The social organization of HIV/AIDS care in treatment programmes for adults with serious mental illness

• Published in: AIDS care 2003-12, Vol.15 (6), p.763-774
• Main Authors: Wright, E. R., Martin, T. N.
• Format: Article
• Language: English
• Subjects: Acquired Immune Deficiency Syndrome; Acquired Immunodeficiency Syndrome - psychology; Acquired Immunodeficiency Syndrome - therapy; Adolescent; Adult; Adults; Aged; AIDS; AIDS/HIV; Attitude of Health Personnel; Biological and medical sciences; Care; Community Mental Health Services - organization & administration; Delivery of Health Care - organization & administration; Female; Health care; Health Care Services; Health Professions; HIV; HIV Infections - psychology; HIV Infections - therapy; Hospitals, Psychiatric - organization & administration; Human immunodeficiency virus; Humans; Indiana; Male; Medical sciences; Mental disorders; Mental Disorders - psychology; Mental Disorders - therapy; Mental health; Mental health professionals; Mental Health Services; Mental Health Services - organization & administration; Mental Illness; Mentally ill people; Middle Aged; Organization of mental health. Health systems; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Severely; Social organization; Social psychiatry. Ethnopsychiatry; Social Workers; Society; USA
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540120310001618612

As the HIV epidemic expands within the mental health system, mental health professionals (MHPs) are under increased pressure to provide more HIV-related care to clients in treatment for serious mental illness. Scientific understanding of MHPs' readiness to provide these services, however, is limited. This paper examines the distribution of HIV care experience, HIV care-related knowledge, and related attitudes among 524 MHPs employed in three CMHCs and two state psychiatric hospitals in central Indiana. The results indicate that both clinical experience and subjective readiness to provide HIV care are concentrated among a few MHPs - primarily gay, lesbian, or bisexual (g/l/b) staff - within each facility. This informal system for organizing HIV care highlights the unique contributions g/l/b staff members make both in providing direct HIV care and in making sure that HIV-related issues are addressed in mental health settings. The implications of g/l/b staff members' "gate making" function for improving the provision of HIV-related mental health services are discussed.