title: Building primary care practitioners' attitudes and confidence in mental health skills in a post-conflict society: a Cambodian example.
abstract: Our program attempted to integrate community mental health in primary care settings in Cambodia and to evaluate the effects of training on local providers. The training program underwent an extensive evaluation to determine its impact on the mental health knowledge, confidence in performing medical and psychiatric procedures, skills and attitudes of its trainees. One hundred four Cambodian primary care practitioners (PCPs) were trained in a primary care setting in Siem Reap, Cambodia, over a 2-year period. There was a significant improvement in PCPs' confidence in all clusters of medical and psychiatric procedures (counseling, medical evaluation, prescribing medications, psychiatric diagnosis, assessing risk for violence, traditional treatments, and treating trauma victims) comparing baseline to posttraining and baseline to 2-year follow-up (p < 0.05). Only confidence in prescribing psychotropic medications improved from posttraining to 2-year follow-up. This study supports the feasibility of training PCPs in a culturally effective manner in a postconflict society.
authors.affiliation: Harvard Program in Refugee Trauma at Massachusetts General Hospital, Boston, Massachusetts 02138, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Henderson
authors.forename: Richard F
authors.initials: RF
authors.lastname: Mollica
authors.forename: Svang
authors.initials: S
authors.lastname: Tor
authors.forename: James
authors.initials: J
authors.lastname: Lavelle
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Culhane
authors.forename: Doug
authors.initials: D
authors.lastname: Hayden
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002160:Cambodia; D002960:Civil Disorders / Q000523:psychology; D002983:Clinical Competence / Q000592:standards; D003156:Community Mental Health Services / Q000458:organization & administration / Q000592:standards; D003466:Cultural Characteristics; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy*; D010821:Physicians, Family / Q000193:education* / Q000523:psychology / Q000592:standards; D020377:Self Efficacy