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For people with HIV who have psychological comorbidities, effective management of mental health issues is crucial to achieving and maintaining viral suppression. A new study within the Program Refinements to Optimize Model Impact and Scalability based on Evidence (PROMISE) study evaluated an HIV Coordinated Care Program (CCP) for Ryan White Part A clients in New York City. Providers and clients agreed that insufficiently managed mental health issues are a common barrier to achieving and maintaining viral suppression. These findings suggest the potential value of formally integrating mental health services into HIV care coordination provision.
“The findings from qualitative interviews conducted with providers and recipients of HIV care coordination services highlight the strong emotional bonds that patient navigators frequently develop with their clients and how these relationships, along with the informal, but meaningful emotional support navigators routinely provide for their clients, are central to the effectiveness of care coordination, particularly for clients managing mental health issues,” says Research Associate Professor Honoria Guarino. “Moving forward, HIV care coordination programs may benefit from formally recognizing frontline providers’ emotional support work as a documentable service category and instituting corresponding mechanisms for reimbursement, training, and supervision.
“The current study highlights the importance of mental health in HIV/AIDS care coordination programs. Patients will struggle to adhere to treatment plans and manage their care if their mental health is not prioritized and most of that responsibility falls on their patient navigators,“ says first author, Miguel Hernandez. “However, patient navigators mentioned many times that there were systemic barriers to providing adequate mental health services in their programs. For example, navigators did not have counseling or mental health training. Providing emotional support was not part of their original job descriptions, but it is an inevitable part of the job. Systems and programs must prioritize mental health and ensure navigators are trained in the correct competencies and that there is structure to support adequate mental health services within an HIV/AIDS care coordination program.”
