Adolescent Mental Health in Vietnam 2024–2026: Prevalence, Drivers, School-Counsellor Capacity, and the Operational Scope of Self-Help Guidance Content

Any guidance series for Vietnamese adolescents 14– 19 that omits a documented account of mental-health prevalence, structural drivers, and scope-of-help boundary will be ungrounded. This paper supplies that grounding. Four questions are addressed. (a) What is the documented prevalence of depression, anxiety, suicidality, school burnout, and academicpressure-related distress among Vietnamese adolescents 14–19? Best-available evidence from Tran et al. 2017, UNICEF Vietnam 2018/2022, the Vietnam Ministry of Health adolescent health surveys, and WHO Global School-Based Health Survey reanalyses indicates point-prevalence estimates in the 15–30 percent range for depressive symptoms (instrument-dependent: PHQ-9 / CES-D / DASS-21 thresholds) and 18–35 percent for anxiety symptoms, with substantial methodological heterogeneity, urbanrural and grade-level gradients, and post-COVID upward shift. (b) What are the structural drivers? High-stakes-exam pressure (kỳ thi tốt nghiệp THPT, examination for university admission), academic-tracking ladder, sleep deprivation, family expectation, peer hierarchy, and post-COVID schooling disruption have stronger and more consistent Vietnamese evidence than socialmedia exposure, for which the international literature is contested (Twenge 2017/2023 versus Orben-Przybylski 2019, Haidt 2024 versus Vuorre-Przybylski 2024). (c) What is school-counsellor capacity? MOET Circular 31/2017 established the schoolcounsellor function but the implementation is uneven: most public secondary schools share part-time counselling staff, formal training varies, and the role frequently collapses into discipline support rather than mental-health intervention. (d) What is the scope-of-help boundary for a self-help guidance textbook? Selfhelp content is appropriate for awareness, normalisation of helpseeking, time-management, sleep hygiene, study-load regulation, peer-support skills, and recognition of red-flag indicators in self and peers. Content must escalate to professional referral whenever red-flag indicators (active suicidal ideation with plan or intent, sustained functional impairment over 2+ weeks, self-harm, eating-disorder behaviours, psychosis-spectrum experiences) are reported or observed. The paper's substantive operational contribution is the Scope-of-Help × Red-Flag × Referral table (§5.4), which the Layer I series uses to draw the boundary between selfhelp content and professional-referral content. Four Vietnamese referral pathways are documented: hospital psychiatric services (Bệnh viện Tâm thần Trung ương I & II, Bạch Mai Psychiatric Department, provincial psychiatric hospitals), private mentalhealth services (Vinmec, Family Medical Practice), the MOET