Skip to main content

Voices from the Field: A Cambodian-led Approach to Mental Health

  • Chapter
  • First Online:
The Palgrave Handbook of Sociocultural Perspectives on Global Mental Health

Abstract

Drawing on the work of the Transcultural Psychosocial Organization Cambodia, this chapter explores the extent to which models of mental health care can be ‘adapted’ for use in different countries. The chapter problematizes assumptions that systems of understanding about emotional wellbeing, and associated interventions intended to support emotional wellbeing, have failed to develop in low-income countries. The chapter reflects on both the challenges and opportunities that arise when knowledge and practice from the East and West dynamically interact. The case is made that an absence of awareness of the interplay between culture and mental health can serve to reduce the success and appropriate implementation of interventions, and may devalue and undermine resources and systems of support that are already present. The chapter highlights how this is relevant not only for the Global Mental Health community seeking to work across continents and countries but also for services within high-income countries that seek to develop and deliver interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 299.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    TPO will be used throughout this chapter to refer to TPO Cambodia.

  2. 2.

    In the time of the Khmer Rouge information, such as that an individual was educated or spoke a foreign language could lead to their death. This led to a culture in which people ‘dumbed down’ their background and disowned knowledge and skills.

  3. 3.

    Up-to-date information on the range of mental health work TPO is currently involved in is available on their website, http://www.tpocambodia.org.

References

  • Agger, I. (2015). Calming the mind: Healing after mass atrocity in Cambodia. Transcultural Psychiatry, 52(4), 543–560.

    Article  PubMed  PubMed Central  Google Scholar 

  • Adichie, C. (2009). Recorded at TED Global, July 2009, Oxford, UK. Duration: 18:49. Retrieved March 2, 2015, from http://www.ted.com/talks/chimamanda_adichie_the_danger_of_a_single_story?language=en

  • BBC News. (2005). Trauma risk for tsunami survivors. Retrieved May 30, 2015, from http://news.bbc.co.uk/1/hi/world/asia-pacific/4229233.stm

  • Beck, A., Rush, J., Shaw, B., & Emery, G. (1987). Cognitive therapy of depression. New York: Guildford Press.

    Google Scholar 

  • Brickell, K., Prak, B., & Poch, B. (2014). Domestic violence law: The gap between legislation and practice in Cambodia and what can be done about it. London: Royal Holloway, University of London.

    Google Scholar 

  • Chheng, K., Leang, S., Thomson, N., Moore, T., & Crofts, N. (2012). Harm reduction in Cambodia: A disconnect between policy and practice. Harm Reduction Journal, 9, 30.

    Article  PubMed  PubMed Central  Google Scholar 

  • CIA World Factbook. (2014, June). Retrieved May 3, 2015, from https://www.cia.gov/library/publications/the-world-factbook/geos/cb.html

  • Chhim, S. (2012a). Baksbat (broken courage): The development and validation of the inventory to measure baksbat, a Cambodian trauma- based cultral syndrome of distress. Culture, Medicine and Psychiatry, 36, 640–659.

    Article  PubMed  Google Scholar 

  • Chhim, S. (2012b). Baksbat (broken courage): A trauma-based cultural syndrome in Cambodia. Medical Anthropology, 32(2), 160–175.

    Article  Google Scholar 

  • Chhim, S. (2013). Psychiatry, psychology and law: A place for baksbat (broken courage) in forensic psychiatry at the Extraordinary Chambers in the Courts of Cambodia (ECCC). Psychiatry, Psychology and Law, 21(2), 1–11.

    Google Scholar 

  • Chhim, S. (2014). A qualitative and quantitative investigation into ethno- cultural framing of trauma in Cambodia: Baksbat (broken courage), a Cambodian trauma syndrome akin to PTSD. Submitted for the degree of Doctor of Philosophy, School of Social Sciences Faculty of Arts, Monash University, Melbourne, Australia.

    Google Scholar 

  • Dallos, R., & Draper, R. (2005). An introduction to family therapy systemic theory and practice (2nd ed.). Open University Press: Berkshire.

    Google Scholar 

  • Errebo, N., Knipe, J., Forte, K., Karlin, V., & Benek, A. (2008). EMDR-HAP training in Sri Lanka following the 2004 tsunami. Journal of EMDR Practice and Research, 2(2), 124–139.

    Article  Google Scholar 

  • Gilbert, P. (2010). The compassionate mind (compassion focused therapy). London: Constable & Robinson Ltd.

    Google Scholar 

  • Glover, J. (2001). Humanity: A moral history of the twentieth century. New Haven, CT: Yale University Press.

    Google Scholar 

  • Herman, J. (2001). Trauma and recovery: The aftermath of violence—From domestic abuse to political terror. London: Pandora.

    Google Scholar 

  • Higginbotham, N., & Marsella, A. (1988). International consultation and the homogenisation of psychiatry in Southeast Asia. Social Science and Medicine, 27, 553–561.

