process of determination, sets of strategies can be researched continuously or simultaneously, unlimited number of strategies can be evaluated but it also has some disadvantage such as: Implementation required intuition predication and is based on experience Discussion between managers, staff in the process of analysis and strategic selection can aris different opinions

1.1.3.9 Strategic management in nonprofit organizations

In comparison with profitable companies, non-profit organizations operate in the monopoly environment, provide products or services that have little or no ability

to measure achievement, and almost entirely depend on external funding Especially for these organizations, strategic management provides a perusable means of spreading to develop and demonstrate the requirements of necessary financial support

1.2 Current status of the system of mental health care of some countries

1.2.1 Developing countries

In some developing countries, mental illness is an enormous challenge to the development and a financial burden of medical branch and the country, too, but almost all of them receive support from Government Organizations and foreign NGOs Cambodia has more than 600,000 annual psychiatric patients under treatment, Mental Health Care (MHC) system is a national hospital and eight provincial general hospitals with psychiatric department Malaysia currently has a policy on mental health and guidelines on the development of community services

of MHC in order to reduce its dependence on the Psychiatric Clinics For Thailand MHC system includes inpatients and outpatients, in Thailand MHC system in the community is thereby boosting so the number of inpatient beds decreased by 7%

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within 5 years; Ministry of Health plays an important role in building and managing MHC networks from village level to regional level, after treatment patients in the hospital are transferred to functional rehabilitation centers

1.2.2 Developed countries

Ministry of Health of Singapore established the Committee of national mental health, this Committee includes psychiatrists and managers of Ministry of Health, and the Committee is responsible for advising the Health Ministry to build objectives and policies of MHC the nation For Korea, in recent years, this country

of gimchee has constantly strengthened and developed comprehensive MHC system

of community-based; they build models combining public and private, between Community Health centers and universities, hospitals and provide services of visit, consultation at home and functional rehabilitation activities to enhance people's Mental Health activities through these centers Japan has made changes in mental health policy since 2002, which is combination of treatment and MHC right in the community instead of just treatment in the hospital; they enhance education for people raising understanding of the symptoms of mental disorder, constantly reform MHC system

1.2.3 The current status of the system of mental health care in Vietnam

In the previous centuries, Vietnam had no base of psychiatric treatment and no mental physician In 1915, the first “crazy” hospital was built in Bien Hoa with about 1,500 beds After that, the colonial had the second mental hospital built in Voi (Bac Giang) with 400 beds and a neuropsychiatry department of Bach Mai Hospital

in Hanoi In fact these bases were places to detain patients Patients had to lie on cold cement stalls or in narrow isolated chamber After liberation, “crazy” hospitals were converted into mental hospitals In 1963 the National Mental Hospital 2 was established with a scale of 450 beds

According to figures reported by the National Mental Hospital 1, many provinces and cities in the North has built psychiatric hospital with scales of 50-150

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beds, providing treatment for inpatients and mental stations, after turning into psychiatric department in the center of social illness prevention (CSIP), it was responsible for outpatient management and treatment Until 2009, there were 34 mental hospitals in the country (including two hospitals under the Ministry of Health), 55 psychiatric departments (24 in provincial hospitals, 26 in SCIP and 05 mental stations) The whole country had 5000 inpatient beds in psychiatric hospitals and departments It’s a rate of 5.8 psychiatric beds per 100,000 people Human resources for health serving at MHC are: 10 Professors, 20 Doctors, 27 specialist doctors no 2 (SD2), 70 masters, 178 specialist doctors 1 (SD1), 584 doctors, 2200 mental nurse and other staff Rate of mental doctors is 1/100.000 people

In 2001, the group of mental experts in Vietnam proceeded investigating clinical epidemiology of 10 common mental illness: schizophrenia, depression, epilepsy, anxiety disorders, intellectual decline in the elderly; psychosis after brain injury, mental retardation, behavior disorders in adolescents, mental disorders caused by alcohol, mental disorders caused by drug; there have been14.9% of the population getting of this illness

