Capacity Building Project: Serving the Mental Health and Substance Abuse Needs of HIV Infected Persons in Texas
In late 2008, DSHS requested a proposal from the University of Texas, School of Social Work to conduct a multi-year capacity building project to serve the mental health and substance abuse needs of HIV-infected individuals in Texas. The project, which began in May 2009, sought to explore the underutilization of services and to assess the capacities in Texas to provide mental health and substance abuse services, with the purpose of establishing a better referral network for individuals diagnosed with HIV and AIDS. The contractor conducted formative research on mental health and substance abuse services in Texas available to individuals diagnosed with HIV infection and AIDS to assess:
- Current practices of state and private mental health providers, including but not limited to physicians, psychologists, and nurse practitioners;
- Availability of mental health services for individuals diagnosed with HIV and AIDS;
- Access to mental health services for individuals diagnosed with HIV and AIDS; and
- Capacity of mental health providers to serve individuals diagnosed with HIV and AIDS.
To achieve this goal, several studies were conducted targeting Administrative Agencies, mental health and substance abuse providers, case management providers and HIV+ clients receiving substance abuse and mental health services. The following themes emerged in every study of the project:
- Stigma - stigma related to HIV status, mental health or substance abuse status, or LGBT identity were all noted as affecting acces to and maintenance of mental health and substance abuse services;
- Assessment tools and assessment skills - all groups stressed the importance of utilizing standardized mental health and substance abuse assessment tools and having the proper training to utilize these tools to refer clients to providers;
- Training - training was recommended specifically on the diagnosis and treatment of mental health disorders (particularly for HIV/AIDS physicians), dual diagnosis, post-traumatic stress disorder (PTSD), and cultural competence in the area of Lesbian, Gay, Bisexual and Transgender (LGBT) issues;
- Client issues and readiness - while all groups discussed client motivation and readiness as impacting access and maintenance of treatment, there were differing opinions amongst the group, most notably between the client group and the other groups;
- Integrated care - factors related to integrated care include integrated MHSA models of treatment, the utilization of multi-disciplinary teams, and service provision within the context of medical care; and
- Resources and networking - all groups reported a need for more substance abuse treatment and mental health services throughout the state, as well as emphasizing a greater value on networking between providers.
Next steps for the project will include recruiting new mental health and substance use disorder providers and compiling a statewide comprehensive resource guide for mental health and substance use services.
View the report executive summary (PDF : 245 kb).