SAN MARCOS, Texas — Mental health in Cambodia is a serious issue. As the country continues to grapple with the aftermath of the Khmer Rouge era, a new spotlight is being shined on the subtle but deep connection between poverty and mental health. In the aftermath of the genocide that claimed nearly two million lives between 1975 and 1979, the scars of trauma run deep and are exacerbated by the relentless grip of poverty that plagues the country. Survivors and their descendants find themselves trapped in a cycle where economic poverty amplifies mental health issues and brings up past traumas.
The Bogen Project spoke with Dr. Michael Tao, medical director of the Fresno Center, a nonprofit that provides mental health resources, immigrant assistance, and community support to underserved communities. Pioneering efforts led by the Fresno Center highlight the urgent need to address poverty as a crucial element in the fight for spiritual well-being, offering a glimmer of hope in the face of deep-seated challenges. .
poverty in cambodia
According to the Asian Development Bank (ADB), 17.8% of Cambodians lived below the national poverty line in 2019. The 2022 Cambodia Poverty Assessment Report highlights that significant progress has been made in poverty reduction over the past decade, but that achievement is now overshadowed. The economic impact of the COVID-19 pandemic. According to the 2019-20 Cambodia Socio-Economic Survey (CSES), the Royal Government of Cambodia has set the national minimum poverty line at 10,951 riel per person per day. The assessment draws on a wide range of data sources to examine poverty trends, the impact of the pandemic, and its fiscal impact. Despite significant progress in poverty reduction between 2009 and 2019, recent gains have been undermined by the pandemic, exposing the pre-existing economic vulnerabilities of Cambodian households.
Furthermore, although living standards have improved and urban-rural disparities have narrowed, access to basic services and income opportunities remain uneven. Structural transformation and rapid economic growth, particularly in manufacturing and services, have played a vital role in poverty reduction, but challenges remain, such as moderate productivity and insufficient economic diversification. During the pandemic, the government used the ‘IDPoor’ registry for cash transfers, providing vital income support to registered households despite remaining disparities in coverage. This study therefore suggested that policymakers seize the opportunity to address emerging risks and promote a more inclusive and resilient recovery.
The relationship between poverty and mental health in Cambodia
Dr. Michael Tao said: “In general, we know that there is a bidirectional relationship between poverty and mental health. That is, poverty is a risk factor for poor mental health, and vice versa, and poor mental health is a risk factor for poverty. ” The correlation between poverty and mental health among Cambodians is multifaceted, as revealed by various studies.
Although income level alone is not consistently correlated with common mental disorders, the poor living conditions that accompany low income are still significantly associated with mental health problems. Economic insecurity, characterized by sharp declines in income, exacerbates the risk of mental illness, as seen in examples such as farmer suicides in parts of India and the hardship faced by small-scale farmers due to globalization. Let me do it.
Moreover, the psychological toll of poverty is compounded by shame, stigma, and hopelessness, as the stories of people in rural China and Guinea-Bissau demonstrate. Social changes such as rapid urbanization and migration are contributing to higher rates of depression and suicide, especially among vulnerable populations. Furthermore, low levels of education have emerged as a consistent risk factor for mental disorders, and poor educational outcomes perpetuate the cycle of poverty and mental distress among Cambodian communities.
Challenges and developments in psychiatric care in Cambodia
Since the overthrow of the Khmer Rouge regime in 1979, the state of mental health care in Cambodia has changed significantly. After the closure of its only psychiatric hospital in 1975, Cambodia initially relied solely on traditional healers for mental health care. However, in the 1990s, with support from both international and local organizations, Cambodia began reintroducing formal mental health care incorporating Western psychiatry. A method that parallels conventional treatment methods.
Despite progress, Cambodia’s mental health system remains underdeveloped, with only 56 psychiatrists in referral hospitals and 37 mental health clinics across the country, making access to quality services difficult. Ease and affordability pose major challenges. Key concerns include high prevalence of anxiety disorders, depression, PTSD, and suicidality, which are further exacerbated by Cambodia’s war-torn past, poverty, and limited access to healthcare. Masu.
The shortage of trained professionals calls for increased investment in training programs to ensure adequate support for individuals dealing with mental health issues, especially in rural areas where access to services is limited. This highlights the urgent need for integration into the health care system.
Cambodian mental health services
The current state of Cambodia’s mental health services highlights progress, setbacks, and continuing needs. The Cambodian Ministry of Health established a Mental Health Subcommittee in 1992 and began efforts to train mental health professionals. As a result, approximately 60 psychiatrists and several psychiatric nurses currently serve her population of more than 16 million people. Once international funding ended, the initially rapid professional growth slowed, leading to fewer training opportunities and a shortage of qualified personnel.
The Royal University of Phnom Penh offers programs in psychology and social work, but graduates often secure jobs with NGOs, as there are few established positions in these fields in public hospitals. Government investment in mental health is minimal, accounting for only 0.02% of total health spending in 2012.
Mental health services were once more accessible, but in recent years there has been a decline in inpatient beds and specialist services, particularly in rural areas where access to medication and psychosocial support is limited. NGOs are critical to filling these gaps in mental health care by providing psychotherapy and community-focused drug rehabilitation programs. Despite these efforts, challenges persist in drug availability and prescribing practices, and comprehensive reforms are needed to ensure that all Cambodians have equitable access to quality mental health services. The need is emphasized.
Fresno Center Tackles the Problem
The Fresno Center (TFC) is a nonprofit organization dedicated to helping people achieve self-sufficiency, fulfillment, and productivity in their communities. It also aims to preserve cultural heritage and promote cross-cultural understanding. One ongoing initiative, the Living Well program, focuses on Fresno County’s Cambodian community and provides specialized mental health services to Asian Pacific Islanders. “The biggest barriers we have in addressing poverty-related mental health issues within the Cambodian community include medical care that speaks Cambodian and understands Cambodian culture, transportation, language barriers, housing, etc. Including lack of providers.” Dr. Tao explained to the Bogen Project.
The program is an important component of the county’s behavioral health services, which focus on serving low-income individuals, many of whom face homelessness and food insecurity. TFC prioritizes cultural competency in mental health care, emphasizing the need for health care providers who understand Cambodian culture to provide effective care. Despite the challenges, Cambodians actively seek and benefit from mental health services, and there are many success stories. “This is evidenced by the relief clients experience when they are able to utilize coping mechanisms to effectively reduce stress and anxiety. This is evidenced by the reduction in physical health symptoms that have resulted from years of unmanaged mental health symptoms.” Dr. Tao told The Bogen Project.
Looking to the future
Integrating cultural understanding and comprehensive mental health support is providing a path to healing for Cambodian communities and making great strides towards alleviating the intertwined challenges of poverty and mental health. With continued efforts and collaboration between local and international partners, the vision of a more resilient and supported Cambodian society where mental health is a priority is increasingly a reality.
– Luciana Schuelly
Luciana is based in San Marcos, Texas, USA and focuses on global health for The Borgen Project.
Photo: Flickr
