violet wrote: ↑Sun Nov 24, 2019 2:10 pm
any stats/inside info on the number of students entering into mental health related studies?
Mental health in primary health care in a rural district of Cambodia: a situational analysis
Published: 24 January 2018
Specialist mental health services
There are no mental health specialists in Lvea Em District. The closest in-patient facility for mental health care is KSFH, 40 km from the referral hospital in Lvea Em District; only 2 of 11 participants in the districts were aware of this. One psychiatrist in Phnom Penh said that 10 psychiatrists worked in KSFH, 10 in-patient beds were available and the hospital was open 24 h a day all week. Only one of 10 respondents from the health care centres reported KSFH as the closest in-patient facility.
Education, knowledge and service training
The heads of the health care centres stressed that no pre-service training had been provided in mental health for PHC workers. Around one-third of the nurses have had training in mental health care at least 2 days in the last year, provided by CCAMH. The nurses had been trained in child mental health and development but also in aspects related to maternal care. One respondent also commented that the medical doctors had very limited training in mental health during their education
Psychiatry has recently been included in the medical programme for undergraduate students, and 30 theoretical hours per year was allocated for mental health during year 4–6. One psychiatrist (former medical and psychiatrist student in Phnom Penh) explained that medical students now might have an internship in psychiatry during their education but not necessarily everyone has that possibility. To become a specialist in psychiatry in Cambodia, 3 years of education are necessary and in 2015, only four psychiatrist residents graduated.
There is no existing education for psychiatry nurses in Cambodia; the only psychiatry nurses in the country were educated during a training programme by a Norwegian university in the late 1990s to the beginning 2000s. No education for psychiatry nurses has been maintained in the country after the support from abroad ended.
Mental health care in primary health care
From the questionnaires and interviews the very limited access to mental health services at the district level is evident (see Tables 5, 6). Health care staff reported that no mental health services were provided in the district but if a patient with mental health came to the health service, health workers tried to take care of the patient. Minor mental health problems such as anxiety and sleep problems might be treated since drugs should be present (see Table 5).
Section VΙ: Monitoring and evaluation
Respondents from both the national and provincial levels said that there was an existing general health information system in Cambodia but not a separate one for mental health care, though HIV and TB had their own reporting systems. Furthermore, there is no monitoring evaluation system for quality of mental health care in PHC in Cambodia. One of the psychiatrists in Phnom Penh expressed that mental health care was included in the information system but it was not comprehensive yet. According to respondents at the national level, there is a need for a system to identify patients since today there is no unified code for the patients in Cambodia.
Mental health policies and plans
There are both similarities and differences between Lvea Em District and Cambodia as a whole according to politics, policies and plans for mental health. The limited implementation of mental health care into PHC has resulted in a minor focus on mental health reflected in the low resources and knowledge in the district. Reports from WHO have also indicated that the mental health plan was only partly implemented in the country [28]. Although Cambodia has a budget for mental health, it is far below sufficient (0.01%) when compared to high-income countries where it is usually around 5.1% of the total health care budget or even in other low-income countries where it can be around 0.5% [3]. No legislation for mental health has been created even though it had been described as a development objective in the mental health plan. By comparing the background information with data and quotes from the respondents, it seems like the plans, guidelines and goals were far from being fulfilled.
Availability of mental health services
The limited resources of mental health specialists and mental health care both in the district and in the country, along with the lack of knowledge about its availability, are huge challenges for the improvement of the mental health care system. The 60 psychiatrists in Cambodia corresponds to one psychiatrist per nearly 260,000 inhabitants, while in Sweden the corresponding number is one psychiatrist per nearly 4400 inhabitants [29, 30].
full study
https://ijmhs.biomedcentral.com/article ... 018-0185-3
