Integrating mental health services into human immunodeficiency virus clinics: Lessons from task-sharing between clinical and lay healthcare providers in Ethiopia.

Journal: The Ethiopian journal of health development = Ya'Ityopya tena lemat mashet

Volume: 34

Issue: 1

Year of Publication: 

Affiliated Institutions:  U.S. Centers for Disease Control and Prevention- Ethiopia, Addis Ababa, Ethiopia. U.S. Agency for International Development- Ethiopia, Addis Ababa.

Abstract summary 

Globally, mental health problems are more common among people living with human immunodeficiency virus (PLHIV) than among the general population. Mental health problems affect human immunodeficiency virus (HIV) treatment adherence and retention. To address this challenge, partners used a task-sharing approach among lay healthcare works and clinicians to integrate mental health services into HIV services at pilot hospitals in the Amhara and Tigray regions of Ethiopia. In this model, trained lay healthcare workers proactively screened patients using a mental health screening tool and subsequently linked potential clients with trained clinicians working at HIV clinics for further diagnosis and treatment.We retrospectively gathered secondary data, including demographic characteristics and diagnosis information, from mental health clinicians' and case managers' quarterly reports from HIV clinics during the implementation period (January 1, 2013 to March 31, 2014).During the initial three-month implementation period of the project (January to March 2013), case managers screened 5,862 PLHIV for mental health disorders. Case managers referred 687 (11.7%) patients with suspected mental health disorders to clinicians for further evaluation and management. Of the total patients screened by case managers in this period, clinicians confirmed that 454 (7.7%) had a mental health disorder. Overall, the concordance between the case managers' screening results and the clinicians' diagnoses was 67.8% over the 15-month pilot implementation period.Routine screening of PLHIV for mental health disorders helps to proactively identify and manage patients with co-morbidities. The integration of mental health services into HIV care through a task-sharing approach is a feasible strategy that could increase access to mental health services among PLHIV.

Authors & Co-authors:  Ahmed Ismael I Weldegebreal Teklu T Mekonnen Alemayehu A

Study Outcome 

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Statistics
Citations :  Ciesla JA, Roberts JE. Meta-analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry. 2001;158(5):725–30.
Authors :  3
Identifiers
Doi : 
SSN : 1021-6790
Study Population
Male,Female
Mesh Terms
Other Terms
Africa;Ethiopia;HIV;Mental health;integration;task-sharing
Study Design
Case Study,Cross Sectional Study
Study Approach
Country of Study
Ethiopia
Publication Country
Ethiopia