Num Samkhan and Nat Poung are two of the thousands of migrant workers who returned to Cambodia from Thailand because of COVID-19. Even though they are healthy and safely living with family, the months since their return have been stressful.
“I worry about not earning money to support my family,” Samkhan told Dr Yel Daravuth, Technical Officer at the World Health Organization (WHO), when asked about how COVID-19 has impacted his mental health. “I haven’t worked yet
since coming back from Thailand.”
Similarly, Poung has not been able to make a living since returning to Cambodia in May. Without a source of income, she has felt depressed and even thought about suicide. Receiving mental health support has been a crucial lifeline for her.
“When village health support groups visited to ask and talk about my mental problems and provided some solutions to make me feel better, I could smile,” said Poung.
Dr Yel Daravuth, Technical Officer at WHO, left, and Professor Kao Sovandara, psychology professor at RUPP, right, speak to Mr Num Samkhan at his family home in Banteay Meanchey.
© MoEYS/Hang Bou
Joint UN programme supports the mental health of vulnerable people
“There is no health without mental health,” said Dr Li Ailan, WHO Representative to Cambodia. “COVID-19 has threatened mental health in Cambodia, particularly for vulnerable Cambodians, such as migrant workers. WHO and the UN are working
to ensure that these vulnerable groups have access to mental health and psychosocial supports.”
In May, the World Bank estimated that the pandemic has endangered at least 1.7 million jobs in Cambodia,
putting immense socio-economic—and emotional—stress on Cambodians. Workers in many industries have had their salaries cut or their livelihoods threatened; students and families have had to adapt to schools being physically closed; and
everyone has coped with greater social isolation and uncertainty. These challenges have made many people feel anxious and distressed.
As a result, demand for mental health services has increased. WHO and the UN System have worked closely with the Royal Government of Cambodia (RGC) to strengthen the mental health services offered at health facilities and in communities.
“Mental health and psychosocial support is a core component of any public health response, and it takes a whole-system approach,” said Dr Nargiza Khodjaeva, Technical Lead, NCD and Health through the Life-Course, WHO. “We must address
mental to stop COVID-19 and prevent long-term impacts on Cambodians’ wellbeing.”
Within the UN COVID-19 Response and Recovery Multi-Partner Trust Fund, the project Strengthened National Preparedness, Response and Resilience to COVID-19 in Cambodia supports the RGC in protecting returning migrants and their communities from COVID-19
and providing them with essential socio-economic services. WHO, the International Organization for Migration, UNFPA and UNICEF are delivering this joint programme together, to provide a holistic approach as one UN.
WHO has provided technical and budgetary support to the Department of Mental Health and Substance Abuse (DMHSA) of the Ministry of Health (MOH) and the Royal University of Phnom Penh (RUPP) to improve the ability of health staff and Village Health Support
Groups (VHSGs) to provide mental health and psychosocial support to vulnerable populations, including migrant workers, and to raise awareness among community leaders of the importance of mental health.
Professor Kao Savandara, psychology professor at RUPP, facilitates a MOH-RUPP capacity building training for VHSGs on suicide prevention and anxiety management.
© MoEYS/Hang Bou
Strengthening mental health services in communities
From July to September 2020, more than 240 health staff, including 98 women, attended capacity building trainings on mental health and psychosocial support held by the DMSA. Doctors, nurses and midwives were among the health staff that improved their
skills in addressing mental health issues such as stress, anxiety disorders and depression. They also learned about suicide prevention, basic counselling skills, and how to mitigate the risks of gender-based violence.
“Having participated in a two-day capacity building on mental health and psychosocial support during the COVID-19 outbreak, I have well understood stress, anxiety disorder and depression management,” said Ms Pen Sophy, a nurse at Puok District
Referral Hospital, Siem Reap. “I’m going to share this knowledge with people in hospitals and the community.”
Participants from the community, rehabilitation facilities and prisons also attended these trainings, to improve mental health services offered outside of health facilities.
A health professional shares her thoughts on mental health and psychosocial support service delivery at health facilities at a training led by Ms. Chou Phallyka, Deputy Director of DMHSA.
Additionally, RUPP, in collaboration with WHO, conducted awareness-raising activities and trained village chiefs and VHSGs on providing mental health and psychosocial support to vulnerable people, including returning migrants, in their communities. To
date, more than 140 village chiefs and people from VHSGs, including 53 women, have attended these trainings, which have improved their understanding of mental health issues, counselling and when to refer community members to health centres.
VHSG members have already used this training to provide critical mental health support.
“After leaving the capacity building training on mental health and psychosocial support… [I was able to] encourage a woman who was upset and wanted to kill herself,” said Mrs Chen Mom, a member of a VHSG in Kamriang District, Battambang.
“After listening to her, I encouraged her to think in a positive way.”
Mental health support for all
These initial capacity building and awareness-raising activities were conducted in Banteay Meanchey, Battambang and Siem Reap, provinces that had particularly high numbers of migrant workers return from Thailand. Because of the programme’s success
in these three provinces, WHO has begun to expand the programme to eight additional provinces in close collaboration with the MOH and the Ministry of Education, Youth and Sport.
“Our goal is to expand the programme nationwide and strengthen service delivery at all levels, starting from the community level at primary health care centres,” said Dr Khodjaeva. “Everyone should have access to the mental health and
psychosocial support that they need without stigmatization.”
Further investment in this support will contribute to a safer and healthier future, where many more people like Samkhan and Poung can better cope with adversity.
“It is good to know that there are village health support groups in my community who have gained knowledge and skills on mental health and psychosocial support that I can ask for help,” said Poung. “Mental health awareness is important
in the community.”