Mental Health under Social Strain: A Sociological Perspective among Healthcare Students in Vietnam

Abstract

Mental health is a critical determinant of academic achievement, professional competence, and long-term well-being. Healthcare students are especially vulnerable given their intensive training, financial pressures, and societal expectations. This study examined the determinants of mental health among healthcare students in Ho Chi Minh City, focusing on both positive well-being and psychological distress. An explanatory sequential mixedmethods design was employed. Quantitative data from 525 students were collected using the WHO-5 Well-Being Index, GHQ-12 General Health Questionnaire, and MSPSS-12, alongside indicators of chronic social strain and the academic environment. Logistic regression and PLS-SEM tested direct and moderating effects, guided by Pearlin’s stress process model, Cohen & Wills’s (1985) and Thoits’s (2011) social support theory, and Keyes’s dual-continua model. Qualitative data from 15 in-depth interviews were analyzed through interpretative phenomenological analysis. Results indicated that 43.6% of students had low well-being and 59.8% experienced psychological distress. Academic pressure most strongly harmed well-being, while financial strain consistently predicted distress. Peer support sustained wellbeing, and family support reduced distress. Academic factors such as lecturer relationships, counseling awareness, and student engagement offered conditional protection. Overall, healthcare students’ mental health is socially structured, with distinct drivers for well-being and distress. The dual-continua framework provides a proper lens than single-axis models. Policies should tackle structural inequalities, expand institutional support, and strengthen peer- and community-based initiatives.