Cambodia is a low-income country in south-east Asia. It covers an area of 181 035 km2 and has a population of 14.5 million, of whom 42% are less than 15 years old. Life expectancy is 56.8 years and 36% of the population live on less than US$0.50 per day. Cambodia experienced a brutal civil war and genocide in the 1970s under the Khmer Rouge regime, during which approximately 1.7 million Cambodians were killed (Chandler, 1999) and the social and medical infrastructure was almost completely destroyed. No mental health services existed throughout the conflict and subsequent Vietnamese occupation, despite the incalculable impact of the Khmer Rouge regime on Cambodians’ mental health. The current political situation is more stable, although there remain concerns about human rights abuses (Khan, 2005).

Historical perspective

From 1935 to 1975, all psychiatric care was provided by a single psychiatric hospital located about 9 km to the south of Phnom Penh. By 1975, the patient population of the 800-bed hospital had grown to around 2000. Under the Khmer Rouge, the psychiatric hospital was destroyed and it is likely that all the patients were murdered. Across the country most professionals of all types were also killed – only 43 doctors survived, none of whom were psychiatrists (Savin, 2000). Between 1975 and 1994, there were no statutory psychiatric services and no mental health training in Cambodia.

Revitalisation of psychiatry in Cambodia

In 1994, a cohort of 10 junior doctors joined the Norwegian-funded Cambodian Mental Health Training Programme; they graduated in 1998. A second cohort of 10 completed training in 2001 and, in addition, 40 psychiatric nurses have now been trained in Cambodia. The first out-patient department was opened in Phnom Penh in May 1994. The present mental health service situation in Cambodia is summarised in Box 1.