Mental Health & EMDR Therapy in Cambodia; Those Fighting Against the Odds

Mekong Project Nil Ean Personal Online Therapy

Life has a funny way of leading you to where you need to be. This is no different for Nil Ean. He has always had a passion for people and an intense curiosity when it comes to the human psyche. Whilst he was still busy with his Bachelor’s degree he was already volunteering with a variety of NGO’s in the field of mental health. He then decided to do his Master’s degree in clinical psychology.

Where he was once focused on a future as psychotherapist or counsellor (services not readily available in Cambodia), other doors opened up. He and a few other students were chosen to specialise in trauma treatment (EMDR) via the German-funded project called ‘Mekong Project’. Through this program their specialised training and journey into EMDR started. So whilst they were busy finishing up their Master’s degree, their focus already started to shift. They started to work more and more with traumatized clients. They also noticed and observed how many of their other clients have various forms of traumatic experiences impacting their mental health.

Suddenly, their EMDR training gave them an entirely new way of looking at their clients.

After seeing the benefits of EMDR therapy, Nil eagerly grabbed the opportunity for European accreditation within the field from the UK. All this whilst tackling his PhD in clinical psychology (which will be completed as soon as international travel and presentations are allowed again under Covid regulations). And whilst this would be enough to make even the biggest academics shake in their boots, Nil is already keeping an eye out for the next opportunity to upskill himself even further in order to serve his community better.  

Mental Awareness in Cambodia

As a psychologist and EMDR therapist, Nil and his team have their work cut out for them. Mental health and well-being have not been a priority in Cambodia ‘till recently. Cambodians culturally have a very different way that they view disease or illness – physically or mentally. When Cambodians’ mental well-being is impacted, it is often displayed via somatic symptoms. In other words, psychological distress is displayed as physical ailments for which they then seek medical treatment. Extreme mental illnesses are often viewed in a religious fashion where strange behaviour is immediately linked with things such as possession. This is especially true for those living in rural areas.

The media and social media has actually played a big part in mental health awareness in Cambodia.

Not only did it educate Cambodians regarding what mental health is, but also gave them the right and the courage to speak out regarding their own mental well-being. This awareness also led to much more governmental support in the area. The government even started making provision for their staff when it comes to mental health resources. Nil and his team have also been tasked with providing mental health training to health care workers all across the country. So slowly but surely everything and everyone is starting to integrate in order to improve the overall mental health of those in Cambodia – from the government to local NGO’s and the community.  But it is very much still early days when it comes to mental well-being awareness and mental health services within Cambodia.

The mental health issues in Cambodia

Although the concept of mental health is quite new to the Cambodian people, that sadly doesn’t take away from the fact that they need mental health services just like any other community in the world. And Cambodians have very specific struggles that only qualified local professionals such as Nil and his team can diagnose and treat. Mental health issues in Cambodia can be very generational/age-related. The older generation struggles more with their civil war past. The younger generation struggles with issues such as domestic violence the most. This usually stems from their childhood. Recent studies have shown that 1 out of 3 Cambodians suffered abuse at the hands of a parent. Another source for these traumatic events are motor vehicle accidents. Cambodia has an extremely high accident rate.

Covid has added another layer of complexity to the mental wellness and treatment of mental illnesses in Cambodia.

Where many in the rest of the world who were struggling with depression due to lockdown or sudden unemployment could simply book an online therapy session and jump on a Zoom call, Cambodia simply does not have the infrastructure for this – especially in the rural areas. So therapists at the centre is forced to reach out via conventional telephone call to follow-up and ensure that they know that support is available to them during this difficult time. The heart-felt passion and effort Nil and his team have towards their clients are inspiring.

Another challenge during the global pandemic is getting medication to clients, since most of these medications need to be collected from public hospitals. So lockdown and travel restrictions pose many further challenges to an already very challenging situation.

Funding

Unfortunately, most mental health NGO’s such as Nil’s is funded from outside of the country and they are mostly reliant on private investors.

In fact, 90-95% of their funding for their entire operation is reliant on the private sector and donors. The Cambodian Department of Mental Health and the Ministry of Health has come a long way since realising how important mental wellness is and what an immense socio-economic impact it can have on a country. They have strategy plans and are actively involved in certain activities and events. But the focus is still mostly on the public health infrastructure such as health centres and referral hospitals. Whilst the opportunity is there for NGO’s to hand in their proposals in the hope of securing some budget, the funds are simply not available in order to achieve all that needs to be achieved within the mental health sector.

Despite this huge challenge, they are constantly busy with sustainable strategies in an effort to be more self-reliant.

What is truly wonderful is the supportive network that’s available in the form of other NGO’s. These various NGO partners (who generally have different target groups) often come together to discuss the problems and challenges they face and try to come up with solutions to counter them. Although they cannot help fund each other’s programs, they are acutely aware that they can achieve more when they work together. A truly admiral attitude.

Many of these mental health NGO’s have also realised what a big role trauma plays in their own client’s lives, and because the resources and skilled professionals within the EMDR field in Cambodia is so rare, they end up knocking on Nil and the teams door.

The hope for the future

Nil has been working in the area of mental health for more than 20 years and he is constantly aware of all that still needs to be done and how critical it is for people to work together in order to truly bring about positive change. Cambodia is still in dire need of more mental health professionals and resources in order to tap into the high-quality mental health services they so desperately need. His hope for the future is also that NGO’s and mental health professionals from all around the world can once again start coming together in a post-Covid world where they can network, learn from one another and contribute to each other to make the world a better place when it comes to individual’s mental health.

If you would like to find out more about the work Nil and his team is doing in Cambodia or would like to get involve or make a donation towards their efforts, please visit their official website here: https://emdrcambodia.org/