What do young Cambodian mental health professionals think about the future of mental health care?

“The main reason I chose to work in mental health is because I saw how few people were in this field in the country. When we have a physical illness, we usually know where to go. But when it’s our mental health, many of us don’t know who to turn to. 

I remember when I was about six or seven. A distant relative of mine – he was a regular person, had a job, and lived a normal life. But one day, he started talking to himself, behaving in ways we didn’t understand. 

People thought he was cursed, so the family took him to traditional healers in the village. He didn’t get better. It wasn’t until six months later that they finally realized he was struggling with a mental illness. They took him to the hospital.  

After he received mental health support, he could talk and work normally just like anyone else. That was the first time I saw firsthand how mental health can affect people’s lives. It also became one of the many reasons I studied psychiatry. 

I used to work as a doctor specializing in psychiatry. Now, as a Technical Officer, I help develop national policies and guidelines for mental health and substance use services. 

One of the things I’m most proud of is seeing the change in some health centers where we’ve trained health workers and village health support group (VHSG) volunteers. 

Before, when people had headaches, insomnia, or signs of mental distress, doctors would look for a physical cause, and they couldn’t find anything. Even when the doctors suspected it was mental health-related, they didn’t have the skills to diagnose the patients. But after our training, they can now assess the severity of someone’s mental condition, recommend treatment, or refer them to a specialist. 

Still, we’ve only been able to do this in a few provinces. My vision is to scale this training across all 25 provinces in Cambodia. And right now, our medical schools only offer general psychiatry. I believe if we could make the curriculum more comprehensive – including specializations in child and adolescent mental health – it would make a real difference.” 

“Unlike adults, children fall asleep easily. So when they start having nightmares or night terrors – waking up in the middle of the night crying, screaming, terrified – oftentimes it means something is not right. 

I’ve been working as a psychiatrist in the child and adolescent unit in this hospital for the past two years. I’ve seen how much a child’s mental health can affect every part of their life, especially their education. And if we don’t intervene and just let a 12- or 13-year-old give up on their dreams, that would be just cruel. 

There’s one girl I remember clearly. She was diagnosed with trichotillomania, a hair pulling disorder. She pulled out her hair, body hair, and even her eyebrows when she was anxious or stressed.  

When I first met her, she didn’t utter a single word. She wouldn’t even look up at anyone. The second time I saw her, she said one word: ‘Yes.’ Just that one word made me so happy.  

In the sessions that followed, she slowly began to open up to me and the psychologist. We started working with her and provided counseling to better understand her situation. 

The last time I saw her, I noticed her little eyebrows were starting to grow back – very short. But it filled my heart. She’s also gone back to school. That’s what matters to me. Whether she becomes an outstanding student or not is beyond our control. As long as she gets to go back to school, that’s enough for me. That’s what keeps me going. 

What I hope to see more of in Cambodia is an increase in mental health professionals, especially psychiatric nurses and social workers. I want for us to be able to work in a full multidisciplinary team, like they do abroad. So when patients start to feel better, they don’t just get discharged; they’re supported in rejoining society. They can go back to school or work to support themselves as well as their families.” 

“The generations of our grandparents and parents went through long-term suffering during the civil war, which shaped their perspectives and the way they communicate. It affects parenting and family dynamics in many ways. One common example is when adolescents say they’re struggling, adults may unintentionally downplay their problems. 

Most of my clients are adolescents, but there are parents too. They explained their difficulty in understanding their teenage children. They were trying to view life from their children’s perspectives and came for professional help. 

Mental health professionals are crucial, but I believe the support needs to go beyond the counselling room. Everyone can learn basic skills to care for oneself from a young age, like regulating emotions and practicing mindfulness exercises. We may want to start from places like schools, which is exactly what we are doing.  

The Ministry of Education, Youth and Sport and the Ministry of Health have developed a Psychological First Aid Curriculum, which can help teachers support students who are in distress.   

Another thing I’m excited about regarding the Special Initiative for Mental Health is the development of the country’s first mental health counselling hotline. CTRO is proud to be part of these developments. We hope to continue contributing to mental health through our expertise and expand our impact by building the capacity of service providers like me.” 

“My dad is a psychiatrist. Growing up, I’d hear him say, ‘Most problems come from poor communication.' That always stuck with me. I used to wonder. Why is it so hard for families to talk? Why do we keep everything inside until it gets too serious? 

My passion led me to psychiatry. After medical school, I chose to specialise in this field and later received additional training in France, focusing on children and adolescents. 

I work mostly in family therapy. What I’ve learned is, when one person is struggling, the whole family often plays a part.  

I remember a case of a high school girl. A bright, hardworking and top student. But miscommunication with her mother led her to miss an important exam. 

She fell into depression. Couldn’t sleep. Constant headaches. They went from doctor to doctor until they finally came in for mental health counselling. I invited the mother to join the sessions too. Once they started opening up to each other, things began to change. What I love about family therapy is that often we don’t need to use medicine – we can do counselling through open and clear communication within the family. 

These days, I notice more parents, especially those living in the city and suburban areas, are starting to understand that any issues that a child has can be linked to mental health, not just physical ones. Yet, in rural areas, that kind of awareness is still limited. 

That’s why I’m hopeful about the Special Initiative for Mental Health. I hope to see mental health services strengthened and expanded into communities and provinces. I’d love to see more psychiatrists placed in provinces, even just one per province. This way, parents don’t have to travel all the way to the capital for help. Early support makes a big difference – it can prevent a child’s struggles from growing into something much more serious.”