21 May, 2015
Cambodia has some of the world's worst mental health statistics. Experts say the large number of cases is partly a result of Khmer Rouge rule in the 1970s.
The Cambodian government spends little on mental health services. The World Health Organization says such services are, in its words, "critically neglected."
Experts do not believe that will change anytime soon, because few Cambodian students are interested in psychiatry as a career -- they have little or no interest in the treatment and prevention of mental disorders.
Most Cambodians live in rural areas. But few mental health services are provided there. So people must go to psychiatric centers in cities, like the Khmer-Soviet Hospital in Phnom Penh. It is one of the busiest clinics in the country.
Yem Sobotra is the director of the clinic. He says that, 15 years ago, it cared for between 70 and 150 patients every day. When our reporter visited recently, the daily average was 400. The clinic has just 10 psychiatrists and 10 nurses or aides. So most patients are treated for just a few minutes and leave with a bottle of pills.
Dr. Yem Sobotra knows medicine can help patients, but is not the only answer. He says the clinic could help people more if it had more money and other resources.
"So we (have) not much time to give good service for them -- especially for psychotherapy. We just only (give) some short counseling, short psychotherapy to the patient."
In addition to the lack of trained mental health specialists, Cambodia does not have the newer drugs used in neighboring Vietnam and Thailand.
Cambodia needs more psychiatrists, but few young people seem interested in the subject. Nationwide, just six students are taking the three-year-long study program.
Experts say low pay and the challenges of studying psychiatry keep many Cambodians from wanting to get training
TPO-Cambodia is a respected mental health non-profit group.
Dr. Chhim Sotheara is its executive director. He says Cambodia has many needs but few resources, especially in rural areas. And he says the government is not doing enough. He also says the psychiatry training program should be offered to other health care workers.
"We don't have anyone who are enrolling in the psychiatry training program, so that's not going to happen. So I think the transferring (of) skills from the specialist psychiatrist to GP, GP to nurse, and to village health support group(s), traditional healers, the monks, the nuns and all this would be good."
Dr. Muny Sothara is deputy director of the government's newly-created Department of Mental Health and Substance Abuse. He says there has been an improvement in mental health care services in recent years. But he admits more is needed.
"For the coming future we need to improve the quality of the existing trained staff and mobilize new general practitioner(s) and nurses in order to operate more mental health unit(s) in other sector(s) down."
Our reporter repeatedly asked Cambodian officials how many doctors and nurses have been trained in mental health care. But the question was never answered.
The Cambodian government spends about $1,000,000 a year on mental health services. That is much less than is needed. So it is not likely that the country's mental health care delivery system will improve any time soon.
I'm Christopher Jones-Cruise.
Correspondent Robert Carmichael reported this story from Phnom Penh. Christopher Jones-Cruise adapted it for VOA Learning English. George Grow was the editor.
Words in This Story
statistics – n. numerical information
psychiatry – n. the area of medicine that deals with mental or emotional disorders
clinic – n. a place where people get medical help
psychotherapy – n. treatment of mental or emotional disorders by talking about problems instead of using medicine or drugs
enroll – v. to enter (someone) as a member of something
transfer – v. to use (something, such as an idea or a skill) for a new or different purpose
GP – n. acronym for General Practitioner; a person (especially a doctor) who is not a specialist
mobilize – v. to come together for action
Are there enough mental health services available in your country? We want to hear from you. Write your thoughts in the comments section.