The online version of this article (https://doi.org/10.1186/s13033-018-0185-3) contains supplementary material, which is available to authorized users.
While mental and substance use disorders are common worldwide, the treatment gap is enormous in low and middle income countries. Primary health care is considered to be the most important way for people to get mental health care. Cambodia is a country with a long history of war and has poor mental health and limited resources for care. The aim of this study was to conduct a situational analysis of the mental health services in the rural district of Lvea Em, Kandal Province, Cambodia.
A cross-sectional situational analysis was done to understand the mental health situation in Lvea Em District comparing it with the national one. The Programme for improving mental health care (PRIME) tool was used to collect systematic information about mental health care from 14 key informants in Cambodia. In addition, a separate questionnaire based on the PRIME tool was developed for the district health care centres (12 respondents). Ethical approval was obtained from the National Ethics Committee for Health Research in Cambodia.
Mental health care is limited both in Lvea Em District and the country. Though national documents containing guidelines for mental health care exist, the resources available and health care infrastructure are below what is recommended. There is no budget allocated for mental health in the district; there are no mental health specialists and the mental health training of health care workers is insufficient. Based on the limited knowledge from the respondents in the district, mental health disorders do exist but no documentation of these patients is available. Respondents discussed how community aspects such as culture, history and religion were related to mental health. Though there have been improvements in understanding mental health, discrimination and abuse against people with mental health disorders seems still to be present.
There are very limited mental health care services with hardly any budget allocated to them in Lvea Em District and Cambodia overall. There is dire need for scaling up and integrating mental health into primary health care to improve the population’s access to and quality service of Cambodian mental care.
Additional file 1. Adapted PRIME situation analysis tool.
World Health Organization. Mental health: strengthening our response. http://www.who.int/mediacentre/factsheets/fs220/en/2016. Accessed 02 Dec 2017.
Institute for Health Metrics and Evaluation. Global burden of disease. https://vizhub.healthdata.org/gbd-compare/2016. Accessed 02 Dec 2017.
World Health Organization. Mental health atlas 2011. Geneva: World Health Organization; 2011.
World Health Organization. mhGAP: Mental Health Gap Action Programme: scaling up care for mental, neurological, and substance use disorders. Geneva: World Health Organization; 2008.
World Health Organization. Mental health action plan 2013–2020. Geneva: World Health Organization; 2013.
The World Bank. Cambodia 2014. http://data.worldbank.org/country/cambodia. Accessed 17 Dec 2015.
Cambodian information center. Country profile of Cambodia 2015. http://www.cambodia.org/facts/. Accessed 17 Dec 2015.
National Institute of Statistics MoPPP, Cambodia. General population census of Cambodia 2008; 2008. http://www.stat.go.jp/english/info/meetings/cambodia/pdf/pre_rep1.pdf. Accessed 04 Jan 2016.
The Fund for Peace. Fragile states index 2016. http://fsi.fundforpeace.org/rankings-2016. Accessed 17 Dec 2015.
McLaughlin D, Wickeri E. Mental health and human rights in Cambodia. New York: Leitner Center for International Law and Justice Fordham Law School; 2012.
World Health Organization, Ministry of health Cambodia. Health Service Delivery Profile, Cambodia, 2012. Phnom Penh: World Health Organization, Ministry of health Cambodia; 2012. p. 2012.
World Health Organization. Integrating mental health into primary care: a global perspective. Geneva: World Health Organization; 2008.
Mar R. General Health Assessment, Lvea Em District, Kandal Province, Cambodia. Farmington: University of Connecticut Health Center; 2008.
PRIME. PRIME’s situation analysis tool; 2015. http://www.prime.uct.ac.za/research/tools. Accessed 25 Sep 2015.
World Health Organization. Mental Health Gap Action Programme Implementation Guide (mg-GAP-IG) for mental, neurological and substance use disorders in non-specialized health settings. Geneva: WHO; 2016.
Central Intelligence Agency. The World Factbook, Cambodia; 2017. https://www.cia.gov/library/publications/the-world-factbook/geos/cb.html.
Ministry of Health Kingdom of Cambodia. Health strategic plan 2008–2015. Phnom Penh: Ministry of Health Kingdom of Cambodia; 2008.
Ministry of Health Kingdom of Cambodia (ed.). Cambodia: Second Health Sector Support Project (HSSP2). Phnom Penh: Ministry of Health; 2008.
Ministry of Health Kingdom of Cambodia (ed.). Guidelines on minimum package of activities for Health Center Development 2008–2015. Phnom Penh: Ministry of Health; 2007.
Ministry of Health Kingdom of Cambodia (ed.). National guidelines on complementary package of activities for referral hospital development from 2006–2010. Phnom Penh: Ministry of Health; 2006.
IRIN—humanitarian news and analysis. Analysis: what ails Cambodia’s mental health system? 2015. http://www.irinnews.org/report/95054/. Accessed 17 Dec 2015.
World Health Organization. Mental health atlas country profile 2014 Cambodia. Geneva: World Health Organization; 2014.
Swedish Medical Association. Läkarfakta 2016 (Medical facts 2016). https://www.slf.se/upload/Lakarforbundet/Trycksaker/PDFer/Läkarfakta_2016.pdf; 2016.
Statistics Sweden. Swedens population 2015. http://www.scb.se/en_/Finding-statistics/Statistics-by-subject-area/Population/Population-composition/Population-statistics/Aktuell-Pong/25795/Behallare-for-Press/399296/; 2015.
Unite for sight. Cultural perspectives on mental health 2015. http://www.uniteforsight.org/mental-health/module7. Accessed 09 Dec 2017
Shibre T, Spångéus A, Henriksson L, Negash A, Jacobsson L. Traditional treatment of mental disorders in rural Ethiopia. Ethiop Med J. 2008;46(1):87–91. PubMed
- Mental health in primary health care in a rural district of Cambodia: a situational analysis
Miguel San Sebastian
- BioMed Central