The prevalence of depression among people living with HIV/AIDS is nearly two times higher than people who are HIV-negative. Providing support and access to treatment for depression helps improve management of chronic conditions like HIV/AIDS and overall health.
Despite the interdependent relationship between depression and HIV treatment, depression is often underrecognized by medical and community service providers treating this population.
HIV Depression Care Toolkit
To address these barriers, the National Council for Behavioral Health released the HIV Depression Care Toolkit — an online resource that explores the components of the collaborative care model’s systematic integration in primary care settings and how to apply it to treat individuals with depression.
Submit your contact information to access the supporting webinar recordings and slides for this toolkit from integrated health consultant Laura Leone, DSW, MSSW, LMSW.
Additional resources include one free coaching call per organization on a first-come, first-served basis.
Questions? Please contact Ayla Colella at AylaC@TheNationalCouncil.org.
Treatment Option for Patients
Drawing upon clinical guidance developed at the University of Washington, and research evidence from the Cochrane Library, the National Council believes that community mental health providers should implement the collaborative care model as a treatment option for patients living with HIV.
Collaborative care is an evidence-based intervention for adult patients who have a diagnosis of major depression or anxiety, often in conjunction with another major health problem.
This innovative approach is born out of the IMPACT study, the largest depression treatment study to date.
Addressing Depression in Primary Care
Studies have shown that collaborative care is one of the most effective interventions for depression, anxiety disorders and comorbid medical conditions such as heart disease, diabetes and cancer. For patients, this also leads to:
• Less physical pain
• Better functioning
• Higher quality of life
• Greater patient and provider satisfaction
• More cost-effective
Because depression is under-diagnosed and under-treated among patients living with HIV, lack of access to timely, high-quality treatment is one of the greatest barriers to care. With this toolkit, you can examine the core principles and standard framework of integration to conduct depression screening and regular tracking using the collaborative care model.
Educate all Staff: Putting Integration into Practice
Team-based care can improve the patient care process. Prescribers, therapists, case managers, peer specialists and nurses should all regularly discuss medication adherence and the benefits of collaborative care with their patients. Best practices and considerations for talking to patients and families include patient-centered language, tips for open communication among team members, problem-solving patient needs and shared patient care coordination for better decision making.
Dive into Brief Interventions
Regaining a sense of control over one’s life problems is the most important factor for resolving depressive symptoms. Suggested approaches for healthcare staff to know and utilize:
- Behavioral Activation Process: Learn the four steps.
- Cognitive Behavioral Therapy: Walk through examples.
- Motivational Interviewing: Ensure that all staff are trained in effective communication and engagement strategies for empowered decision making.
- Problem-solving Treatment: Tenants and strategies for teaching patients skills they can use in the future to avoid depression.
- Activity Monitoring Worksheet
- Daily Monitoring Form
Additional Resources for Providers
- A suicide screening guide that helps providers identify risk factors.
- Overview of wellness plan to guide patients through monitoring signs and symptoms of depression and warning signs of relapse.
- Documentation best practices of assessment and treatment planning.
Strengthen the Field: Collect, Analyze and Utilize Data
Explore the clinical, programmatic, and operational benefits of data-driven decision making and considerations around the sustainability of practices:
- Utilize electronic health records and data to demonstrate patient improvements in care such as progress toward recovery goal.
- Clinicians, as a group, should review and discuss their individual variation in utilization of the Collaborative Care model periodically. How many ongoing cases can your clinic support at a time given current staffing? What is your average length of treatment? Learn to scale up growth and development for sustaining organizational changes.
Depression Care Collaborative
In 2012, the National Council launched the Depression Care Collaborative – the first of several annual learning communities for community behavioral health organizations committed to systematically using the PHQ-9, an evidence-based depression measurement tool.
In 2015, with the support of myStrength, a digital behavioral health company that provides tools to effectively extend care through web and mobile self-help resources to consumers, the National Council offered expert consultation to help Hill Country MHDD Centers, Community Services Group, Burke and Peak Wellness Center implement clinical and systematic change.