It’s been a hard year for a grade 12 student in Koh Kong.
“Every night, I stayed in my room, turned off the light, and thought about everything. I had insomnia, slept at 2 or 3 a.m., didn’t eat, and always had headaches even though I was not weak,” the 18-year-old said earlier this month.
“I lost interest in doing anything. I wanted to stay alone even though I have a lot of friends.”
It wasn’t necessarily Covid-19 that brought on what she described as depression. She had long felt heavy pressure and expectations from her family and the people around her as the eldest child in the family, she said.
But the pandemic didn’t help. She couldn’t concentrate on her studies, and she wanted space to be alone.
Amid long months of shuttered schools due to Covid-19, Unicef and other children’s organizations have warned of the toll the isolation and disruption of routines were causing young people around the world.
In Cambodia, too, mental health workers say they’ve seen a spike in adolescents seeking help. Surveys have shown bouts of anxiety and depression among young people. The recent reopening of schools could be a relief, but it might not be an easy transition.
Sy Rato, a psychiatrist at the Khema International Polyclinic, said he was seeing three to four times as many patients now compared to before the pandemic — most of them adolescents.
“The Covid-19 caused adolescents to change their lifestyles, and it affected their daily life,” he said. Many were struggling to eat and get work done.
“They’re losing connections, and their problem-solving is not good,” Rato said. Longer hours spent on social media created more anxiety, he added.
Hoeur Sethul, director of Khmer Counseling and Psycho-Education Services, said feelings of loneliness were rife among adolescents. This was compounded by a loss of soft skills — being able to understand and deal with the world around them — amid their isolation.
“Loneliness and isolation are the main factors that lead adolescents to have a mental breakdown,” Sethul said.
Some adolescents were coming in for help, but most of those were international school students, he said. They seemed to be more aware about mental health, while some other students might find it more difficult to afford mental health services, he said.
“Recently, I did research on the quality of mental health services in Cambodia,” Sethul said. “Our service is very low. This means that the quality of our services is still limited, resources are still limited, and community-based services are still limited.”
Back to School
In Cambodia, Unicef and partners have tracked the well-being of residents amid the pandemic. In one survey, 16 percent of youth aged 15 to 19 said they had felt anxious or depressed since the pandemic began.
A joint study by the Education Ministry and Unicef after school closures in 2020 had starker findings. Some 58 percent of secondary school students reported experiencing at least one mental health issue since the closures.
In the survey of 15,000 Cambodians, 43 percent of respondents said they believed boys had been put at greater risk of violence, abuse and exploitation during school closures, and 36 percent believed the same for girls.
“Children in Cambodia, like the rest of the world, have faced so many challenges during the COVID-19 crisis,” Foroogh Foyouzat, Unicef representative in Cambodia, said in the report. “The closure of schools, the dramatic changes in social interactions, and the socio-economic impact of the pandemic on Cambodian families have all come at great cost to the mental health of children and young people.”
Choeun Sreymao, a chemistry teacher at Preah Vihear’s Chea Sim Tbeng Meanchey High School, said this month after a week of in-person classes that the students who showed up to school seemed OK — but many hadn’t.
“Since the school was closed for a long time, many students were tired of learning, and some students dropped out,” Sreymao said.
Secondary schools across the country began to reopen last month amid widespread Covid-19 vaccinations. Universities and primary schools are set to follow suit from November 1.
Chea Sim Tbeng Meanchey’s school director would be doing a round of visiting families urging students to return, Sreymao said. She thinks her director, who is “strict,” will be persuasive.
“[But] even if they come back, I don’t know if they’ll want to learn or not,” Sreymao said.
For the Koh Kong 18-year-old, her school’s reopening became something to dread.
“Even though the school reopened, ultimately I did not want to go to school. The feeling of wanting to go to school, wanting to pass grade 12, is no longer the same,” she said.
“At first, I thought it was just anxiety but when I tried to figure it out, I thought I had depression. Even if I pretended to be happy outside, deep inside I was depressed,” she said. “I always live to exist as they expect.”
She felt far from those close to her, the grade 12 student said.
“Whenever I tell my friends, they respond to me, why do I act like this? No one understands me, so I want to stay alone,” she added. “Before I was a talkative person, but now I always stay silent.”
Sethul, the counseling services director, said thinking about not being able to sleep and other problems can exacerbate the issue.
“I encourage you not to worry about the symptoms because when we talk about the symptoms, we will feel that we are depressed. But try to understand ourselves and find what has changed. For instance, we used to sleep well, but now we cannot sleep, feel anxious and frustrated,” he said. Sethul added that he hoped mental health services could be made available in every school.
Meanwhile, Rato, the Khema clinic psychiatrist, has founded “Arom Station,” a digital campaign to raise awareness about mental health. Its Facebook page has mental health information and motivational quotes.
It also offers free consultations to people struggling with their mental health.
Rato said it was important to get help quickly. He said mental health problems could be seen as a stigma, but mental health workers were there to help. Sometimes, people can simply feel like they are unable to do the problem-solving that’s needed in their lives.
“Don’t let it become a serious mental issue,” Rato said. “Those who are upset can consult with us. We are here to listen, encourage and help you to find a solution.”
Resources in Cambodia:
• Arom Station provides information and free consultations.
• TPO Cambodia and Khmer Counseling and Psycho-Education Services offer mental health services and counseling.