Геннадий Петрович Котельников : к 65-летию со дня рождения

Few studies from low- and middle-income countries use qualitative methodologyto explore suicidal behavior among young people. In Cambodia, young peopleface the challenge of rapidly changing times and are vulnerable for suicidalbehavior as revealed by research in transitional economies. This study seeks togain a deeper understanding of the suicidal phenomena from a gender, psychosocialand cultural perspective. Six focus-group discussions were conductedamong boys and girls, aged 15–19 years, in two secondary schools in a suburbanarea close to Phnom Penh, the capital city. The data was analyzed using thematicanalysis approach. The participants highlighted the gender difference in suicidalbehavior by describing the suicide-prone, acting-out male as ‘plue plun’, whilesuicide-prone females were described as caught in constricted, tunneled-thinkingbehavior, expressed as ‘kath klei’. Parental attitude and family environment werealso pointed out as the chief causes of discontent and there was a strong wish onthe part of young people to find space for modern values within the traditionalfamily. The young people’s awareness of their challenges in everyday life suggeststhat school-based programs to prevent suicidal behavior ought to be gendersensitiveand peer-focused

‘Striving to negotiate… dying to escape’ : suicidal expressions among young people in Cambodia

Background Suicide among young people is a global public health problem, but information on determinants and understanding of suicidal expressions are lacking in low and middle income countries (LMIC). Though school-based interventions are common in many parts of the world, evidence for efficacy is less reported, particularly from post-conflict countries. Aim To explore suicidal expressions and their determinants with psychosocial and gender perspective in Cambodia and Nicaragua and to evaluate a school based intervention to promote mental health and prevent suicidal behavior among young people in Cambodia. Method School students between the age of 15-19 from Cambodia and Nicaragua responded to Attitude Towards Suicide (ATTS) and Youth Self-Report (YSR) questionnaires. In addition, Life Skill Dimension Scale Adolescent Form (LSDS-AF) was used in schools in Cambodia, one experimental and the other control, to measure the impact of intervention. Six focus group discussions (FGDs), both gender-specific and mixed groups, were held to understand young people’s perception of gender, culture, religion and media and their impact on suicide among them. Results Paper I. Revealed few gender differences in suicidal expressions, except girls reporting more attempts than boys. Girls exposed to suicide among friends and partners were likely to report own suicidal expressions and girls with internalizing syndrome were at risk for suicidal expressions.    Paper II. Cambodian teenagers reported more mental health problems but fewer suicidal expressions as compared to Nicaragua. The determinants varied between countries.   Paper III. Participants of FGDs mentioned “Plue Plun” male and “Kath Klei” female to describe gender difference in suicidal behavior among young people in Cambodia who found it a challenge to negotiate between traditional and modern values. Paper IV. Suicide ambiguity in Buddhism, stigmatizing culture and double edged media were seen as suicide-provoking by the young people in Cambodia, who recommended peer-focused, school based program. Paper V. School based Life Skills Intervention overall benefited girls. Boys with high risk behavior had shown improvement on many Life Skills dimensions, as well as in their mental health profile. Conclusion The gender and cultural differences in suicidal expressions and their determinants among teenagers emphasize the importance of culturally sensitive and gender-specific suicide prevention programs. The influence of religion and media ought to be considered while planning intervention programs. School-based program may be a window of opportunity to promote mental health and prevent suicide among young people in Cambodia

L'Avenir de Luchon : journal scientifique, littéraire, annonces et réclames : guide général des baigneurs et des touristes aux eaux thermales, bains de mer de la France et de l'étranger

02 avril 19221922/04/02 (N87)-1922/04/02.Appartient à l’ensemble documentaire : MidiPyren

Conducting research with young people at the margins : lessons learnt and shared through case studies in Cambodia, India, Sweden and Zambia

Building on the value of engaging with and enabling the participation of marginalised young people in research, theaim of this article was to profle practical and procedural issues faced when conducting studies with young peoplewho experience some form of marginalisation. Drawing on observations and research experiences from four diversecase studies involving young people who were either imprisoned in Cambodia, living in informal urban communitiesin North India, residing in rural northern Sweden or attending school in rural Zambia, learnings were identifed underthree thematic areas. Firstly, a need exists to develop trusting relationships with stakeholders, and especially the participating young people, through multiple interactions. Secondly, the value of research methods that are creative andcontext sensitive are required to make the process equitable and meaningful for young people. Thirdly, it is importantto fatten power relations between adults and young people, researchers and the researched, to maximise participation. These fndings can inform future youth research in the feld of global public health by detailing opportunitiesand challenges of engaging in research with young people on the margins to promote their participation

The effect of a life skills education program on mental health and social competenciesamong young prisoners in Cambodia : an intervention study

Introduction: Numerous studies globally confirmed that young prisoners are more susceptible to mental health problemscompared to adult prisoners and the general population. The lack of life skills has been reported as one of the main reasons forthis vulnerability. This study aimed to assess the effectiveness of a life skills education program on mental health and life skillsamong young prisoners in Cambodia. Method: This is an intervention study, applying a ‘difference-in-difference’ analysis. The life skills education program wasimplemented to promote essential skills for mental health and social competence among young prisoners. Mental health and lifeskills competence were evaluated using the Youth Self-Report and Life Skills Development – Adolescent Form scales, respectively.Four prisons were selected from a total of 24 prisons in Cambodia, a post-conflict country in Southeast Asia. A total of 412 youngprisoners aged 15–24 years participated in the study and were randomly assigned to intervention and control groups. Results: Both the intervention and control groups reported decreased mental health problems (DiD=3.78, p=0.34) and improvedlife skills competencies (DiD=0.39, p=0.80) after the intervention; however, the differences were not statistically significant. Conclusion: The life skills intervention program had no significant effect on young prisoners’ mental health and life skillscompetencies. Further studies should be conducted to evaluate the impact of the life skills education program in the prison setting,particularly in low- and middle-income countries (LMICs) such as Cambodia

