Integrated Network for Cambodians (INC)
Integrated Network for Cambodians (INC) is a Community-Designed Integrated Service Management (ISM) Model. INC’s model redefines public mental health services by integrating mental health, physical health, and substance abuse services. INC’s primary goal is to reach the underserved Cambodian population with culturally sensitive care while removing barriers to access. It works directly within the community by collaborating with non-traditional service providers to support the recovery of clients.
Pacific Asian Counseling Services (PACS) is the lead agency for INC and provides the mental health and substance abuse services while The Children’s Clinic (TCC) provides physical health services. The Cambodian Associations of America (CAA) reach out through education linkage, engagement and advocacy
Spiritual traditions such as the use of the Buddhist Blessing Ceremony, mindful meditations and cooking classes as well as healing practices such as acupuncture are used as part of the treatment modality along with Western counseling services.
“Anxiety symptoms attacked me and was more painful than my Asthma. No one understood what I was feeling inside except for my therapist and the INC team. When I am able to be free of anxiety, my wish is to share my own experiences to help others to also be free of pain.”
“I am so thankful for the services that I received from INC. Because of INC and my therapist, I was given an entire new life to live.”
INC works to overcome the stigma associated with mental illness and remove some of the barriers to care with culturally sensitive care and linguistically appropriate services.
“I didn’t know that I was suffering from PTSD & depression until I received support from INC. I felt all alone. …I learned that I could help myself and each day I am eager to learn more about my symptoms and how I can have a better life.”
Our cooking classes were very popular. The clients were the teachers and it was a way to pass on their tradition to others. The classes usually took place in a temple and the monks were fed as well as the guests. The classes were free and open to clients, family members, staff, temple members and guests.
“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
"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
“My psychiatrist in Cambodia told me that there wasn’t a cure for my disease (PTSD). When I met with my therapist in the INC program, she taught me how to overcome my anxiety, showed me that there is a cure and I did not have to live my life full of pain and suffering.”
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
The Innovation Plan began in the last quarter of FY2011-2012 and with a fourth-year extension, it ended in FY14-15. Due to strong outcomes from the programs, INC and other models continue to be funded under the MHSA CSS Plan by the Los Angeles County Department of Mental Health.
To be enrolled as a client in INC, an individual must meet the medical necessity criteria for special mental health service and either have a chronic medical condition that requires ongoing care and/or a substance abuse issue. Counseling services are provided at no cost for Medi-Cal recipients and indigent clients. For medical treatment, clients can be seen at low cost to no-cost depending on which programs they are eligible for at TCC.
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. 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
"I used to be afraid to go out but now I jump at the opportunity to go out." E.H., client
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.