H2M: a GP-focused multidisciplinary team for patients living with HIV and hepatitis C

Sternhell, Peter; Landstra, Jodie; Andersson-Noorgard, Kurt

doi:10.1177/1039856211432477

Cited by 3 publications

(10 citation statements)

References 14 publications

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“…In terms of treatment modalities, 2 of the 10 studies involved interventions that integrated HIV and mental health services (Curran et al 2011, Duffy et al 2014) while in one other study, these services were also integrated with Hepatitis C treatment (Sternhell et al 2012). Three studies involved interventions that integrated HIV, mental health and substance abuse services (Daughters et al 2010, Leclerc et al 2005, Woods et al 1998 while three other study interventions integrated these services along with primary (Taylor 2005), and risk reduction services (Rosenberg et al 2010).…”

Section: Meso-levelmentioning

confidence: 99%

“…In four of these studies however, off-site referrals were made only when the patient required more specialized mental health or HIV services (Daughters et al 2010, Curran et al 2011, McCarthy et al 1992, Sternhell et al 2012. For example, in one of the interventions that combined a brief behavioural activation approach and cognitive behavioural approach to treat depression and improve HIV medication adherence, patients were only referred for psychiatric treatment at a different facility when they were diagnosed with a psychiatric condition (Daughters et al 2010).…”

Section: Meso-levelmentioning

confidence: 99%

“…In 10 of the studies, services were integrated via inter-agency collaborations or mechanisms for external referrals to an intermediary: a collaborating agency or a collaborative network of providers. Nine of the studies were conducted in a high-income country, six of which in the USA (Curran et al 2011, Daughters et al 2010, Woods et al 1998, Wood 2008, Taylor 2005, Rosenberg et al 2010, one in Australia (Sternhell et al 2012), one in France (Leclerc et al 2005) and one in UK (McCarthy et al 1992); one study was conducted in a low-income country, Zimbabwe (Duffy et al 2014). Nine studies were reported in full papers and one was a conference abstract (Duffy et al 2014).…”

Section: Meso-levelmentioning

confidence: 99%

“…Nine studies were reported in full papers and one was a conference abstract (Duffy et al 2014). Of these, there were four descriptive studies (Woods et al 1998, Wood and Austin 2009, Sternhell et al 2012, Taylor 2005, two case-series (Daughters et al 2010, Leclerc et al 2005, two RCTs (Curran et al 2011, Rosenberg et al 2010, one non-randomized intervention study (McCarthy et al 1992) and one mixed-methods study (Duffy et al 2014).…”

Section: Meso-levelmentioning

confidence: 99%

“…In most of the studies, integration of services generally occurred via established referral systems between facilities or agencies that provide separate services (Duffy et al 2014, Sternhell et al 2012, Rosenberg et al 2010, Daughters et al 2010, McCarthy et al 1992, Taylor 2005). In four of these studies however, off-site referrals were made only when the patient required more specialized mental health or HIV services (Daughters et al 2010, Curran et al 2011, McCarthy et al 1992, Sternhell et al 2012.…”

Section: Meso-levelmentioning

confidence: 99%

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Interventions and approaches to integrating HIV and mental health services: a systematic review

Haldane

Cervero-Liceras

Ong

et al. 2017

European Journal of Public Health

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Background: The frequency in which HIV and AIDS and mental health problems co-exist, and the complex bi-directional relationship between them, highlights the need for effective care models combining services for HIV and mental health. Here, we present a systematic review that synthesizes the literature on interventions and approaches integrating these services. Methods: This review was part of a larger systematic review on integration of services for HIV and non-communicable diseases. Eligible studies included those that described or evaluated an intervention or approach aimed at integrating HIV and mental health care. We searched multiple databases from inception until October 2015, independently screened articles identified for inclusion, conducted data extraction, and assessed evaluative papers for risk of bias. Results: Forty-five articles were eligible for this review. We identified three models of integration at the meso and micro levels: single-facility integration, multi-facility integration, and integrated care coordinated by a non-physician case manager. Single-site integration enhances multidisciplinary coordination and reduces access barriers for patients. However, the practicality and costeffectiveness of providing a full continuum of specialized care on-site for patients with complex needs is arguable. Integration based on a collaborative network of specialized agencies may serve those with multiple co-morbidities but fragmented and poorly coordinated care can pose barriers. Integrated care coordinated by a single case manager can enable continuity of care for patients but requires appropriate training and support for case managers. Involving patients as key actors in facilitating integration within their own treatment plan is a promising approach. Conclusion: This review identified much diversity in integration models combining HIV and mental health services, which are shown to have potential in yielding positive patient and service delivery outcomes when implemented within appropriate contexts. Our review revealed a lack of research in lowand middle-income countries, and was limited to most studies being descriptive. Overall, studies that seek to evaluate and compare integration models in terms of long-term outcomes and cost-effectiveness are needed, particularly at the health system level and in regions with high HIV and AIDS burden.

