For those living with disabilities in Cambodia, factors are often compounded with the daily realities of navigating their condition while facing stigma and barriers to accessing healthcare and community support. These overlapping challenges create a largely unseen but substantial burden for the disability community in Cambodia.
Cambodia’s recent history continues to shape the health and well-being of its population, with the effects of past conflict still evident in everyday life. This historical context combined with ongoing challenges such as poverty, food insecurity and limited access to healthcare has left many people in Cambodia vulnerable to psychological distress.
Patients with disabilities are at a higher risk of experiencing psychological distress and post-traumatic stress disorder (PTSD). Psychological distress is a general state of emotional suffering which can include symptoms such as irritability, demoralisation and anxiety or depression, typically arising in response to social, interpersonal or economic stressors.
In contrast, PTSD is a specific mental health condition that can develop following exposure to traumatic events and is characterised by symptoms such as intrusive memories, negative mood changes and avoidance of trauma reminders.
Hidden mental health burden
Taken together, these overlapping pressures create fertile ground for psychological harm. Now, research led by Dr Alan Maddock from the RCSI School of Population Health sheds light on just how heavily this burden falls on patients with physical disabilities in Cambodia.
The study, published in Current Psychology, analysed data from 465 prosthetic and orthoic patients across three clinics in Cambodia, from March 2023 to June 2024. The findings reveal that over one in five participants (21.2%) were experiencing clinically significant psychological distress, while more than a quarter (26.1%) screened positive for PTSD symptoms.
These numbers were particularly striking, as these patients were seeking healthcare services, and mental health needs may be even greater among those without access to care.
Drivers of mental health outcomes
Beyond highlighting the scale of the issue, the research provides important insights into the factors shaping mental health outcomes in this population. Using a culturally adapted psychological model, Dr Maddock’s team identified two key risk factors, worry and rumination, both forms of repetitive negative thinking, that increase vulnerability to distress.
At the same time, the study identified three protective factors that can help reduce psychological distress and PTSD symptoms: acceptance, nonattachment (the ability to let go of distressing thoughts), and attention regulation (the ability to focus and manage attention).
The analysis shows how these factors interact, offering a clearer understanding of the psychological mechanisms at play and highlighting opportunities to strengthen resilience through targeted, culturally appropriate interventions.
Pathway to relevant interventions
The findings have significant implications for healthcare delivery in Cambodia and similar conflict zones. With limited access to specialist mental health services, with an average of just one psychiatrist per 260,000 people, the study points to the potential of integrating low-intensity psychological supports into existing healthcare systems.
In particular, the authors highlight mindfulness-based interventions as a promising, culturally aligned approach. Given that the majority of Cambodia’s population practices Buddhism, such interventions may resonate more strongly and improve engagement.
Short, tailored programmes delivered within prosthetic and orthotic services could help patients build key psychological skills, reducing distress and improving overall well-being without placing additional strain on already limited healthcare resources.
This research provides actionable evidence on how to support these vulnerable populations by integrating mental health support into routine physical care, this research highlights a practical pathway towards more holistic healthcare.
For patients living with physical disabilities in Cambodia, this could mean not only improved mental health outcomes but also better rehabilitation experiences and quality of life.
Dr Alan Maddock is a Lecturer in Psychology at the Department of Health Psychology at RCSI's School of Population Health.
RCSI is committed to achieving a better and more sustainable future through the UN Sustainable Development Goals.
