Cambodia's largest mental health non-profit will suspend the bulk of its community mental health operations for more than a year as it awaits a new round of funding from the Australian government, according to its executive director.
In a country with high rates of depression and post-traumatic stress disorder, and where access to care is almost nonexistent in many provinces, the Transcultural Psychosocial Organization (TPO) helped to fill a major gap in services. However, with its next phase of funding not due to begin until late 2018 – if it’s approved at all – there are concerns the yearlong pause in services could negatively affect Cambodians who rely on TPO for frontline mental health care, particularly in rural areas.
Sotheara Chhim, executive director of TPO, called the hiatus concerning and “very sad”. “Our work is not only in mental health,” Chhim said. “It’s conflict resolution, human rights, gender, poverty alleviation. So many of these people are trapped in a vicious cycle of poverty, mental illness and violence.”
With the end of a four-year, $226,000 grant from Australia’s Department of Foreign Affairs and Trade in June, TPO is cutting staff and freezing its gender-based violence community mental health programme, according to Sotheara. The majority of TPO’s work will now focus on the Khmer Rouge tribunal.
The Ministry of Health’s Mental Health Department performs only limited community outreach. As of last year, only about 50 psychiatrists were working in the country – or roughly one for every 300,000 people – and just six of Cambodia’s 25 provinces had at least one psychiatrist working in their referral hospitals.
Under its gender-based violence programme, TPO deployed workers to some of Cambodia’s most underserved provinces to educate local leaders about mental illness, teach residents new financial skills and provide counselling to victims of domestic abuse, sexual assault or other traumatic events.
Researcher Theresa de Langis called TPO’s services “extraordinarily important”, particularly in rural areas.
“So many of the survivors there are still suffering from trauma and psychological injuries related to the conflict,” de Langis said. “Even a few months of interruption could really make a difference in a patient’s life. You hate to see these things get cut. They should really be prioritised.”
Hath Hang, 37, a mother of three from Battambang province, has been receiving services from TPO since 2013. As a survivor of domestic violence, Hang said she was concerned about the programme’s yearlong hiatus.
“If it closes, it will make people who have mental health problems face difficulties, because we do not know where to get [help],” Hang said. “They listen to our problems and teach us how control our anger when we attempt to commit violence.”
In a statement yesterday, the Australian Embassy said two Australian grants to TPO had ended as scheduled and that the Australian government is currently designing a new programme to combat violence against women in Cambodia that, if approved, would start next year.
The Australian Embassy and Australia’s Department of Foreign Affairs and Trade are marking the end of the programme with an event today.
Additional reporting by Mech Dara