Development of mental healthcare in Cambodia: barriers and opportunities

Abstract

Background: Despite the increasing recognition globally of the importance of mental health for sustainable development, significant barriers remain to developing mental health services in low-and middle-income countries. This study explored the particular barriers and opportunities for developing mental health services in Cambodia and how these compared with those described in other low-and middle-income countries. Methods: For this qualitative study, 18 experienced mental health professionals from different disciplines were selected using purposive sampling. Semi-structured interviews were carried out in Phnom Penh and thematic analysis of the data was completed. Results: Five key themes were identified: (1) Prioritising mental health in Cambodia, (2) Strengthening collaborations between mental health stakeholders, (3) Developing a mental healthcare model appropriate for the Cambodian culture and context, (4) Increasing the quantity and (5) Improving the quality of mental healthcare. All five themes were referred to by all 18 participants and the two most repeated themes were (2) Strengthening collaborations and (5) Improving the quality of mental healthcare. Conclusions: The themes identified in this study both corroborate previous barriers identified to developing mental health services in low-and middle-income countries and shed new light on opportunities of particular importance in Cambodia. Strengthening collaborations between key stakeholders in mental health and prioritising the quality of mental health education, training and service provision were both cited as being significant opportunities for enhancing the development of mental health services in Cambodia. These have not been widely described before as being important factors.

Barriers and enablers to access and utilization of mental health care services across Southeast Asia: A preliminary scoping review

“…Poor health literacy, especially a lack of understanding about mental health, was reported in six studies (Hall et al, 2019;Nguyen et al, 2019;Parry et al, 2020;Putri et al, 2021;Subramaniam et al, 2021;Trang et al, 2021;Zay Hta et al, 2021). Hall et al (2019) and Zay Hta et al ( 2021) reported that the lack of available information contributed to the poor knowledge held by the SEA population, while Subramaniam et al (2021) identified that mental health education was a low priority in schools and workplaces.…”

Untitled

“…The The 1970's genocide in Cambodia led to death of a third of the population and the destruction of all infrastructure including healthcare (Parry et al, 2020). Parry et al (2020) describe the 1991 Paris Peace Agreement, providing the stability to begin to rebuild the nation, including health care. Nongovernmental organisations (NGO) have played a major role in the rebuilding of mental healthcare (Leng, 2018).…”

“…The provision of health care in Cambodia is very different to Western nations and this can present extra challenges to the counsellor when a client has health difficulties requiring medical care. For example, in Cambodia there are currently 60 psychiatrists to serve a population of around 16 million (Parry et al, 2020). The basics of diet, exercise and sleep can also present extra challenges.…”

“No matter what, we just work with the trauma…”: Mental Health Therapists’ Care of Diverse Sexual and Gender Identity Citizens in Cambodia

“…The mental health needs of the Khmer community compel a caring global response. Anxiety and depression, both considered common mental health conditions, reportedly affect a high percentage of Cambodians, with up to 80% and 53% meeting criteria, respectively (Parry et al, 2020). The prevalence of post-traumatic stress disorder (PTSD) in the Cambodian population has been reported at rates up to 86% (Parry et al, 2020), and substance use disorders are estimated to affect 41.9% of the population, although the true rate is likely higher (Saing et al, 2020).…”