The number of suicides in Cambodia is on rise as economic pressures push more people into debt and the stressful cycle of unresolved financial repayments.

Data Kiripost recently received from Cambodian National Police spokesman, Chhay Kim Khoeun, reveals that suicide cases in the first six months of 2023 has increased by 13 compared to the same period last year.

“In the first half of 2023, there were 473 suicide cases, resulting in 468 deaths and six injuries,” stated the report. It also showed that the total number of deaths due to suicide increased by 12, compared to the same time in 2022.

Mental health & economic pressures

Psychotherapist Yim Sotheary, founder of Phnom Penh-based mental health hub Sneha Centre, told Kiripost that in Cambodia and worldwide, youth are more vulnerable to suicide than other age groups.

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Meanwhile, political aspects, as well as economic pressure and personal past trauma, are key factors that lead to suicide, she said.

“This year, we can see our economy is facing difficulties. Furthermore, we noticed the influence of post-Covid times is also a part of pressure that cause suicide,” Sotheary told Kiripost.

She added that unresolved issues during Covid-19 until now are burdens for many people and lead to stress, depression, and other mental health issues.

Most of the clients that seek mental health counseling from Sneha Centre are in serious stages of depression and stress, she noted. Sotheary added that she has encountered clients who have attempted suicide, but after seeking mental health support, they have reversed their decision.

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“From what I see, those who have attempted to commit suicide are those who did not seek mental health support,” she said.

“Signs of depression that can be found among clients are they tend to lose interest in daily activities, lack motivation and cannot see a better future. This leads to lack of motivation to live. What I always notice is family, work and social pressures are complicated for them to find a way out.”

Most of the time, youths between the ages of 18 and 25 are prone to pressure from their parents and family. These include high expectations regarding work, salaries and financial codependency.

“The youths that consult with me, they are in the average age group and are from middle-income families. This means they are not too poor or too rich, but are facing daily economic pressures,” she said.

“The pressure of attempting to earn as much money as possible is such a heavy burden for them. The phrase ‘Success Success’ is also a big pressure for youths whenever we measure how successful they are based on the amount of money they could earn.”

The middle age group of people, between 30- and 40-years-old, are more likely to face anxiety than depression.

“They are extremely worried about their future. They said what are they going to do next with family situations, like how to earn extra income to support their family. Comparing their family to other families in many ways,” Sotheary said.

“Due to stress, they encounter suffocation and other illnesses. Some worry about when they will die and who is going to look after their family and take care of the wealth that they have.”

Anxiety is a feeling of worry, nervousness, or unease about something with an uncertain outcome. It can have an impact on physical health issues, according to the UK's Mind organization.

According to research, having long-term physical health issues such as diabetes, stomach ulcers, and cardiac issues may be more likely to occur in people who experience anxiety. However, there is insufficient data to definitively identify the risks or identify populations that stand to suffer the most.

Most people who seek help from psychologists rarely notice their own symptoms in the early stages of depression, unless they hit the serious stage and decide to seek mental health solutions from professionals.

“It becomes a normal habit now that people wait until they face depression in the last serious stage when they can no longer handle the situation and find help. This is not a good habit. When we start to feel stress, we should try to find someone to listen to us. It is better than having it longer,” she warned.

Sotheary encourages citizens to seek mental health support as soon as possible when they encounter mid-levels of stress.

How to seek mental health support

Sotheary said signs to watch out for include changes in sleep pattern and an emergence of extreme emotions. This can be done by reflecting on changes in patterns in recent weeks or months.

“Am I easily angry or anxious? How fast can I get aggressive and react? How much happiness have I been losing? Have I lost my appetite? How do I lose my daily functioning and work capacity?” she said.

Sneha Centre’s website offers free mental health evaluation functions for people who are uncertain about their mental health. It ranks individuals’ mental health in different levels based on the score.

Sotheary suggest that to help cut down on suicide attempts starts with society helping each other. She gave examples of being a good friend, colleague and listener. Having a strong and supportive family network is also fundamental.

She admitted that the cost of mental health treatment is expensive in Cambodia. She urged the government and associated organizations that work in mental health well-being to assist in making the price more affordable and accessible for all.

