Editor’s note: The story is written from the perspective of Australian Ray Kuschert, who has been living in Vietnam over the past decade. 

As ‘A Whiter Shade of Pale’ played softly in the background, I sat in the lonely bar, my face hidden from the only other person in the place. I sat alone and cried uncontrollably into my hands, not knowing why my emotions were taking me to the brink of my existence. 

My thoughts were not right or logical. I begged to be swallowed up into the ground and, at the same time, I begged for an angel to walk through the door with a kind word. 

It was 2014 and I was suffering with severe depression in my second year of living in Ho Chi Minh City.  

Having survived that moment, I now feel I need to be brave enough to make men’s mental health a subject for everyone, especially expat men in Vietnam. And whilst both male and female expats experience mental health issues from time to time, this story is pointed to all the expat men across the country. 

Mental health issues such as anxiety, depression, and a raft of other conditions occur in all societies around the world.

It was noted in a WHO report in March 2023 that “an estimated 3.8 percent of the population experience depression, including five percent of adults (four percent among men and six percent among women), and 5.7 percent of adults older than 60 years.”

Meanwhile, a report of global suicide statistics by the International Association for Suicide Prevention in 2021 showed “the global suicide rate is over twice as high among men than women.”

I recall back in 2014, my condition forced me to seek medical help and at that time there were few options available in Ho Chi Minh City, but that is no longer the case with new services now accessible to everyone in the community. 

Even though Vietnam is an amazing country and a beautiful place to live, we need to look at why mental health is such an important topic for expats in Vietnam. Actually, this is not a story unique to expats in Vietnam but it is a community topic we need to discuss because, like every other community around the world, there are many people suffering.

The nature of mental health issues is highly individual, making it impossible to encapsulate them in a few words. Each person's experience is unique, and attempting to summarize this complex issue briefly would be insensitive.

To me, my mental illness is when the pain of surviving today is so great that you forget there is a tomorrow.  

In discussions at a few local bars in Ho Chi Minh City and Vung Tau, there appear to be some common factors that raise themselves above others when it comes to looking at mental health, in particular, the mental health of expat men living in our community here in Vietnam. 

First up, and most importantly, is the sense of isolation. Language barriers, changes in work, and reduced options for socializing are just a few of the reasons that many expats can become isolated, and this is only accentuated by being so far away from family.

Adding to this sense of isolation is the lack of recreational activities outside of work. While many expats enjoy fulfilling lives here, some struggle with the absence of familiar hobbies. The available pastimes can be difficult to discover and often come with language barriers, further isolating individuals from both expat and local communities.

The simplest of things that we are used to doing in our home countries are sometimes not available. As an Australian, it is common for me to take a road trip to the coast and just spend a couple of days driving in the countryside. Nothing makes me feel better than a weekend on the open road in the Australian countryside.  

Another interesting and common aspect noted by expats who raised this issue is the inability to be functional. In our home countries we used to fix cars, build things, fix things, and even just mow the lawn for the neighbor. This is important for many men and not having the ability to do manual things can add to feelings of worthlessness.

As a result, men will often turn to visiting bars to overcome these feelings. Whilst the connections made at local bars are invaluable for most men, it can also have its challenges, namely the increase in the consumption of food and alcohol.

Career and jobs are yet another part of the maze of mental health in our community. Whether it is too much work, not enough, or doing something that is not fulfilling, career plays a significant role in managing mental health for men. 

Every country and every culture treats mental health in a different way. Not having the familiarity of the services and support you are used to in your home country, even just being able to talk to a stranger, makes the problem even more difficult for some expats.

The good news is that in recent years the mental health support services available to English-speaking expats have improved greatly. International clinics now offer services that were once very difficult to locate in Vietnam.

In addition, many expats now have access to online support, with the pandemic having expanded cybersupport options for people worldwide.

Mental health is a subject that people don’t like talking about, especially men, but it is us men that need to stand up and be there for other men when things are not going great. 

Over the past decade, I spent periods feeling isolated and periods when medical support was the only solution to help me to ride the storm in order to find a sunny day at some time in the future, and they always arrived.

From my experience with mental health issues, I have learned that there are no quick-fix words that will solve the problem. My recovery came from the right connections, the right choices, and the right medical support. Thankfully, things continue to improve in Vietnam and this helps everyone, including expats when times are a bit difficult. 

Living in Vietnam offers you the most memorable and life-changing experiences but there are also moments when the days are not so bright. When the dark days become everyday, it is time to speak to someone. 

So, this is a personal message to every expat living in Vietnam that has been there or is there at the moment. You are not alone and there are sunny days ahead. 

My 'Three Steps To Recovery' plan: talk to someone, make good choices, and focus on one small improvement every day.

For everyone else, make sure you ask your friends “Are you ok?” This one simple question could save a life.

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