Integration of Mental Health Service in HIV Care At Two Hospitals in Ethiopia

PRESENTATION TYPE: Individual Poster

CATEGORY/THEME: NIDA International Poster Session

TITLE: Integration of Mental Health Service in HIV Care at Two Hospitals in Ethiopia

ABSTRACT BODY:

Introduction: Mental health problems are more than twice as common among people living with HIV (PLHIV) compared to the general population. In one study in Ethiopia, nearly a half of PLHIV were found to be depressed or anxious. Co-morbidity is higher (two-thirds) among people co-infected with HIV and TB. Also, about 30-40% of HIV+ pregnant women and new mothers in Ethiopia reported symptoms of depression. Substance use problems are the most prevalent of mental health problems even more prevalent than depression. Substance use can be harmful even if someone does not become addicted.  It can have an impact on physical health, change behaviours (including promoting risky sexual behaviour and HIV acquisition or transmission), and harm families financially and legally.                                                              

Methods: Before the implementation of the service, Trainers of Trainees (TOT) trainings, basic trainings and onsite trainings on Mental Health and HIV were given to health professionals who had been working in Anti Retro viral Treatment (ART) clinics. A cross sectional study was conducted among 206 PLWHIV assessed for mental health problems at pilot sites, from June 2011 to June 2012. Data was collected by reviewing the patient cards and  register books for the type of  the mental health problems, treatment, counseling and support given by health care providers. Descriptive analysis of the study findings was made.

Results: The report of preliminary results from the two hospitals showed shortly after the training both Pilot sites started identifying and managing cases with mental health problems in chronic care clinics. Out of 206 cases identified over a period of one year, substance use was the commonest disorder (45.6%) followed by depression (16.5%), anxiety/psychotrauma (10.2%), difficulty living with HIV (9%) thought problem (7.3%), others (7%) and epilepsy (4.4%) respectively.            

Conclusions: The pilot project further illustrated how prevalent psychiatric illness is among PLHIV along with the importance and feasibility of mental health service integration in chronic HIV care. Integration of mental health services in HIV chronic care setting is crucial given the magnitude of mental health illness in such setting; it is also feasible to implement with short term training of existing health care providers in the respective clinics and hence, should be adopted as standard of care.