Competence building in child mental health -A Norway-Cambodia transcultural experience

The prevalence of mental health and neurodevelopmental disorders in young people is high in low- and middle-income countries. Collaboration between institutions from high-income countries and institutions in resource-poor settings may enhance professional competence. This may be a key to bridging the gap between service needs and ability to meet those needs. However, there are challenging issues in transferring knowledge from a Western context to a different cultural and socioeconomic situation. The aim of the present study is to describe significant aspect of a transcultural competence building project in Cambodia in child mental health from the perspective of the staff. A Norwegian expert team developed and implemented a program at Centre for Child and Adolescent Mental Health (Caritas-CCAMH) in collaboration with the staff two weeks per year over a 14-year period. The study has a qualitative approach using thematic analysis of the transcripts from a focus-group interview with 11 staff members at the end of the 14-year period. The multidisciplinary staff described a learning process characterized by collaboration in planning and implementation. Mixing theory and practice in clinical case discussions with a bio-psycho-social perspective was perceived as the cornerstone of the teaching process. A pedagogical strategy that involved constant reflection back and forth enabled the customization of the content and method of capacity building despite the differences in socio-economic conditions and learning styles. This model of continuity, low-investment, and low-intensity capacity-building may enrich the child and adolescent mental health settings in low- and middle-income countries.publishedVersio

“Overcrowded but lonely” : exploring mental health and well-being among young prisoners in Cambodia

Purpose – Young prisoners are one of the most vulnerable groups in society for mental health problems and ill-being. Therefore, there is a crucial need to understand their physical, psychological and social situations. This study aims to explore young Cambodian prisoners’ experiences and perceptions of mental health and well-being, their determinants and their coping strategies. Design/methodology/approach – Six focus group discussions were carried out in three prisons with atotal of 48 young prisoners between the ages of 15 and 24 years (50% women, 50% men). Semistructured questions guided the discussions, and thematic analysis was applied to analyse the data. Findings – Young prisoners reported multifaceted experiences of mental health and well-being. The majority described adverse mental health experiences, while some revealed better well-being, partlyinfluenced by the socio-economic support from outside the prisons and previous involvement or not indrug abuse. The experience of physical overcrowding without emotional attachment among the fellow prisoners was perceived as the overarching determinant of loneliness and mental health problems, while socio-emotional support and rituals were described as the most important coping mechanisms. Originality/value – This pioneering study from Cambodia gives young prisoners an opportunity to voice their experiences and perceptions of mental health and well-being in the prison setting. The findings inthis study underline the importance of prison authorities tackling overcrowding to promote well-being andreduce mental health problems. Also, the coping mechanisms outlined by the participants should be considered when planning psychosocial interventions

Investigating the Situation for Children with Autism and Their Families in Cambodia

Following periods of conflict and instability during the oppressive regime of the Khmer Rouge (1975–1978) and the period of Vietnamese occupation (1978–1992), the Kingdom of Cambodia has adopted policies and initiatives that aim to ensure greater equity and stability across all services in the country as a signatory to international agreements for the promotion of universal primary education (United Nations 2015). The education of children with disabilities continues to present challenges to both policy makers and service providers in Cambodia, though government agencies have made a commitment and invested resources to improve facilities and increase awareness of the difficulties experienced by children and families. Previous studies of provision for children on the autism spectrum in Cambodia suggest that they are little understood and that many experience difficulties accessing appropriate services or support. However, these reports have often been based on localised small-scale studies and have not provided a broader national perspective of the situation. A national analysis of the situation for persons with autism was conducted to provide a more detailed picture of the experiences of children with autistic spectrum disorders and their families. Data were collated using focus groups and interviews with service users and providers from a purposive stratified sample across the country. The findings reveal that a limited awareness and understanding of autism amongst both professionals and the general public has limited opportunities for development. Education facilities and expertise are limited, and access to therapeutic and specialist medical provision is poor. The pervasive nature of poverty has been a major contributory factor in the slow development of and accessibility to services to this population. A number of recommendations have been made and are being used to shape future policies for children with autism and their families in Cambodia

Manual-based group intervention for siblings and parents of children with neurodevelopmental disorders in Cambodia

Abstract Siblings of children with neurodevelopmental disorders (ND) are at increased risk of mental health problems. The burden on families of children with ND is exacerbated in low-income countries with limited health services and dependency on informal care systems. Yet, there is little research on family impacts of ND in non-Western settings, and no evidence-based interventions for siblings. We examined initial outcomes and feasibility of a manual-based intervention for siblings and parents of children with ND, called SIBS, delivered in Cambodia. SIBS has promising evidence from an open trial in Norway. We delivered eight groups for 52 siblings ( M age = 12.7 years, SD  = 2.7; 44.0% female) and 56 caregivers ( M age = 43.5 years, SD  = 8.5; 61.1% mothers) of 54 children with ND at the only public child mental health clinic in Cambodia. We aimed to improve sibling and parent mental health and family communication. The SIBS intervention comprises three separate sibling/parent group sessions and two joint sibling-parent dialogue sessions. Parent-reported mental health scores for siblings were higher than sibling self-report. Parent mental health problems at baseline were high, with no difference between mothers and fathers. There was significant improvement in parent mental health and parent-rated mental health for siblings from baseline to 4-month post-intervention (effect sizes d  = 0.44 to 0.52). There was no change in sibling-reported mental health or family communication. Sibling- and parent-rated user satisfaction was high. We conclude that the SIBS intervention showed promise in Cambodia. However, revision of the communication component is needed