Thursday, May 26, 2011

Mental Health in Cambodia

So, there's this man in my Wat. (A Wat is a large complex that holds the local buddhist temple, monks' housing, maybe a small school, some places to put cremated people, and such stuff). This man has been there for months. He is tethered to a post. Yepp, tied by rope like a dog. He has maybe a 2 meter radius to walk around. Sometimes I see the monks take him out for a walk. I asked my khmer tutor why the man was tied to a post everyday and he replied that the man had a nervous issue. In other words, someone decided he was mentally ill. Apparently, he's tied to the post so he doesn't wander off and get lost somewhere. He's at the Wat because the monks to pray over him and bless him to treat his mental illness.

In Cambodia, mental health issues are everywhere. How can they not be with Cambodia's long history of genocide and oppression. Plus, its not like everything is all hunky dory now either. The problem is that no one really understands mental illness and there's really no one around to deal with it. The majority of medical professionals are midwives or nurses. There are very few doctors and most doctors work in expensive clinics or for NGOs.

I think this illustrates a fundamental issue in how the public views mental health in general. Clearly, if you have a physical ailment and die it doesn't matter what state your mind is in cause it no longer exists. There's enough need for professionals to treat physical illness in Cambodia to justify many more years of neglect in training mental health professionals. But that's precisely why it's so difficult to find treatment for mental health not only in Cambodia but around the world. People never think it's all that important. First, it's difficult to pin down, difficult to diagnose. Whereas a broken bone or a cold are fairly easy to diagnose. Second, it's difficult to treat properly.

But people forget that mental illness is illness of the brain. It is based on a physical organ. When people say "it's all in your head" that is, very literally, true! The chemicals and electrical impulses in your brain interact in an almost unfathomable way every millisecond of your life to create who you are. When shit goes wrong, its a physical ailment. The unique issue of mental health is that if chemicals make your thoughts then your thoughts also make chemicals. That's why going to a shrink works. When you talk things out, work out issues in a totally unphysical way all that talking results in a physical change in your brain (in my opinion your most important organ). That's why drugs work and talking works too. The physical is the mental and mental is the physical. Most people never grasp this relationship and dismiss psychiatry as a bunch of mumbo jumbo. However, neglecting mental health is neglecting your brain and without a brain you (at least how you currently view yourself) doesn't exist.

It's sort of insulting to your own brain to say that mental health isn't important enough to address.


  1. You should check out Ethan Watters' "Crazy Like Us".

  2. Also Foucault's "History of Madness"