Integrating mental health and HIV care could mean better treatment, longer lives

    (Kasia Bialasiewicz/Bigstock)

    (Kasia Bialasiewicz/Bigstock)

    HIV and mental health issues often travel together, and experts are trying to improve communication between primary care doctors and behavioral health providers.

    Recently, the University of Pennsylvania’s Mental Health AIDS Research Center and Department of Psychiatry held a symposium for people on the front lines of mental health to explain the significant impact HIV has on behavioral health.

    Research has made life better and last longer for people who are HIV positive. But the population has higher than average rates of mental illness. That’s because, in the beginning, HIV disproportionately affected people sometimes stigmatized by the mainstream culture — including gay men, sex workers and intravenous drug users.

    “In terms of HIV itself, mental illness has always traveled with HIV infection, and as we’ve gotten better at treating HIV and we’re able to keep the viral load suppressed and people are doing better, we’re seeing an increasing need for mental health interventions,” said Dr. Francine Cournos, a professor of clinical psychiatry at Columbia and the symposium’s keynote speaker.

    “Yes, we’re saving people, but some of them are dropping out of care … some of the reasons are that they have mental illness.” 

    While HIV-positive people are living longer, those with severe mental illness are not getting the same longevity, she said. People with schizophrenia can die 15 to 25 years sooner, for example.

    Worldwide, depression affects about 30 to 50 percent of those being treated for HIV.

    “The only way we’re going to really be able to address that is if we build health care and mental health care together, into the care of that population,” said Cournos.

    Dr. Michael Blank, professor of psychology at Penn, said Philadelphia has a good chance of integrating those two, citing the Penn Mental Health AIDS research center.

    “And we really think that, together, we can sort of bring Philadelphia forward as a model for the nation,” he said.

    Under the collaborative approach, mental health providers might test for HIV as a matter of routine, potentially diagnosing the problem early enough to help patients live much longer.

     

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