In 2006, with funding from the Atlantic Philanthropies funds (AP) Vietnam Veterans of America Foundation (VVAF), experts from Research and Training Centre for Community Development (RTCCD), National Mental Hospital 2 in coordination with the Department of Health of Da Nang, Khanh Hoa to conduct the research topic "Assessment and modeling of MHC and functional rehabilitation in the community in Da Nang and Khanh Hoa", which assessed the need on a wide range of issues on Mental Health and provided a validation data for understanding the burden of community Mental Health, including: services and care in the community with mental illness and the importance the cultural environment of Vietnamese people

Vietnam

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- The system of specialized hospitals treating underdevelopment mental illness, the south from Da Nang including the National Mental Hospital 2, Ho Chi Minh City Mental Hospital, Mental Hospital in Binh Dinh, Ba Ria Vung Tau Mental Hospital, Ben Tre Mental Hospital, and the Provincial Mental Hospitals, were established and operated with state funds (fully subsidized) by the national target program on mental health care, the remaining provinces only have specialty clinics which overhaul and treat common diseases While psychiatric departments are attractive to investors, so the pressure increasing overload;

- The speed of population growth, development of science and technology, and the fierce competition of market economy make demand of examination and treatment of mental illness increase more and more, putting pressure on demand of improving facilities, modernizing medical machinery and equipment and demand of increasing staff of the human system of the mental branch

- Major revenue of mental hospitals in is from the State budget, revenues are not enough for expenditure While capital budgets are tight, and heavily carry application-approval mechanisms, verbose procedures and time consuming In collection of fees, there are many cases of revenue loss because patient families can not afford to pay, because some patients need meatment all their lives

- Due to the particular nature of the specialist psychiatry, attraction and retaining of good doctors is very difficult, in order to attract top talents, the hospital must have incentives such as salary, housing regulation, setting up the training mechanism of doctors and physicians at renowned universities abroad while budget is very limited;

1.3 Demand for strategic planning for the National Mental Hospital 2 1.3.1 The general tendency of mental health issues

- Mental health issue is the issue of civilization Our country is in its early industrialization and modernization, especially in the XXI century, we proceed to

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build a knowledge economy Competitive pressures, economic recession, natural hazards, etc inevitably lead to its implications on human health problems, especially mental health arising and psychiatric patients increasing more and more;

- The rate of population growth in our country also increased more rapidly compared to other countries in the world, the number of psychiatric patients have increased naturally by certain percentage

1.3.2 Network of mental health care in southern provinces

- Most of Northern provinces after peace was restored in 1954 have built provincial mental hospitals Meanwhile, in the south only a few province have had psychiatric hospital, some remains have not had effective mental health care department;

- The facilities of the units of mental health care are poor, backward, failing

to meet the needs of the professional development of mental health care

1.4 The need to set out a develop strategy of the National Mental Hospital 2

Due to the geographical conditions of our country which stretches thousands

of kilometers from north to south, the direction of professional technical specialists

to the provinces from Da Nang has become reality and was established more clearly

by the Ministry of Health at the decision of the Minister of Health promulgating the Regulation on Organization and Operation of the National Mental Hospital 2, No 4606/QD-BYT signed on 23/12/2004 With the current situation and development needs of mental health sector in the country, the Ministry of Health issued the Regulation on organization and operation of the National Mental Hospital 2 with a scale of 840 beds with clearer functions and responsibilities:

- Direct examination and treatment, prevention and functional rehabilitation for mentally patients of provinces and cities from Da Nang to the south, at the highest line;

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- Directing to build a network of mental health care for Southern Provinces

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CHAPTER II CURRENT OPERATION SITUATION

OF NATIONAL MENTAL HOSPITAL 2

1 The legal basis to build planning

- Pursuant to Decree no 49/2003/ND - CP of the Government of 15/03/2003

on regulating the functions, authority and organizational structure of the Ministry of Health;

