Addressing Mental Disorders: The Missing Link to Effective HIV Prevention, Care, Treatment, and Support
Meeting Summary: July 24, 2012
Canadian Institute of Health Research (CIHR)
Department of Health and Human Services (HHS) Office of Global Affairs
New York and New Jersey AIDS Education and Training Center
From July 22-27, 2012 an estimated 24,000 delegates, including people living with HIV/AIDS (PLHIV), researchers, implementers, journalists, policy makers, funders, advocates, and philanthropists from around the world gathered in Washington, DC for the 19th International AIDS Conference. This premier biennial conference seeks to shape the international response to the AIDS epidemic. In conjunction with the International AIDS Conference, CIHR, the HHS Office of Global Affairs, Health Canada, and the New York and New Jersey AIDS Education and Training Center co-hosted a satellite session on July 24, 2012, entitled, “Addressing Mental Disorders: The Missing Link to Effective HIV Prevention, Care, Treatment, and Support,” along with other supporting organizations, including the National Institute of Mental Health, the United States Agency for International Development, the Joint United Nations Programme on HIV/AIDS, and the World Health Organization. Given that mental illness is both a risk factor for and a consequence of HIV/AIDS, the International AIDS Conference provided a unique opportunity to highlight the need to integrate mental health services into HIV/AIDS prevention, treatment, care, and support platforms. Accordingly, researchers, policy makers, advocates, and implementers working in the fields of HIV/AIDS and mental health shared promising models for the integration of mental health services into HIV/AIDS care programs, described challenges, and discussed the way forward for reducing the treatment gap for mental illnesses affecting PLHIV in high-, middle-, and low-income countries.
Former U.S. Ambassador Jimmy Kolker, currently the Principal Deputy Director of the Office of Global Affairs, opened the session by describing the gap between the mental health needs for PLHIV and available care. Francine Cournos, M.D., provided a research overview by highlighting the critical role treatment for mental illness/substance abuse can play in reducing morbidity and mortality, as well as improving the health outcomes for PLHIV with co-occurring mental illness/substance abuse. A diverse set of panelists working in the U.S., Canada, Vietnam, Uganda, and Zimbabwe discussed models, key ingredients, and challenges for integrating mental health treatment into HIV/AIDS programs.
The following themes emerged from the presentations and discussions:
- Task shifting/sharing (a process of assigning tasks to less specialized health workers) is a viable solution for addressing human resource deficiencies in mental health service delivery in low resource settings. Task shifting can be sustainable if health care providers are integrated into the workforce in tandem with other measures, such as continuous training, supervision, and opportunities for upward occupational mobility;
- Comprehensive and effective mental health services (prevention, treatment, care , and support) for PLHIV with co-occurring mental disorders/substance abuse includes biomedical, behavioral, and psycho-social intervention; and,
- Cultural competency in research, including participatory and decolonizing methodological approaches, can inform mental health services aimed at addressing the unique needs for members of ethnic minority groups, including aboriginal populations.
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