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Section: Meso-levelmentioning

confidence: 99%

Section: Meso-levelmentioning

confidence: 99%

Section: Meso-levelmentioning

confidence: 99%

Section: Meso-levelmentioning

confidence: 99%

Section: Meso-levelmentioning

confidence: 99%

See 3 more Smart Citations

Interventions and approaches to integrating HIV and mental health services: a systematic review

Haldane

Cervero-Liceras

Ong

et al. 2017

European Journal of Public Health

View full text Add to dashboard Cite

show abstract

Interventions and approaches to integrating HIV and mental health services: a systematic review

Chuah

Haldane

Cervero-Liceras

et al. 2017

Health Policy and Planning

121

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BackgroundThe frequency in which HIV and AIDS and mental health problems co-exist, and the complex bi-directional relationship between them, highlights the need for effective care models combining services for HIV and mental health. Here, we present a systematic review that synthesizes the literature on interventions and approaches integrating these services.MethodsThis review was part of a larger systematic review on integration of services for HIV and non-communicable diseases. Eligible studies included those that described or evaluated an intervention or approach aimed at integrating HIV and mental health care. We searched multiple databases from inception until October 2015, independently screened articles identified for inclusion, conducted data extraction, and assessed evaluative papers for risk of bias.ResultsForty-five articles were eligible for this review. We identified three models of integration at the meso and micro levels: single-facility integration, multi-facility integration, and integrated care coordinated by a non-physician case manager. Single-site integration enhances multidisciplinary coordination and reduces access barriers for patients. However, the practicality and cost-effectiveness of providing a full continuum of specialized care on-site for patients with complex needs is arguable. Integration based on a collaborative network of specialized agencies may serve those with multiple co-morbidities but fragmented and poorly coordinated care can pose barriers. Integrated care coordinated by a single case manager can enable continuity of care for patients but requires appropriate training and support for case managers. Involving patients as key actors in facilitating integration within their own treatment plan is a promising approach.ConclusionThis review identified much diversity in integration models combining HIV and mental health services, which are shown to have potential in yielding positive patient and service delivery outcomes when implemented within appropriate contexts. Our review revealed a lack of research in low- and middle- income countries, and was limited to most studies being descriptive. Overall, studies that seek to evaluate and compare integration models in terms of long-term outcomes and cost-effectiveness are needed, particularly at the health system level and in regions with high HIV and AIDS burden.

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Mapping the effectiveness of integrating mental health in HIV programs: a scoping review

Conteh

Latona

Mahomed

2023

BMC Health Serv Res

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Introduction Mental health and substance abuse issues are increasing among HIV-positive people, and it negatively impacts health outcomes like engagement, retention in HIV care, and adherence to ART. Thus, national ART programs must include mental health management. The scoping review sought to map evidence on the efficacy of combining HIV and mental health care. Methods The Arksey and O’Malley methodological framework was used to map the existing research on integrating HIV and mental health services to identify knowledge gaps. Two independent reviewers screened articles for inclusion. Studies on HIV-mental health integration were considered. We searched numerous sources, extracted data, and summarized publications by integration model and patient outcomes. Results Twenty-nine articles met the criteria for this scoping review. Twenty-three studies were from high-income countries, with only six from low and middle-income countries in Africa (Zimbabwe 1, Uganda 3, South Africa 1, and Tanzania 1). Most of the literature discussed single-facility integration although multi-facility and integrated care through a case manager was researched as well. There was a reduction in depression, alcohol use, increased social function, decreased self-reported stigma, decreased psychiatric symptoms, and improved mood in PLHIV who received cognitive behavioral therapy in settings implementing integrated care. When providing integrated mental health services to PLHIV, healthcare workers reported feeling more comfortable discussing mental illness. Personnel in the mental health field reported less stigma and increased PLHIV referrals for mental health services due to integrated HIV and mental health care. Conclusion According to the research, integrating mental health services into HIV care improves the diagnosis and treatment of depression and other mental disorders related to substance abuse in PLHIV.

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H2M: a GP-focused multidisciplinary team for patients living with HIV and hepatitis C

Abstract: Over eight years, H2M has become a well utilized and valued specialty team with over 1,200 referrals in that time. Patients with other chronic health conditions, such as diabetes, cardiac and renal disease, could benefit from a similar service model.

Cited by 3 publications

References 14 publications

Interventions and approaches to integrating HIV and mental health services: a systematic review

Interventions and approaches to integrating HIV and mental health services: a systematic review

Interventions and approaches to integrating HIV and mental health services: a systematic review

Mapping the effectiveness of integrating mental health in HIV programs: a scoping review

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