カンボジア王国の精神医学・医療についての報告

Abstract

A feature of the mental health situation in Cambodia is that no health personnel with special knowledge in mental health and no Western-style mental health system survived after the Khmer Rouge reign (1975-1979), and the population had the traumatic experience of genocide during the reign. In the 1980s, no Western-style mental health services were available, but traditional healers, like Kruu Khmer, monk, village elder or medium were providing some care. In the early part of 1990s, the international community attempted to reconstruct basic structures of the health system. In 1994, the Ministry of Health of the Royal Government of Cambodia restarted the Western-style mental health system with international community aid and started an educational program to develop psychiatrists. In this article I report on the current situation and the view of mental health in Cambodia. In the first half, I sketch the general state of mental health, like human resource development, clinical services delivery, community mental health and indigenous mental illness beliefs. The latter half considers the effect of psychiatric classification on mental illness with the concept of "culture-bound syndrome" on the basis of the first half. Using a cultural anthropologic perspective, I consider whether that the Western-style mental health system can be complementary to traditional resources and the indigenous beliefs concerning mental health. It is my hope that this report might assist in the development of culturally informed mental health services in Cambodia and in the gradually growing multicultural society of Japan.