Sara Pol-Lim, the Executive Director of the United Cambodian Community in Long Beach, is open about the horrors of her childhood. She was 9 years old the day that Phnom Penh fell to the Khmer Rouge, the brutal regime that murdered millions of Cambodians.

“On April 17, 1975, that was the day I was kicked out of my home and seeing things kids shouldn’t be seeing,” Pol-Lim said. “I remember my parents packing us into a small car because if you didn’t leave home, you’d get shot.”

Pol-Lim, who lost her father and three brothers before moving to the United States, said her family tragedy is familiar. “If you talk to many community members,” she said, “you hear a lot of loss.”

While Pol-Lim speaks freely about her experiences, that candidness is uncommon in the Cambodian community. In Cambodian culture, seeking mental health counseling is taboo.

The mission of the United Cambodian Community (UCC) is to counter that taboo, by helping to eliminate cultural, language and generational barriers that prevent Cambodians from seeking help for mental health issues.

The UCC recently held a community forum with Building Healthy Communities Long Beach and the Cambodian Advocacy Collaborative, Khmer Parents Association and other organizations to enroll residents in the Affordable Care Act, which covers many mental health problems as medical conditions.

Long Beach has the largest Cambodian population outside of the U.S., with 4 percent of the city’s population of Cambodian descent.

Studies show that Cambodians suffer disproportionately from post-traumatic stress syndrome and depression. Forty-five percent of Cambodians surveyed in a 2003 Connecticut health information report self-reported that they had symptoms consistent with PTSD, according to the report Silent Trauma, by the California Diabetes Program.

The National Institutes of Mental Health defines PTSD as a disorder in which sufferers, after a terrifying ordeal, “may feel stressed or frightened even when they’re no longer in danger.”

As a group, Cambodians have high rates of hypertension, diabetes, heart disease, stroke and seizures, a Stanford University report on the Health and Health Care of Asian-Americans found.

Pol-Lim argues that a litany of problems she sees—chronic disease rates, low educational attainment, and even shorter life expectancy—can be linked back to unaddressed PTSD. “I haven’t seen a weekend where I don’t attend a funeral, and it’s sad, because they didn’t get to tell their story,” Pol-Lim said.

Second Generation Risk

Second generation Cambodian immigrants are often touched by the tragedy as well, said Eria Myers, the INC Program Coordinator for Pacific Asian Counseling Services (PACS) in Long Beach. According to the National Institute of Mental Health, PTSD can even develop if the harm happened to a loved one. One trend Myers sees among younger Cambodian-Americans in Long Beach is that they may get bad grades or don’t pursue college and often become disaffected.

Myers can empathize. Her mother, who lived in Cambodia when she was young, witnessed decapitations by Khmer Rouge and was forced to work in a concentration camp, where she became malnourished. Many of their relatives were killed. After emigrating to the U.S. when she was in her mid-20s, she suffered nightmares and flashbacks. Later, her mother sought psychiatric care.

“This is close to my heart,” she said, “When they come in, it is groundbreaking and I see huge change as they continue to seek help for their problems.” PACS offers traditional counseling services focused on sharing experiences, struggles, and successes.

One case, Myers said, was notable. A woman came to the PACS suffering from severe depression, chronic medical problems and had a history of domestic violence. She had PTSD, recurrent anxiety and insomnia, diabetes, hypertension, and severe headaches. The staff members helped the woman detach from her abusive relationship and assisted her in finding suitable housing. The clinician developed a treatment plan to focus on reducing depression. She learned meditation. Now, Myers reports, she is living in a safer environment and she receives ongoing medical care for her many chronic illnesses.

Finding Solace

PACS also offers nontraditional services as well, such as massage and acupuncture, and a “blessing ceremony.” “In the Buddhist tradition, there is a belief that if they did something wrong in their previous life that would contribute to their hardship and struggle, so they go to the temple to ask forgiveness,” she said.

Cambodians in Long Beach also find spiritual sustenance in friendships. Studies have shown that people who have strong connections to a community are less likely to suffer from mental illness and stress-related health problems. Socheat Kuch set up the Mietophoum Khmer Spirit Center, a cozy place packed with books on philosophy, Cambodian literature, and music to be a refuge. Kuch offers translation services to people who walk in and the center regularly hosts weddings and cultural ceremonies. “When they need something, they come here,” said Kuch, “They aren’t alone anymore.”