The Integrated Network for Cambodians (INC) is a Community-Designed Integrated Service Management (ISM) Model funded by the Mental Health Service Act. PACS received a three year contract to provide integrated behavioral, physical and substance services to Cambodians of all ages with a geographical focus in the Long Beach area.
With its community partners, there is outreach and engagement, education, linkage, and advocacy services to the underserved Cambodian population. Together they work to overcome the stigma associated with mental illness and remove some of the barriers to care with culturally sensitive care and linguistically appropriate services.
“The INC staff make PACS a place that I look forward to coming to, it’s my second home…I feel like I’m family.” S.V., client
The model redefines public mental health services by working directly within the community with collaborations between agencies and non-traditional service providers. Spiritual traditions such as the use of the Buddhist Blessing Ceremony and mindful meditations as well as healing practices such as acupuncture are used as part of the treatment modality along with Western counseling services.
“Meditation helps clients have strength and calmness so they are mindful of the energy of forgiveness. One of my clients couldn’t hold a book. Now she can hold it and read it.” H.K., INC staff
INC Blessing Ceremony
To be enrolled as a client in INC, the individual must meet the medical necessity criteria for special mental health services and either have a general medical condition that requires ongoing care and/or a substance abuse issue. If you qualify, counseling services and substance abuse treatment will be free. For medical treatment, clients will be seen at low cost to no-cost depending on which program they are eligible for at the clinic.
INC is made up of PACS and six community partners:
- The Children’s Clinic (TCC) – the Federally Qualified Health Center to provide physical health services
- Asian American Drug Abuse Program (AADAP) – substance abuse counseling
- Cambodian Associations of America (CAA)
- Families in Good Health (FiGH)
- Khmer Girls in Action (KGA)
- United Cambodian Community (UCC)
PACS is the lead agency for INC, providing mental health services and The Children’s Clinic, “Serving Children and Their Families” (TCC) is the Federally Qualified Health Center (FQHC). The five community partners were chosen for their services and knowledge of the Cambodians in Long Beach. The partners provided outreach, education and engagement (OEE) with its community navigators.
1. Asian American Drug Abuse Program (AADAP): Since 1972, it has served all populations of all ages affected by drug and alcohol problems in LA County with a special focus on APIs. Its outpatient treatment program includes: individual, group and family counseling; drug screening; drug diversion; assistance with child protective services and probation, and a residential program.
2. Cambodian Association of America (CAA): Founded in 1975, it is recognized as the oldest and largest Cambodian organization in the U.S. CAA works with low socio-economic Cambodians and provides counseling, education and training services for all age groups, especially older adults as well as social services and cultural activities.
3. Families in Good Health at St. Mary Medical Center (FiGH): Since 1987, it has served APIS in all age groups especially Cambodians. FiGH has three core priority areas to increase health access: 1) maternal/family-child health; 2) chronic disease prevention and management; and 3) youth health development.
4. The MAYE Center: Started in 2014, it serves Cambodians of all ages. It works to help those in the community by giving members the tools and knowledge of self-healing through programs that provide meditation, gardening, yoga and education.
5. United Cambodian Community (UCC): Started in 1977, it has a history of serving low socio-economic Cambodian clients by providing: food distribution, tutoring for children and adolescents, youth leadership groups, substance abuse education, Literacy/ESL classes, education on health issues such as hepatitis and diabetes, enrollment in Medi-Cal and Medicare and advocacy for the community.
“I like this program because the clients explode with a whole basket of things they need and we can help them.” V.T., Community Navigator
WHY CAMBODIANS IN LONG BEACH, CALIFORNIA?
PACS selected this Southeast Asian group because of the tremendous need and disparity in accessing care. The 2010 Census data showed over 37,000 Cambodians living in Los Angeles County and it is widely accepted that nearly 90 percent of Cambodians reside in Long Beach. Due to undercounting and the population’s fear of the government, many conjecture that the number is closer to 50,000. The 2007-2009 American Community Survey found that Cambodians in LA County have the following key indicators: a) linguistic isolation with 85 percent of the 32,631 Cambodians identified as speaking other than English and of that 50.6 percent are identified as speaking English less than very well; b) 44.1 percent over 16 years old are unemployed; and c) out of 7,989 households 14.6 percent have Social Security at about $12,591 annually, 20.5 percent have SSI at about $11,003 and 12.5 percent have cash public assistance of $5,737. The most recent California Student Substance Abuse Survey showed that Southeast Asians (SEA), including Cambodians ranked first among all API groups for cocaine and meth use. A 2002 community survey of Southeast Asian refugees in the U.S. reported that 59 percent of Laotians, Cambodians and Vietnamese met the criteria for pathological gambling.
The largest population of Cambodians outside their home country is in Long Beach and it is the symbolic and physical center of the scattered Cambodians of the world (Needham and Quintiliani, 2007).
Much has been written of the tragedy that unfolded in Cambodia when in 1975 the Khmer Rouge took control of Cambodia. One of their first acts was to physically remove all the citizens from the cities into the countryside as part of their re-education plan. Millions of people were put into segregated work camps. By the time the Vietnamese invaded Cambodia in 1978 and ended the Khmer Rouge regime, over two million men, women and children had died from starvation, disease, abuse, torture, overwork, and just plain murder (Chandler, 1991; Kiernan, 1996). It is within this context that one begins to understand the waves of Cambodian evacuees who came to the United States and the level of trauma these refugees suffered.
The fact that on July 3, 2007, the Cambodian community successfully lobbied for the recognition of the cultural designation of “Cambodia Town” from the City of Long Beach is a tribute to their resilience and commitment.
History of the Mental Health Service Act and ISM:
In November 2004, the voters of California approved Proposition 63 to levy a 1% income tax on individuals whose income was above $1 million per year to help provide services to people with mental illness. This became known as the Mental Health Service Act (MHSA) which had five different components, one of which was Innovation. In 2010, the Los Angeles County Department of Mental Health issued a Request for Proposal for four Innovation programs. One of them was the “Community Designed Integrated Service Management Model” which was shortened to the ISM Model which funded 14 ISM ethnic communities. Four of these were designated for API communities – Cambodian, Chinese, Korean and Samoan.
The Innovation Plan strives to find:
- Develop creative ways to increase a community’s access to integrated care
- Identify and develop strategies to overcome stigma
- Educate the community about mental health (emotional well-being)
- Overcome disparity for underserved communities
INC began in the last quarter of FY2011-2012 and with a fourth year extension, it will end in FY14-15.
The “Integrated Network for Cambodians” (INC) is funded by the Los Angeles County Department of Mental Health under the Mental Health Service Act (MHSA).
“I use to be afraid to go out but now I jump at the opportunity to go out.” Client E.H.