Study Finds Refugees in US Still Traumatized by Civil War

Nearly two-thirds of the adults living in the largest Cambodian-American community in the US show a “shockingly high” rate of psychiatric illness decades after escaping the murderous Khmer Rouge regime, according to a re­cent study by a prominent think-tank.

Over a span of nearly two years in Long Beach, California, re­search­ers with the nonprofit Rand Corporation surveyed a random group of 586 adults who lived in Cambodia during the 1975-1979 Khmer Rouge era.

Their findings assert that the US residents currently have 17 times the rate of post-traumatic stress dis­order and six times the rate of major depression than the overall population.

“More than two decades have passed since the end of the Cam­bodian civil war and the subsequent resettlement of refugees in the United States; however, this population continues to have high rates of psychiatric disorders associated with trauma,” wrote the study’s lead author, Rand psychologist Grant Mar­shall, in an e-mail last week.

“Cambodian refugees are strug­gling,” Mar­shall wrote. “The fact that large numbers of Cam­bodian refugees suffer from one or both of these disorders means that the community is not functioning as well as it should be.”

Touted as the first study to look at the mental health of re­fugees years after their arrival in the US, Marshall said the high rate of mental disorders was compounded by the fact that 70 percent of the respondents were living below the poverty line and had poor levels of education and English proficiency.

Ninety-nine percent of the re­spondents, between 35 and 75 years old, had experienced near-death due to starvation and 90 percent had a family member or friend murdered before traveling to the US, according to the study, which was published last month in the Journal of the American Med­i­cal Association.

Since arriving in the US, 70 percent of the respondents in Long Beach reported being exposed to violence, such as being victims of robbery.

Rand researchers interviewed each of the subjects for roughly two hours in the Khmer language. When they tallied results, they found that the refugees re­ported experiencing an average of 15 of the 35 kinds of trauma test­ed for.

Although the Rand study ex­amined only one refugee community, researchers said they believe their findings apply to other Cam­bodian communities in the US.

About 150,000 Cambodian re­fugees have been admitted to the US since 1975.

Ka Sunbaunat, director of the Mi­­nistry of Health’s National Pro­gram for Mental Health, said that he was not surprised at the high incidence of mental disorders that Rand re­searchers found.

“The rate of psychiatric illness in [Amer­ican] communities is much higher than in Cambodia,” said Ka Sunbaunat, who said he in­itiated a similar study in the US in the 1990s.

“One reason is that post-traumatic stress disorder doesn’t fit in well with Cambodian culture and behavior,” he said, explaining that such a syndrome is regarded more seriously in the West, where treatment is more widely available than in Cambodia.

Ka Sunbaunat said that there were no comparable studies on rates of mental illness in Cam­bodian communities, but that roughly 50,000 people receive treatment at men­tal health outpatient facilities annually.

He added that the number of Cambodians suffering from ma­jor depression is very likely un­der-diagnosed because people, especially those living in remote areas, are unaware of treatment op­tions or are too impoverished to seek out care.


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