Mental Health Context In Cambodia
For the
last decades, Cambodia
has endured intense sufferings: wars, displacement of population, tortures,
starvation, forced labor, landmines, destruction of property, and family
separation… We can say that Cambodia
has suffered a massive and collective psychosocial trauma. Numerous people are
still suffering from these tragic events. Many mental health problems are seen
in Cambodia
and most became chronic, even severe and complicated. Because mental health
services have not been available for a long time, are not yet widely accessible
in the country, and people continue to live in a very unstable situation of
serious mental illness such as schizophrenia, anxiety, PTSD, and depression. The
current factors such as behavioral disorders, schooling problems, domestic
violence, alcoholism, drug abuse, unemployment, natural disasters, accidental
injuries, crimes, and suicides are also common and usually linked to currently
psychological problems.
While the
country’s physical health is generally well improving but mental health is
limited developed to availability and needs of its services. There is no doubt
that a lot of people in Cambodia
need psychiatric care but if people look for care, they generally go first to
any kinds of traditional healers such as Kru or the medium, the monks and
Achar, who try to provide treatments and relief to mentally ill patients with
medicinal plants and/or spiritual means. Meanwhile, an accessibility of public
mental health are arranged in only provincial referral hospitals where
psychiatry ward still face many challenges related to human resources, drug
supplies, materials and so on. And now there are about fifteen psychiatry wards
providing mental health treatment throughout the country.
If we look
at the public health sector, after the Pol Pot regime and until the beginning
of the 1990s there were no mental health services whatover available in Cambodia .
General practitioners treated most patients in the public sector. They never
received any training on mental health and were not able to make a correct
diagnosis and prescribe the right treatment. In general they only treated with
medication and short advice, which rarely fitted with psychotherapy or
counseling approaches. It was only in 1994-95 that psychiatry became a part of
the curriculum of the Faculty of Medicine for training medical doctors and in
1997 it was centralized in the curriculum of the Technical School of Medical
Care and other Regional training Centers.
Therefore,
awareness of what mental disorders and psychosocial problems among Cambodian people
are extremely low and they are often not recognized, even misinterpreted. So
many people continue to live without addressing them or receiving an adequate
treatment. Associated with the lack of knowledge on mental disorders is
stigmatization. Many people strongly believe that mental illness is craziness
or heredity illness, leading to a persistent stigma on the mentally ill people,
their family, and their communities. The big consequence is creating poverty of
people due to mental problems lead to functional impairment and mental
disability, which decrease activity and lower productivity.
So, mental
health care in Cambodia
is till an urgent issue that requires collaboration between public sectors and
partnerships to address them forwardly. The huge task is in front of us to
develop mental health services, which can answer to the needs of our
population.
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