AIDS-Related Services and Training in Outpatient Mental Health Care Agencies in New York

Abstract

Directors of 471 outpatient mental health settings in New York State (82.1 percent of 574 settings located in counties with intermediate to high AIDS case rates) completed a survey about HIV and AIDS services, training needs, and barriers to care. Most of the sites served one to ten persons with HIV infection annually and had staff members who were trained in providing at least one HIV-related service. Nonetheless, 84 percent of the respondents reported unmet needs for training. The likelihood of providing certain services was significantly increased in sites that were in urban locations, primarily served clients with comorbid alcohol or other drug use disorders, lacked funds for providing condoms, had staff members who were trained in HIV and AIDS services, identified particular HIV training needs, believed clients needed condoms, and viewed HIV-related services as very important.

Voluntary HIV Testing Among Adults with Severe Mental Illness: Frequency and Associated Factors

“…Staff training has been identified as the strongest predictor of HIVrelated services, including test counseling, in outpatient mental health care agencies (McKinnon et al, 1999). Integration of HIV prevention into existing mental health services for SMI is a cost-effective strategy (Rothbard et al, 2003).…”

A Multisite Study of the Prevalence of HIV With Rapid Testing in Mental Health Settings

“…51 However, since these recommendations were released, little progress has been made toward integrating HIV testing into mental health care visits. 52–56 Overcoming system-level barriers, including identifying sources of funding for training, credentialing, and procurement of point-of-care rapid HIV testing kits needed for on-site HIV testing, may be required to ensure wider adoption of HIV testing in mental health care settings.…”

Case Managers Discovering What Recovery Means Through an HIV Prevention Intervention

“…These barriers include case manager's concerns regarding confidentiality (Sullivan et al 1999), antiquated beliefs that many SMI persons are asexual, lack of knowledge and skills related to HIV interventions, discomfort with discussions of sexuality, lack of designated funding and lower prioritization of HIV prevention activities as compared to other case management work (Arruffo et al 1996; Brunette et al 2000; Carmen and Brady 1990; Grassi 1996; Knox 1989; Sullivan et al 1999; McKinnon et al 1999; Shernoff 1988; Solomon et al 2007) along with institutional cultures that discourage the systematic addressing of sexual behavior, sexual health, or HIV sexual risk for persons with SMI (Wainberg et al 2007; Blank et al 2008). Case managers often lack the recovery orientation which would allow them to overcome these barriers as outlined by the early leaders of the consumer recovery movement (Deegan 1988; Fisher 1994; Davidson and Strauss 1992; Ridgeway 2001) and more contemporarily promoted by the Substance Abuse and Mental Health Services Administration's (SAMHSA) 2006 consensus statement on mental health recovery.…”