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The Making of Medicine

How We Improved HIV Care by Targeting Mental Health

A new study found that our effort to enhance access to mental health services for people living with HIV has improved outcomes among vulnerable patients. Here’s what we did.

Our Ryan White Clinic was able to expand its mental health services back in 2013, thanks to funding from the Health Resources and Services Administration Ryan White HIV/AIDS Program. We increased patients’ access to psychiatry and psychology services and substance-use counseling, and, most importantly, we did it on site, so it was easy and convenient for the patients to take advantage of these services. That made a huge difference: Mental health visits at the clinic jumped from only 385 in 2012 to 1,183 in 2014.

The access to mental healthcare, in turn, made a big difference for many patients. In a new study reviewing the effects, our folks found:

  • Patients who had access to the expanded mental healthcare achieved better HIV outcomes. The rate of viral suppression – when the virus is undetectable in the body – increased from 57 percent to 88 percent. That’s a great improvement on an important benchmark for the patients’ overall health.
  • Older and white patients benefited more than did other patients. Younger and black patients were less likely to achieve viral suppression after beginning mental healthcare, prompting our researchers to question whether there need to be changes in how care and other services are provided to those demographics.
  • The expanded mental healthcare did not significantly change patients’ engagement in their HIV care, as measured by attending at least two HIV medical appointments within a year.
  • After the expansion, more patients had substance use-related diagnoses, possibly because of increased attention and identification by the mental health providers. If we can help the patients with substance use, that’s wonderful as well.

In a new paper outlining the findings, our researchers are urging other clinics to consider enhancing their on-site mental healthcare, if they can. Doing so made a big difference for many of our patients, and we will hope it will have similar benefits in many other places too.

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