A high prevalence of suicide attempts, post-traumatic stress disorder (PTSD), and anxiety has been found among the general population, according to the results of the first large-scale survey on mental health in Cambodia.
Based on interviews with 2,600 adults aged 21 and over and conducted in nine provinces last year, the survey, published by the Royal University of Phnom Penh’s department of psychology, is a first attempt to identify the mental health problems the public suffers from.
According to the survey, 115 of those interviewed reported previously attempting suicide, while 22 respondents said that a family member had succeeded in committing suicide. More than a quarter of those reported suicides occurred in 2011, which produces a rate of 42.35 suicides per 100,000 of the population—a figure that far exceeds the World Health Organization’s (WHO) average country ratio of 16 suicides per 100,000 people per year.
“The Cambodian suicide rates therefore exceed worldwide numbers,” the survey says, adding that the reported ratio of attempted suicides to actual suicides was more than double in WHO Cambodia’s country average.
“One of the most commonly mentioned worries in this study was the lack of money,” the report states, adding that 87 percent of respondents who entertained suicidal thoughts had no savings or were in debt.
While suicide is prevalent in Khmer music videos and movies, more detailed research needs to be conducted to establish any correlation, the report states.
Sek Sisokhom, head of the psychology department, said that the media might unnecessarily romanticize the notion of suicide.
“The broadcast of karaoke videos and movies shows suicide happens between couples as [if] suicide is an adequate way to respond to lost love. When young people watch TV, they might want to try this, and this is a problem,” she said.
Probable acute anxiety and depression also featured prominently in the report’s results, with 27.4 percent and 16.7 percent of the respondents experiencing symptoms for each disorder respectively. As for PTSD, 2.7 percent of respondents were found to exhibit the symptoms—seven times higher than that found in the general population worldwide.
The high prevalence rates of these disorders point toward a dire need for the government to address the need for counseling and the training of psychiatric staff throughout the country, especially for the poor in rural areas, the survey says.
“However, Cambodia is far from upholding these promises and a higher allocation of money to the mental health sector is urgently required in order to meet the needs of acutely and chronically mentally ill,” the report says.
“The department decided to do this survey because we do not have any mental health survey representing Cambodia country-wide,” Ms. Sisokhom said.
“Since we don’t have that, we cannot judge how big the problem is here and what kind of issues and what kind of need is [necessary] for intervention in order to help our people.”
With funding from the German Development Agency (GIZ), the researchers combined a Western approach with a culturally relevant questionnaire so that respondents would better understand some of the survey’s questions, instead of having to wrestle with the psychiatric jargon.
For example, panic attacks are sometimes described in Khmer as “wind attacks” while sleep paralysis is described as a ghost pushing an individual down (“khmaoch sangkat”). Both symptoms are associated with trauma and PTSD.
Dr. Tanja Schunert, co-author of the study and a GIZ adviser, said the results were “alarming,” especially when looking at the rates of committed and attempted suicides.
“The government should see this report and they should wake up. It should be an alarm for the government,” said Chhim Sothearo, executive director of the Transcultural Psychosocial Organization Cambodia, which offers counseling and psychiatric help to Cambodians.
“There is a huge gap between the problems of the country and the care [being provided].”
Chak Thida, vice-director of the Khmer-Soviet Friendship Hospital—which houses the largest mental facility in the country—said about 300 patients come each day seeking mental health services. About 40 percent need to be treated for anxiety, while about 30 percent suffer from depression, she said.
“There is limited funding [for the mental health sector] and this field is not a priority field,” she said. “But now, we are starting to look more into it.”