Determined, aspiring, and tenaciously creative: working in new ways.
May 22, 2017
Developing Child and Adolescent Mental Health Services in Cambodia
As a long standing WHO priority area, it has been noted that countries with the largest proportion of children and adolescents often lack specific Child and Adolescent Mental Health (CAMH) policies. Additionally lower-income countries, often with less developed health systems, have the fewest child and adolescent psychiatrists and other mental health professionals and the lowest availability of community mental health care.
Cambodia’s Department of Mental Health and Substance Abuse have been gathering resources to set up the first Child and Adolescent Mental Health Service in government health sector. This is a strong leadership role to take, with only one NGO working in Kandal Province as a country specific model of applying global mental health intervention models to children and adolescents , the challenge is to find a way to use existing resources to achieve the greatest possible benefits.
The team visited Melbourne in March 2017, with many components for their program. Individual roles for this pioneering work were identified. From Battambang Province, where the program will be piloted with low threshold interventions, Dr. Seila and Dr. Sivleap talked with clinical leaders and researchers about age and developmentally appropriate approaches, and specificity of different treatment techniques and liaison services, as well as building integrated systems to support health workers selecting the appropriate components and to integrate them into coherent treatment plans especially in paediatric care service. From the department of mental health and substance abuse of the ministry of health, Ms. Phallyka focused on the importance of selecting the key methods and tools for gathering Cambodia specific information and data crucial for effective national policy development, as well as developing the vision, values, principles and objectives of the overarching national strategy and policy.
Visits and meetings with key leaders in this area included time with Mindful, GV Health, Royal Children’s Hospital, headspace, Orygen Youth Health, NorthWestern Health, and University of Melbourne. Here in our international program based in Melbourne, we are often struck by the potential of our visitors- the drive, creativity and ability to seize the opportunities that exist among the many obstacles. This group were remarkable for their commitment to the opportunity to develop and implement evidence-based interventions, modern training programs and effective policies.
The burden associated with mental disorders in children and adolescents is considerable, and it is made worse by stigma and discrimination. This pioneering work will not only provide a better understanding of cultural and society changes and impact on mental health, but is an inspiration for governments and the broader community to prioritise and develop systems to both prevent mental health problems and to respond early to problems when they emerge.
*Thomas Trauer was a leading researcher in mental health outcome measurement and advocate for mental health service development. As a Professorial Fellow at St Vincent’s Hospital (The University of Melbourne), he was involved in research, training and service development in Asia Pacific.
The Thomas Trauer Fund has been established through St Vincent’s Foundation to support the development of mental health services in the Asia Pacific. Donations can be made at stvfoundation.org.au, specifying that the donation is for the Thomas Trauer Fund.