Transcript States of Mind - UK-CAB

in the HIV Community:
State of Mind
&
I Am More Than One Thing
Silvia Petretti, Deputy CEO, Positively UK
UKCAB
4 July 2014
Overview of the State of Mind Report
Findings from I Am More Than One Thing
Recommendations
Overview & objectives
About the States of Mind Report
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A collaborative project between Positively UK and Janssen undertaken in 2013
Survey based document providing insights on the mental health of people
living with HIV in the UK today
Basis for recommendations and discussion around the provision of mental
health care to people with HIV
We commissioned the report to learn about:
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The prevalence of mental health issues among people living with HIV
The relationship between mental health and adherence to ART
The impact of stigma and discrimination on the mental health of people living
with HIV
The services accessed by people living with HIV in relation to their
mental health
All content based on the States of Mind Report, 2013.
Methodology and reach
How we surveyed the HIV community
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Survey open between April and July 2013
Responses predominantly online, with some paper surveys completed
Respondents were recruited by patient advocacy groups from across the U
Who did we reach?
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192 people living with HIV: 63% male, 36% female, 1% transgender
54% white British, 25% black African, 21% other
48% homosexual, 40% heterosexual, 12% bisexual/other
All content based on the States of Mind Report, 2013.
What we found…
Three quarters of respondents had suffered from depression,
anxiety or ongoing emotional distress in the previous 12 months.
However, only four in ten respondents had
accessed counselling or psychology services
in the same period.
All content based on the States of Mind Report, 2013.
What we found…
Mental health issues were more common among women
than men of those who responded to the survey.
All content based on the States of Mind Report, 2013.
Women living with HIV and Mental Health
Women in the general population have higher
prevalence of anxiety and depression. (DH 2013:17),
People living with HIV have higher orevalence of
mental health problems (WHO 2008).
Women living with HIV in the UK experience high
levels of Gender Based Violence but little is known of
how this impacts specifically on mental health and
well-being. (Sophia 2013)
I Am More Than One Thing
Report commisioned by the Women and Health
Equality Consortium and produced in collaboration
between Positively UK, Imkaan, and Rape Crisis.
Looking at vulnerable women experiences with
mental health and access to mental health services.
Focus on BME women, refugees, gay bisexual
women, women victims of sexual violence and
women living with HIV
Literary review and focus groups
Focus Group with Women Living with HIV
Attended by 9 women and peer lead.
Diversity of backgrounds: Black African, Black
Caribbean, White European and White British
Years of diagnosis ranged from 3 to 21
Issues identified by women living with HIV
Mental health problems often pre-dated diagnosis
HIV exacerbated existing mental health issues
Mental health diagnosis and referral to appropriate
services were inconsistent
Lack of awareness of mental health symptoms
meant women didn’t seek support
Internalised stigma and self blame amplified negative
feelings: setting obstacles to seeking support
Women living with HIV and Mental Health
- All women in the group had experienced varied
levels of violence
- Cuts in the welfare system and changes in health
provision impacted on levels of anxiety
- Talking therapies, CBT, women only peer groups
were helpful
- Medications ( eg. anti depressants) were also
useful in managing symptoms
What we found…
Some respondents linked their mental health issues to their
difficulties to adhere to ARV treatment.
All content based on the States of Mind Report, 2013.
What we found…
Discrimination and stigma persist and discourage people
living with HIV from disclosing their status.
Four in ten had not disclosed to colleagues.
One in four had not disclosed to their dentist.
All content based on the States of Mind Report, 2013.
Recommendations & the road ahead
• Further research can shed light upon the complex relationship
between the mental health of people living with HIV and their
adherence to ART
• Improved communication between HCPs and people living with
HIV can help both sides towards an improved understanding of
mental health
• People living with HIV should be able to access psychological
services and should be encouraged to do so by their HIV
clinicians
All content based on the States of Mind Report, 2013.
Women living with HIV Recommendations
More in depth research is needed on the intersection
of gender, HIV, GBV and mental health
Mental health screening in healthcare needs to be on
going and not a one off
Importance of women focused commissioning of HIV
health and social services
Crucial role of peer lead groups for support and
advocacy around women mental health issues
Recommendations & the road ahead
Multidisciplinary approach to care is more important than ever
and closer collaboration between services is needed – including
partnership between the NHS, people living with HIV and
community based organisations.
All content based on the States of Mind Report, 2013.
THANK YOU!