“Normally, the duration of [mental] consultations might be 30 minutes up to one hour, or more than that. For expenditure, we have to spend on office renting and salaries for therapists. For running mental consulting in the private sector, we have to calculate what we have spent,” she mentioned.

Sotheary added that she tries to make the cost of mental health treatment as affordable as possible, but to offer it free of charge is impossible. On average, the cost of mental health consulting ranges from $20 to $100, depending on the knowledge and experience of the psychotherapist.

Stress of bank debts

“I don’t know what business I should do? Nowadays, it’s very difficult. I cannot sleep every night, I’m so upset and worried. Because we are in debt, there are challenges everywhere. I don’t know what to do.”

Tears form in the eyes of street food vendor, Leang Khna, as she describes the stress she faces due to unresolved debts since Covid-19 - a two-year battle.

Standing under the small roof of her food cart, she told Kiripost that after July’s elections, sales have further declined due to a lack of people.

“One day, I can earn only 100,000 to 130,000 riel [$25 to $32.50]. Sometimes I sit for three hours and do not even have one order,” she said.

During the Covid-19 outbreak, her family borrowed money twice from the bank. The first was to help operate her husband's business and the other was to pay back money for her home at a borey.

“After paying 30 percent of the house price, we have to pay bank debt one more time. Now I'm still stuck in debt. If I didn’t buy it [the house] I wouldn't be stressed by debts like this,” she said.

Before Covid-19, both her and her husband earned extra income and were able to afford to buy the house, with the aim of selling food along the street. They also had dreams of opening a small restaurant at her home.

However, the pandemic struck and hit the family’s finances hard. Today, she carries the weight of about $30,000 debt borrowed from the bank at an interest rate of between 0.4 and 0.6 percent.

The 49-year-old mother-of-three said she and her husband must earn more income to repay the debt on time. If not, they face daily fines from the bank of $2.50 for each day repayment is late.

“Previously, I repaid two days late and was fined $5,” she recalled.

As sales decline, without any better options to earn money, Khna has been forced to borrow from relatives and others to repay the bank. This further exacerbates the cycle of debt.

“I'm under so much stress and pressure in my head. When I sell things and get money, I have to buy food, vegetables, and other things to keep selling over the next few days. The money I earn cannot be saved,” Khan said as she fried noodles, her head covered by a wet krama to keep away the fierce sun.

“Selling nowadays, I don’t have any energy and motivation at all. While I’m selling, I normally worry about where I can get the money from to repay the bank debt. I’m always overthinking,” she added.

Debt situation in Cambodia

Kaing Tongngy, head of communications at Cambodia Microfinance Association (CMA), said regarding debts, banks and other microfinances have mechanisms to help borrowers who face challenges in repaying their debts.

“We cannot solve all the issues of customers [debtors], it depends on the situations and conditions of the individual,” he said.

“As an association, we encourage them to raise their issues honestly with institutions, especially for credit officers, so they can understand their situation and capacity to repay debts. So, they can find solutions or credit restructuring that suit customers' situations.”

During economic challenges, CMA does not encourage people, especially debtors, to borrow more money as this fuels the cycle. Only honest discussion from both sides, banks or microfinance and borrowers, helps to find a suitable solution, Tongngy suggested.

Currently, there are approximately four million credit user accounts in both the banking and microfinance sectors. This is equivalent to $50 billion, he said.

According to a National Bank of Cambodia (NBC) report in 2023, consumer loans in the microfinance sector increased by 14.8 percent to $9.7 billion, with 2.2 million accounts. For the microfinance sector, there were 2.1 million credit users with about $9 billion.

Deposits, referring to the money that people put in the bank to get interest rates, stands at $4.9 billion.

People with consumer debt who are struggling financially or who find it difficult to pay off their obligations are more likely to report having lower life satisfaction and higher anxiety, according to a 2018 research by The Aspen Institute called ‘The Burden of Debt on Mental and Physical Health’.

A National Institute of Health study also discovered that high debt-to-asset ratios are linked to greater levels of subjective stress and sadness.

However, currently, there are no specific studies or data available in Cambodia about how debt is linked with suicide.

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