Expat life brings a whole new set of challenges, now during the Covid-19 pandemic more than ever. No matter how much we love living in Cambodia, the physical distance from loved ones and cultural differences can at times lead to feelings of isolation, frustration, or uncertainty. The pandemic, school closures, and lockdowns, only serve to exacerbate those feelings. I talked to local clinics Living Well and Reach Counseling about how expats in Cambodia may be affected. In addition to general advice, at the end of this post there’s a list of mental health resources in Cambodia.

Tips for looking after your mental health in Cambodia.

The extended isolation that many of us have experienced during the pandemic, combined with uncertainty of the situation, has made many of us more aware of our existing mental health problems. Others have developed new mental health issues such as anxiety and depression. As most of us are generally creatures of habit and appreciate routine and stability, it’s no wonder that a complete disruption of routine, often at short notice, can lead to stress.

Complicating things further are school closures and for many, job insecurity. While many expats have tried to make the best of a difficult situation by spending more time at home with family, for others the struggling economy and tourism restrictions have meant lost income, lost jobs, or income insecurity. With limited options to return to our home countries, it’s important to address our mental health issues here in Cambodia.

So how do we know if our mental health is deteriorating and what can we look out for in ourselves or others? Here are some signs for us to watch for:

• Losing interest in things that used to be enjoyable
• Deteriorating personal hygiene
• Withdrawing from family and friends
• Changes in sleeping, eating, and exercise habits
• Reduced ability to concentrate
• Reduced libido
• Feeling anxious or fearful
• Risk-taking behaviors (for example, increased alcohol consumption)

Once we’ve established that we may not be coping as well as we would like to, it’s very important to take steps towards improving our mental health. For some it may be as simple as making self-care more of a priority, increasing our physical activity (releasing those magic endorphins), eating a more balanced diet or confiding in a close friend, but others may prefer to speak to a professional counselor or medical professional specializing in psychology.

How can you help someone who is struggling?

• Frequent open dialogue about mental health fosters a culture where people feel safe enough to speak about how they are feeling
• Check in with family/friends/colleagues; be an open ear and encourage self-care
• Add reassurance that it’s okay to feel affected/low/depressed/anxious, etc.
• Suggest they speak to someone outside of their normal circle if they feel uncomfortable to open up
• Encourage healthy eating and regular exercise
• Don’t be afraid to ask direct questions if you really sense someone is in crisis
• Most importantly, don’t try to minimize someone’s feelings if they suggest they are suicidal. It’s important to seek professional help.

In what ways can a professional counselor help?

• Providing helpful tools and skills (for example how to build better interpersonal skills, how to effectively manage anxiety/stress/depression/anger)
• Provide a safe and neutral space to reflect, process, explore, clarify and grow
• Help identify goals in order to feel a sense of achievement and purpose
• Provide further information and referral to appropriate additional services for complex issues such as domestic abuse

There is absolutely no shame in speaking about mental health issues, and there is always help and support available!

There are more mental health resources in Cambodia than you might think!

What professional help is available in Cambodia?

While mental health services are still quite lacking in Cambodia, last year the Cambodian Association for Counselors and Psychologists was established, providing a platform for counselors and psychologists to raise awareness and understanding of the need for mental health services within the Kingdom of Cambodia. However, there is no legislation or regulation over mental health services in Cambodia, so it’s important to ask questions about the qualifications of the practitioners that you choose to see. If you aren’t happy with their answers, or are outside of Phnom Penh, many international counselors offer online services.

Be aware that the list below covers a handful of services available to expats and is not meant to be a complete guide. An honest discussion with a trusted doctor in Cambodia can be the best way to take action if you are struggling with your mental health. They may prescribe medication or provide referral to an appropriate service. Embassies also keep an updated directory of mental health services — the US Embassy one is here, but other embassies have their own. These services are all in Phnom Penh, but some offer online or phone options for those outside of the city.

Independent counselors and therapists

Living Well

Living Well has been in operation since 2014. They provide clinical and pastoral counseling, spiritual guidance and direction, plus life coaching for individuals, families and children. The cost is $33 per session for members and $55 per session for non-members. Prices include VAT.

