Vancouver, BC (October 3, 2016) Among a sample of individuals living with HIV-of which a significant portion are part of key vulnerable and harder-to-reach populations-over half (54%) had concurrent mental illnesses. Recent media reports in Vancouver have pointed to a growing demand for mental health services in general, with fears that needs may outpace current capacity.
Ongoing research from the BC Centre for Excellence in HIV/AIDS (BC-CfE) suggests optimizing mental health care and treatment could be an important and beneficial part of comprehensive care for individuals living with HIV.
Published in AIDS Care, the study found the most common forms of reported mental health disorders were mood disorders (85%), followed by anxiety disorders (65%), psychotic disorders (7%), personality disorders (4%), eating disorders (3%) and dementia (3%). The high proportion of mental health disorders may be reflective of the sample, which included a significant portion of harder-to-reach populations who may also experience higher prevalence of hepatitis C, illicit drug use and other health complications.
Previous research has found, in comparison to the general population, people living with HIV and AIDS are 2 to 10 times more likely to have at least one concurrent mental health condition. Of the 917 individuals included in this study (surveyed between 2007 and 2010), those who had two or more mental health diagnoses were more likely to report stigma and discrimination, financial insecurities, medical worries, and previous experiences of violence and sexual trauma.
“Improving the underlying mental health of these individuals may be a very effective way of minimizing future harm,” said Dr. Robert Hogg, a Research Scientist with the BC-CfE and a senior author on the paper.”Addressing mental health issues improves access to care and, as a result, reduces future rates of HIV/AIDS morbidity and mortality.”
Another recent BC-CfE study, published in Drug and Alcohol Dependence, found concurrent mental illness was independently associated with increased barriers to accessing health and social services among people who inject drugs (PWID) in Vancouver. Health services included counsellors, drug treatment facilities, dentists, and doctors; social services involved housing, food services, welfare, and social workers.
Mental health conditions were associated with increased barriers to accessing services, even among individuals in addiction treatment. This finding suggests a strong need to link patients within addiction treatment programs to mental health services.
“Future efforts are needed to strengthen the interaction between HIV care and addiction treatment,” said Dr. Bohdan Nosyk, Research Scientist at the BC-CfE and senior author on the paper.”Targeted strategies to seek and treat mental health conditions in settings that serve people who inject drugs will improve the effectiveness of publicly-funded health and social services.”
HIV and HCV among PWID were not independently associated with barriers to accessing care. Previous BC-CfE research has shown the number of PWID with HIV who achieved an undetectable viral load through consistent access to antiretroviral treatment increased from 30% in 2006 to 71% in 2012. It should be noted, uptake of hepatitis C treatment among this population remains low.
Recent BC-CfE results suggest a need to increase focus on optimizing mental health management as part of the continuum of care for people living with HIV and AIDS.”As life expectancy for people living with HIV continues to improve, as a result of our made-in-BC HIV Treatment as Prevention¨ (TasP¨) strategy, it is critically important to optimize the management of concurrent illnesses,” said Dr. Julio Montaner, Director of the BC-CfE.”The promise of an AIDS-free generation is within reach in BC; however, further efforts to optimize the management of concurrent illnesses, including mental illnesses and viral hepatitis, will be needed to ensure nobody is left behind.”