HRSA CARE Action

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U.S. Department of Health and Human Services
Health Resources and Services Administration, HIV/AIDS Bureau
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Photographs
Cover: Clients at the Tarzana Treatment Center, Los Angeles County, CA.
Pp. 3-4: Clients at the Native American Health Center, San Francisco, CA.
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OPENING AVENUES to TREATMENT

“Look to the client, and see what they identify as helpful,” says Armando Smith, chief program officer of Chicago’s Vital Bridges, in discussing how to work with clients who need mental health treatment but are resistant to getting care. “It is important to both recognize that there are differences in how people view mental health treatment and to help folks understand that seeing a mental health professional is just another tool in the toolbox along with churches, support groups, and friends and family.”

In addition to linking clients to mental health professionals, Vital Bridges, which is a Ryan White HIV/AIDS Program–funded agency that provides support services at five locations in the Chicago area, also uses what Smith calls “low-key” mental health interventions. An art therapy group and a Friday afternoon movie group give clients a chance to gather and be with their peers, to talk about issues they are facing, and interact with a mental health professional in a less traditional setting.

Although the art therapy program was conceived as a structured group, it has found more success as a drop-in program with both regular and occasional participants. It is located next to one of the agency’s grocery programs and meets when the pantry is open. Members may “talk for a minute or 10 minutes or not at all. It’s a break, it’s fun, and it serves a purpose in their lives,” says Smith, who also notes that some participants have now asked to see the therapist individually.

The value of social interactions is echoed by Jeff Levy of Live Oak, also in Chicago. Levy, who has been working with PLWHA for many years, says, “I believe that some of my patients have gotten more from their connection with others through community-based supports than sitting with me for an hour. Many of those I see suffer from isolation [that is] often related to changes in their bodies and their appearance, and they need more ways to connect with other people.” Ideas for decreasing social isolation include strengthening connections with family, participating in 12-step meetings, or joining community groups unrelated to HIV.

Levy identifies the aging PLWHA population, many of whom are long-term survivors, as a growing mental health concern. Age is closely linked to issues of isolation, which may be heightened by the loss of significant others and friends to HIV. A study comparing social networks and social isolation in older and younger PLWHA bore out those concerns. The study found that older adults were more likely to live alone; it also found that 38 percent of older adults and 54 percent of older adults of color were at risk for social isolation, compared with 25 percent of study participants ages 20 to 39.42

Whether old or young, newly diagnosed or long-term survivors, many PLWHA will confront mental health challenges. But as Chase-Brexton’s Haltiwanger notes, an HIV diagnosis can spur psychological health: “It can present an opportunity to repair damaged relationships and improve communication. If patients work with a mental health provider, they can cope with their diagnosis and heal those issues that preceded their diagnosis.”

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