Open Monday to Friday 8 a.m to 5 p.m
7th Floor, Gateway House #4, Street 197, Tumnup Teok, Phnom Penh.
livingwellcambodia.org

Reach Counseling – Nichola Heaton

Nichola is a UK certified person-centered counselor who has had a close relationship with Cambodia for the last decade, and has been based in Phnom Penh for the last 3 years. With over 10 years’ experience in counseling, she specializes in domestic violence, bereavement, substance abuse, relationships, life issues and changes. Available by appointment only, sessions are $45 per hour.

8 a.m to 6 p.m, or after hours in emergency
Tel: + 855 (0) 87 214 794
facebook.com/reachcounsellingcambodia

Helena Horalova

Helena has lived in Phnom Penh on-and-off since 2006. Originally from Sweden, she spent many years in London, where she completed her undergraduate and postgraduate studies. Her work in Cambodia has mainly focused on social and behavioral change communication in the public health sector. In 2019 Helena changed her focus to Cognitive Behavioral Therapy (CBT) and has recently completed her studies. She is now a CBT therapist and practitioner, and is available by appointment for adults, in her home-based office or online. You can contact Helena at helenah2@hotmail.com for her fees and more information.

Psychological Services

The Beekeeper

The Beekeeper is a social enterprise co-led by expert practitioners based in Phnom Penh. The aim of the practice is to provide assessment, ongoing support, therapeutic and mindfulness services based on each client’s unique needs. Using a combination of Eastern Philosophies and Western Theory, they specialize particularly in trauma, grief, GSRD, and addiction for adults, children and adolescents. Fees range from $40 to $125.

Open 8 a.m. to 5 p.m.
No.197 Street 19, Phnom Penh, Cambodia
Tel: +855 (0) 7722 1010
mybeekeeper.org

The Bamboo Centre

The Bamboo Centre (formerly Indigo) has an international team of qualified, professional psychotherapists offering services in English and French in addition to Khmer. Counseling is available for individuals (adults, children and adolescents), couples, and families. The Bamboo Centre also offers assessments and training as needed.

No. 17, Street 494, Toul Tom Poung, Phnom Penh
Tel: +855 (0)12 208 318
thebamboocentre.com

Transcultural Psychological Organization (TPO) Treatment Centre

TPO’s Treatment Center in Phnom Penh offers out-patient consultation and treatment of all types of psychosocial, psychological and psychiatric conditions (for expats as well as Khmer). All TPO clinical staff are qualified and experienced psychiatrists, psychologists, counselors and psychiatric nurses.

Open Monday to Friday, 8 a.m to 12 p.m, and 1 to 4 p.m
Tel: +855 (0) 23 63 66 991
tpocambodia.org

Inpatient and mental health emergencies (psychological and psychiatric services)

Most embassies keep a directory of current Mental Health Emergency Services that assist expatriates. There can be a considerable cost associated with inpatient hospitalization. The public hospital system is not free, but accessible to foreigners in a mental health crisis when budget is a factor.

Khmer Soviet Friendship Hospital – Department of Mental Health and Substance Abuse

KSFH has a team of 16 psychiatrists and 4 psychiatric nurses. They also offer outpatient and inpatient services.
Yuthapol Khmemarak Phoumin Blvd (Street 271), Phnom Penh
Tel: +855 (0) 23 217 527

Preah Kossamak Hospital – Psychiatry Department

Street 265, Phnom Penh
Kossamak hospital has a team of 11 psychiatrists and two psychiatric nurses, providing outpatient services only.
Tel: +855(0) 23 883 047

Sunrise Mental Clinic

Sunrise provides psychiatric assessments and management with inpatient and outpatient services, counseling and psychotherapy.
No. 112, Street 432, Toul Tom Poung II, Chamkar Morn, Phnom Penh
Tel: +855 (0) 99 545 565
sunriseclinic.com.kh

Transcultural Psychological Organization (TPO)

TPO has over 50 staff members and collaborates with a vast network of international organizations and committees, in an emergency they may be able to provide referral to appropriate services.
tpocambodia.org

Children’s Services

While some of the centers above offer counseling for children, more detailed information on services specifically for learning difficulties and behavior issues for children will be available in the near future on the site.

Remember, our mental health is as important as our physical health, and gaining access to appropriate support is essential. It’s important that we acknowledge our need for help at times and take the steps necessary for our wellbeing.