THE NEED

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.