    Article  PubMed  Google Scholar 

  • Hinton, D. E., Peou, S., Joshi, S., Nickerson, A., & Simon, N. (2013). Normal grief and complicated bereavement among traumatised Cambodian refugees: Cultural context and the central role of dreams of the deceased. Culture, Medicine and Psychiatry, 37, 427–464.

    Article  PubMed  PubMed Central  Google Scholar 

  • International Food Policy Research Institute. (2015). Sustainable solutions for ending hunger and poverty. Cambodia. Retrieved May 3, 2015, from http://www.ifpri.org

  • IRIN. (2012). Humanitarian news and analysis. What ails Cambodia’s mental health system? Retrieved May 11, 2015, from http://www.irinnews.org/report/95054/

  • Kabat-Zinn, J. (1990). Full catastrophe living: Using wisdom of your body and mind to face stress pain, and illness. New York: Bantam Dell.

    Google Scholar 

  • Kiernan, B. (1996). The Pol Pot regime: Race, power, and genocide in Cambodia under the Khmer Rouge, 1975-79. New Haven: Yale University Press.

    Google Scholar 

  • Kirmayer, L. J., & Pedersen, D. (2014). Toward a new architecture for Global Mental Health. Transcultural Psychiatry, 51(6), 759–776.

    Article  PubMed  Google Scholar 

  • Kleinman, A. (1995). Writing at the margin: Discourse between anthropology and medicine. Berkeley: University of California Press.

    Google Scholar 

  • Marcucci, J. (1994). Sharing the pain: Critical values and behaviors in Khmer culture. In M. Ebihara, C. Mortland, & J. Legerwood (Eds.), Cambodian culture since 1975 (pp. 129–140). New York: Cornell University Press.

    Google Scholar 

  • Nee, M., & McCallum, W. (2009). Roads to development: Insights from Sre Ambel district, Southwest Cambodia. Published by American Friends Service Committee—Cambodia Program as an online resource.

    Google Scholar 

  • Ovesen, J., & Trankell, I.-B. (2010). Cambodians and their doctors. A medical anthropology of colonial and post-colonial Cambodia. Copenhagen: Nias Press.

    Google Scholar 

  • Read, J., Bentall, R. P., & Fosse, R. (2009). Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms. Epidemiologia e Psichiatria Sociale, 18, 299–310.

    PubMed  Google Scholar 

  • Roberts, D. (2001). Political transition in Cambodia 1991–1999. Surrey: Curzon Press (now Routledge).

    Google Scholar 

  • Segal, Z. V., Williams, M., & Teasdale, J. (2012). Mindfulness-based cognitive therapy for depression. New york: Guildford Press.

    Google Scholar 

  • Summerfield, D. (2008). How scientifically valid is the knowledge base of global mental health? BMJ, 336, 992–994.

    Article  PubMed  PubMed Central  Google Scholar 

  • Transparency International The Global Coalition against Corruption. (2015). Retrieved May 3, 2015, from https://www.transparency.org/country/#KHM_DataResearch

  • United States Department of State (2013). Bureau of Democracy, Human Rights and Labor, Cambodia 2013. Human Rights Report, Country Reports on Human Rights Practices for 2013. Retrieved May 2, 2015, from http://www.state.gov/documents/organization/220395.pdf

  • Van de Put, W. A. C. M., & Eisenbruch, I. M. (2002). The Cambodian experience. In J. T. V. M. de Jong (Ed.), Trauma, war and violence: Public mental health in sociocultural context (pp. 93–155). New York: Plenum-Kluwer.

    Google Scholar 

  • WHO (2008). Mental health Gap Action Programme (mhGAP): Scaling up care for mental, neurological and substance abuse disorders. Geneva: World Health Organization.

    Google Scholar 

  • WHO (2010). mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: Mental health Gap Action Programme (mhGAP). Geneva: World Health Organization.

    Google Scholar 

  • WHO (2011). Mental health Atlas. Geneva: World Health Organization.

    Google Scholar 

  • Watters, E. (2011). Crazy like us: The globalization of the Western mind. London: Constable & Robinson Ltd.

    Google Scholar 

  • White, R., Suneet, J., & Giurgi-Oncu, C. (2014). Counterflows for mental wellbeing: What high-income countries can learn from Low and middle-income countries. International Review of Psychiatry, 26(5), 602–606.

    Article  PubMed  Google Scholar 

  • WFP. (2015). World food programme fighting hunger worldwide. Cambodia. Retrieved May 3, 2015, from https://www.wfp.org/countries/cambodia/overview

  • Young, A. (1997). The harmony of illusions: Inventing post-traumatic stress disorder. Princeton: Princeton University Press.

    Book  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Copyright information

© 2017 The Author(s)

About this chapter

Cite this chapter

Gamble, L. (2017). Voices from the Field: A Cambodian-led Approach to Mental Health. In: White, R., Jain, S., Orr, D., Read, U. (eds) The Palgrave Handbook of Sociocultural Perspectives on Global Mental Health. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-39510-8_22

Download citation

Publish with us

Policies and ethics