Mental Health

(i) Introduction

As a country with a history of genocide, prolonged armed conflict and years of dislocation and insecurity, Cambodia has a population with a legacy of serious social and mental problems that have a debilitating impact at its reconstruction and development Worldwide, even in countries with advanced development; mental disorders are the second highest cause of reduced life span.

(ii) Key Issues

In spite of the wide knowledge and acknowledgment of the mental health impact of armed conflict and genocide on a population, donor countries and the government have not yet made a coordinated, national effort to create capacity and services to help people to recover from their mental and emotional problems. The NGOs active in the mental health sector (5) have proven effective models to assist people, but they are under-funded, and are located in less than half the provinces in Cambodia. The Ministry of Health, which has the official responsibility for the management of mental health care, lacks sufficient information and resources to deal with this issue, and has a limited view of the services needed to help people. The problems of children’s mental health are particularly acute, as there is only one NGO actually providing treatment for children with mental illness. The emerging problem of drug abuse among youth is of particular concern, in a post-genocide nation with 41% of the population under the age of 15.

There is currently a WHO-funded consultant leading the process of developing a national mental health plan, in consultation with other relevant ministries and NGOs. But that effort is hampered by the limited human resources assigned to it by the Ministry of Health, where only one part-time staff, a trained psychiatrist with many other responsibilities, is charged with all the liaison work.

(iii) Recommendations to Donors

1. Consider that the resources given for mental health services, rather than taking away from the process of development, may enhance it by increasing people’s ability to make use of other development initiatives.

2. Encourage the Ministry of Health to pay more attention to the impact of mental health on general health, and to provide sufficient and appropriate human resources to develop and manage the program.

3. Consider integrating mental health components in other development or assistance programs, such as community development, human rights, HIV/AIDS programs, disability/land mine programs, education programs, and others.

4. When supporting mental health programs, remember that mental health is mainly not a medical issue, but affects all parts of a person’s life, and therefore requires human resources in addition to medical personnel, such as social workers, psychologists, occupational therapists, community workers, and others.

5. Become familiar with the literature on the mental health impact of armed conflict and genocide on a population.

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