- Pursuant to Instruction No 32/1998/CT-TTg of 09/23/1998 of the Prime Minister on the master plan for economy social development the period of until

2010 period;

- Pursuant to Decision No 35/2001/QD – TTg of 19/3/2004 of the Prime Minister on approving the strategy of care and protection of people's health in the period 2001 - 2010;

- Pursuant to Resolution No 46 - NQ / TW of 23/12/2005 of the Politburo on the protection, care and improvement of people's health in the new situation;

- Pursuant to Decision No 153/QD – TTg of 29/6/2006 of the Prime Minister on the master plan for Health Economics development till 2010 and vision

of 2020;

- Pursuant to Decree 43/2006/ND - CP of 25/04/2006 of the Prime Minister defining the autonomy and self-responsibility in performing their tasks, organizational structure, staffing and finance with public service units;

- Pursuant to Decision No 4606/QD - BYT of 23/12/2004 of the Minister of Health on promulgating the Regulation on organization and operation of the National Mental Hospital 2;

- Pursuant to Decision No 290/QD - BYT of 25/01/2006 of the Ministry of

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Health on organization ranking of the National Mental Hospital 2

2.1 Current situation of the National Mental Hospital 2

National Mental Hospital 2 is located on Highway 1 (Nguyen Ai Quoc street now), about 4 kms from the center of Bien Hoa City, Dong Nai Province to the northeast Hospital campus of the entire area is about 22 hectares, located on higher ground 3 meters above the center of Bien Hoa City

Head office: Nguyen Ai Quoc Street, Tan Phong Ward, Bien Hoa City

Hospital has constantly developed, from a place of detention "lunatic", it has become a base of the treatment of mental illness in a way of humanity and science Especially from the complete liberation of South Vietnam and country reunification

up till now the hospital has become a center for treatment and scientific research, direct the network of mental health care of half the country from Da Nang to Ca Mau

2.2.2 Functions and responsibilities of the hospital

2.2.2.1 First aid – examination – treatment

The hospitals perform the direct function of examination – treatment, disease prevention and functional rehabilitation for mental patients of the provinces and

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cities from Da Nang, at the highest line, particularly:

- Provide direct examination, first aid, treatment for mental patients of provincial, city and equivalent lines in their assigned areas, forced and voluntary treatment of mental patients;

- Examine and assess mental health, take part in mental assessment when requested by law enforcement;

- Provide examination, first aid, treatment of accident injuries, common and other specialized diseases for people in the region according to requirements and meet capability of the hospital;

- Perform other duties as directed and assigned by the Ministry of Health

- Research and participate in scientific research in the field of mental health

to serve examination and treatment, prevention, functional rehabilitation and training;

- Lead and participate in scientific research at all levels;

- Organize international and domestic scientific conferences according to regulations;

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- Organize joint program of scientific research cooperation between foreign and domestic

Source: Department of training and scientific research

- Provide direct guidance on specitality specialized technique for provinces from Da Nang to the south;

- Transfer and technical, specialized support to previous line;

- Consult, monitor and supervise specialized activities of previous line in assigned area

- Implement health programs and projects after being approved by competent authorities;

- Coordinate with other agencies in and out of health economy to implement communication and education of mental health and mental illness prevention in the community;

- Participate in prevention and overcoming of consequences of natural calamities and disasters

2.2.2.5.International cooperation

- Develop international cooperation projects mainly in the fields of staff training and receiving technology, new techniques, financial support and working facilities for the hospital with foreign organizations and individuals legally;

- Develop plans for outbound and inbound delegations in accordance with international cooperative program with the hospital; depute staff, trainees to study and research, work abroad; receive foreign lecturers, trainees to research, exchange experience and study in the Hospital; manage outbound and inbound delegations within the field of activity of the hospital in accordance with the Ministry of Health;