A recent study has estimated that 62 percent of Cambodian refugees living in the

United States suffer from post-traumatic stress disorder (PTSD), with more than half

of those surveyed reporting serious depression in the last 12 months.

By contrast, the rate of PTSD among the US population as a whole is just three percent.

The study was conducted by the non-profit Rand Corporation and used a sample of 490

refugees aged 35 to 70 from the area around Long Beach, California, which is home

to approximately 17,000 refugees.

Results of the study were published August 3 in the Journal of the American Medical

Association (JAMA).

Dr Sotheara Chhim, managing director of the Transcultural Pyscho-Social Organization

in Phnom Penh, said the results are consistent with the experiences of other refugee

groups.

"It doesn't surprise me that the number is so high in the United States,"

Chhim said. "Besides the trauma of the past, people may experience other traumas

settling into a foreign land and adopting to a new culture."

He said similar studies have been conducted with Vietnamese refugees and found those

living in Australia showed a higher percentage of PTSD symptoms than Vietnamese citizens

still living in their homeland.

The mental health of Cambodians still living in the kingdom has not been extensively

mapped.

The most recent study of PTSD in Cambodia found that nearly three out of ten people

suffer from PTSD, according to results published by JAMA in 2001.

However, Ka Sun Baunat, manager of the National Program for Mental Health, believes

the broad statistics may hide layers of detail.

Baunat differentiates between Cambodian citizens who lived through the Khmer Rouge

years and those who did not, estimating that up to 60 percent of the survivors of

the Pol Pot regime suffer from PTSD, anxiety, depression or psychosis, compared with

40 percent among the rest of the population.

He also warned that the children of survivors are especially at risk.

"The mental health issues of the family affect the children," Baunat said,

pointing out that domestic violence is more frequent among parents who have PTSD

and can become a traumatic catalyst for a new generation of mental health troubles.

Compounding the problem is the lack of acknowledgement of mental health disorders

and scant resources to treat patients.

There are only 26 psychiatrists, 40 psychiatric nurses and 165 doctors who have training

in basic and primary mental health care to serve the entire population of 13 million

people, Baunat said.

Cambodia's mental health services are integrated into general health care, with outpatient

services attached to local clinics or regional hospitals in 16 provinces.

But there is only one in-patient clinic in the entire country.

"It is difficult to get funding, and to find qualified staff to run the in-patient

clinic," Baunat said, adding that they are developing the live-in facility in

Phnom Penh and hope to one day expand services in the provinces.

In addition to PTSD, Sotheara thinks Cambodians struggle with other equally harmful

mental health issues.

"Anxiety and depression are also a big thing," he said. "They're mostly

related to the constant hassle of the daily struggle to survive here."