SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements:
Volume 3, Issue 16 (August 7, 1998)

This document has been superceded by our Online Knowledge Base on Innovative Models of HIV/AIDS Care. Click here to access the Knowledge Base. Click here to access descriptions of 27 Innovative Models of HIV/AIDS Care and the lessons learned from these projects. SPNS/Fax was written, published, and distributed by fax by The Measurement Group between 1995 and 1998.

Information dissemination from 27 Innovative Models of HIV Care projects funded as Special Projects of National Significance by the HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration (HRSA).

Introduction

Welcome to SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements. In each issue of SPNS/Fax, we will highlight findings from the HRSA Special Projects of National Significance Program Cooperative Agreements. The projects have been funded to develop innovative models of HIV/AIDS care. SPNS/Fax reports are distributed every two weeks by fax machine to all subscribers. All issues of SPNS/Fax are also available at this Web site. Due to slight differences in the media, issues distributed by fax machine may appear slightly different from those posted on this Web site, but the content is identical.

HIFY Report Discusses Mental Health Needs for Youth with HIV

Health Initiatives for Youth (HIFY) aims to improve HIV services for youth. Between August 1997 and February 1998, HIFY conducted twenty, unstructured, face-to-face interviews with mental health service providers in San Francisco and Los Angeles, California, to examine common psychological issues affecting HIV-positive youth. A report on the findings from these interviews, entitled Mental Health Services and the Changing Needs of Youth with HIV, has recently been released by the project.

For many HIV-positive youth, mental health issues existed before knowledge of their HIV infection. For others, the issues arose as a result of learning their HIV status. In either case, learning one's HIV status or coping with the consequences can exacerbate mental health disorders in young people. Many HIV-positive youth experience depression and anxiety, and providers report working with a significant number of HIV-positive youth diagnosed with Bipolar Affective Disorder and Adjustment Disorder. Contributing to the complex nature of these disorders are issues related to abuse – physical, emotional and sexual – and drug use. Typical behaviors stemming from these mental health problems include denial, high-risk sexual activity, physical violence and aggression, self-mutilation, and substance abuse.

To improve mental health services for HIV-positive youth, providers recommended targeting several areas. Ideally, mental health services should be closely linked with primary medical care and ancillary services. Emergency shelter and transitional housing, as well assistance with completing high school and to go on to college, were services that providers wanted to see expanded. Because not all HIV-positive youth have identical needs, mental health services must be designed to meet the needs of young people with unique issues. For example, homeless youth often need a wide range of services, such as housing and substance abuse treatment, to stabilize their lives. Those youth with more stable lifestyles need support to reduce isolation.

Summary of Recommendations to Improve Mental Health Services for Youth

  • Create comprehensive service networks linking primary medical care and ancillary services

  • Tailor mental health services to be culturally and age appropriate and meet the needs of different youth

  • Incorporate peers into the delivery of mental health services by developing peer counseling components and other similar methods of youth involvement

  • Adapt innovative services to attract youth and retain them in care

  • Address Aging In and Out of Services to help youth navigate the larger HIV service system

Providers also addressed the importance of peer involvement in service delivery. It has been shown that youth living with HIV can have a powerful impact on the lives of other young people. Several providers discussed the issues surrounding utilization of peers, especially when peer staff are dealing with the same issues as the clients they serve. When using peers as providers, it is necessary to develop flexible internal policies that accommodate the needs of HIV-positive peer staff, and to educate adults about the ability of youth to provide services. Another key issue for young people is when they "age out" of the adolescent services system: such youth may feel disappointment, abandonment, resentment, and anger. Therefore, it is critical that a care plan be developed to make their transition smooth and allows these young people the opportunity to establish relationships within the adult service delivery system.

For a copy of the report or for further information contact James Colgrove, Health Initiatives for Youth, 1242 Market Street, 3rd Floor, San Francisco, CA, 94102, 415.487.5777, 415.487.5771 (fax), colgrove@hify.com (e-mail).

SPNS/Fax is produced by The Measurement Group–PROTOTYPES Evaluation and Dissemination Center (EDC). Editorial comments should be made to The Measurement Group at 5811A Uplander Way, Culver City, California 90230, 310.216.1051, 310.670.7735 (fax).
 

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