Olofsson Sofia, Sebastian Miguel San, Jegannathan Bhoomikumar
1Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Centre for Child and Adolescent Mental Health, Takhmau, Cambodia.
Int J Ment Health Syst. 2018 Jan 24;12:7. doi: 10.1186/s13033-018-0185-3. eCollection 2018.
While mental and substance use disorders are common worldwide, the treatment gap is enormous in low and middle income countries. Primary health care is considered to be the most important way for people to get mental health care. Cambodia is a country with a long history of war and has poor mental health and limited resources for care. The aim of this study was to conduct a situational analysis of the mental health services in the rural district of Lvea Em, Kandal Province, Cambodia.
A cross-sectional situational analysis was done to understand the mental health situation in Lvea Em District comparing it with the national one. The Programme for improving mental health care (PRIME) tool was used to collect systematic information about mental health care from 14 key informants in Cambodia. In addition, a separate questionnaire based on the PRIME tool was developed for the district health care centres (12 respondents). Ethical approval was obtained from the National Ethics Committee for Health Research in Cambodia.
Mental health care is limited both in Lvea Em District and the country. Though national documents containing guidelines for mental health care exist, the resources available and health care infrastructure are below what is recommended. There is no budget allocated for mental health in the district; there are no mental health specialists and the mental health training of health care workers is insufficient. Based on the limited knowledge from the respondents in the district, mental health disorders do exist but no documentation of these patients is available. Respondents discussed how community aspects such as culture, history and religion were related to mental health. Though there have been improvements in understanding mental health, discrimination and abuse against people with mental health disorders seems still to be present.
There are very limited mental health care services with hardly any budget allocated to them in Lvea Em District and Cambodia overall. There is dire need for scaling up and integrating mental health into primary health care to improve the population's access to and quality service of Cambodian mental care.
虽然精神疾病和物质使用障碍在全球范围内都很常见，但在低收入和中等收入国家，治疗缺口巨大。初级卫生保健被认为是人们获得精神卫生保健的最重要途径。柬埔寨是一个有着长期战争历史的国家，心理健康状况不佳，护理资源有限。本研究的目的是对柬埔寨干丹省勒韦埃姆农村地区的精神卫生服务进行现状分析。
进行了一项横断面现状分析，以了解勒韦埃姆区的心理健康状况，并与全国情况进行比较。使用改善精神卫生保健计划（PRIME）工具从柬埔寨的14名关键信息提供者那里收集有关精神卫生保健的系统信息。此外，还为地区卫生保健中心（12名受访者）开发了一份基于PRIME工具的单独问卷。获得了柬埔寨国家卫生研究伦理委员会的伦理批准。
勒韦埃姆区和该国的精神卫生保健都很有限。虽然存在包含精神卫生保健指南的国家文件，但可用资源和卫生保健基础设施低于建议水平。该地区没有为精神卫生分配预算；没有精神卫生专家，卫生保健工作者的精神卫生培训不足。根据该地区受访者有限的知识，精神疾病确实存在，但没有这些患者的记录。受访者讨论了文化、历史和宗教等社区因素与心理健康的关系。虽然在理解心理健康方面有了进步，但对精神疾病患者的歧视和虐待似乎仍然存在。
勒韦埃姆区和柬埔寨整体的精神卫生保健服务非常有限，几乎没有为其分配任何预算。迫切需要扩大精神卫生服务并将其纳入初级卫生保健，以改善柬埔寨民众获得精神卫生保健的机会和服务质量。
