PHNOM PENH, CAMBODIA — After the Khmer Rouge Genocide that wiped out nearly a quarter of Cambodia’s population between 1975 and 1979, only 43 of the country’s 450 physicians remained. In fact, the Khmer Rouge shut down the only mental health hospital that existed in the country in 1975. Starting in the 1990s, however, the country began to restore mental health care. An influx of international medicine and partners created resources like the 1994 Cambodian Mental Health Training Programme to train local doctors as psychiatrists. In addition, organizations are dedicating themselves to the promotion of mental health awareness in Cambodia.
In 2002, an estimate stated that about 40 percent of Cambodians suffer from various mental health problems. PTSD affects the country especially. A survey conducted in 2011 to research rates of PTSD in four post-conflict zones of the world, Algeria, Cambodia, Ethiopia and Gaza. The study surveyed a random selection of 610 people from Cambodia, and De Jong and others found that 28.4 percent of the sample group had PTSD. Cambodia ranked second highest out of the four countries.
The stigma of mental illness is high in Cambodia, and family and friends often turn away patients who experience those hardships. Nevertheless, there are organizations and people dedicated to well-functioning mental health services and decreasing the stigma surrounding mental health.
Organizations Promoting Mental Health Awareness in Cambodia
The World Health Organization has sponsored The Cambodia-WHO Country Cooperation Strategy 2016-2020 which has the mission to develop community-based rehabilitation services, therapy and consultation services and expand resources for people with both mental and physical disabilities. The general goals of the strategy also focus on investing in universal health coverage and achieving the targets of the United Nations Sustainable Development Goals by 2030. The WHO has certainly made progress towards those goals. For example, it established the Department of Mental Health and Substance Abuse, under the Ministry of Health in 2014 which has increased many mental health services and legitimized the importance of mental health in more people’s lives.
Transcultural Psychosocial Organization Cambodia (TPO) is a nonprofit organization that trains people, businesses or other organizations in mental health literacy. For example, it has trained workers as part of mental health support groups for landmine victims at the War Amputees Rehabilitation Services Center. TPO also provides treatment at its center. According to a report on Mental Health and Human Rights in Cambodia, only 2 percent of health centers offer mental health care to out-patients. TPO’s center provides access to services and specialized treatment for anyone. TPO also works to create policy change around mental health and raise public awareness of mental health issues, and especially in rural areas.
The Centre for Child and Adolescent Mental Health (CCAMH) works to protect the younger generations of Cambodia from growing up and having their mental disabilities, struggles and illnesses worsen. By focusing on neglected, poor mental health symptoms in children, the organization is promoting mental health awareness in Cambodia to all. CCAMH is a collaborative project that the Ministry of Health and Caritas Cambodia work on together. It is based in Phnom Penh and its center is located in Kandal Province. CCAMH provides support-group formation among parents, conducts surveys for mental health research, installs counseling services at local schools and promotes aspects of healthy primary schools like libraries and playgrounds.
The Relationship Between Poverty and Mental Health Illnesses in Cambodia
TPO stated that mental health illness is twice as common among poor communities than more wealthy communities in Cambodia. Even though poverty rates have declined drastically — in 2014 this metric stod at 13.5 percent compared with 47.8 percent in 2007 — 4.5 million Cambodians remain near-poor, with a high risk of falling back into poverty.
Some experts describe poverty in Cambodia as both a cause and a consequence of mental health illnesses. Professionals like Dr. Ka Sunbaunat, Director of the National Program for Mental Health have noted that some stressors of mental health issues include food and job insecurity. The other side of this reality shows that people in poverty are unable to pay for medical services to treat mental disabilities, and only 24 percent of Cambodia’s population has medical care covered.
As Cambodia attempts to improve personal and national economic development, it is important that more mental health initiatives receive government support. By promoting mental health awareness in Cambodia, the stigma around mental illness that holds people back from receiving help will diminish.
– Melina Benjamin