August 29, 2017
Over the course of their entire lives, persons living with HIV/AIDS are greatly impacted by mental health concerns at staggering levels. Nearly 50% experience significant anxiety in any given year. Up to 60% experience symptoms of a depressive disorder in a twelve-month period. The suicide rate among people living with HIV is twice that of the general population, and 40% of HIV-related suicides occur in the first twelve months after diagnosis, an especially risky period for mental health concerns. Mental health professionals who are specifically trained in HIV/AIDS have provided critical assistance over the entire course of the epidemic. But a program (aka Mental Health Care Provider Education in HIV/AIDS Program) that provides this essential training via the HIV/AIDS & Mental Health Training Resource Center has just been eliminated from the proposed 2018 federal budget and must be restored.
The mental health practitioner's role has become more meaningful because the complexities of HIV/AIDS treatment necessitate access to psychological care, especially as it relates to aspects such as medication adherence. Mental health practitioners need specific training in working with HIV-affected populations. The Center has sought to address the overlap between mental disorders and HIV/AIDS through a program designed to educate clinicians in the neuropsychiatric, ethical, adherence and psychosocial aspects of HIV/AIDS. Over more than thirty years, this program has trained over 130,000 social workers, psychiatrists, psychologists and allied behavioral health providers through professional education and training activities in all 50 states and U.S. territories.
The Center, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and managed by Education Development Center, is a collaboration of the American Psychiatric Association, the American Psychological Association, and the National Association of Social Workers' HIV/AIDS Spectrum Project. In rural, suburban and urban communities across the U.S., social workers, substance use counselors and outreach workers, as well as adult services workers, AIDS services and community clinic staff and mental health providers (including psychiatrists and psychologists) are on the frontlines of HIV prevention, care and treatment. Even as medical developments change the shape of the HIV epidemic, people living with HIV continue to experience greatly increased risk of serious mental concerns. This is especially true now with an aging population of people living with HIV whose needs continue to expand.
Through its efforts, the HIV/AIDS & Mental Health Training Resource Center is helping to build a skilled and resilient workforce ready to respond to a health crisis (such as the growing opioid epidemic), committing itself to prevention efforts that keep clients and patients healthier and, ultimately, reducing the burden on systems and health care costs. A workforce that is trained to connect HIV prevention, substance use awareness and physical and mental health wellness is a workforce dedicated to building stronger youth, stronger families and healthier communities. This is the type of workforce necessary to support the National HIV/AIDS Strategy.
Our representatives need to know that it is important for providers to understand the mental health and behavioral health aspects of HIV/AIDS prevention and treatment. Why is training still needed?
The Center has accumulated a rich library of materials, all of which are available online and all of which are designed for mental health professionals. For example, the archive includes practice briefs on timely topics such as health care providers' role in HIV and tobacco use. Numerous webinars have been produced on issues ranging from improving clinical conversations concerning sex to pre-exposure prophylaxis (PrEP), to high-risk clients. Other webinars have focused on high-risk groups such as women, youth, the homeless and rural populations. Apart from webinars, online courses provide critical information on topics such as cognitive disorders and HIV, and HIV and health care disparities. Finally, an HIV and aging toolkit comprising written materials, videos and references is available to help practitioners improve care for this growing population. (Disclosure: I was a consultant for several webinars and the aging toolkit.)
How can you help?
The U.S. Congress is still creating this year's budget, which in FY 2017 had included just over $700,000 for SAMHSA to administer this vital education program. The Senate Appropriations Committee needs to hear from all of us! Let your elected member know that it is important to you -- to your family, your clients and your community -- to continue funding the Mental Health Care Provider Education in HIV/AIDS Program by including it as an item in the SAMHSA's FY 2018 budget request. Here's what you can do:
David Fawcett, Ph.D., L.C.S.W., is a substance abuse expert, certified sex therapist and clinical hypnotherapist in private practice in Ft. Lauderdale, Florida. He is the author of Lust, Men and Meth: A Gay Man's Guide to Sex and Recovery.
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