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Culture-Specific Mental Health Intervention The Mental Health HIV Services Collaborative (MHHSC) Program

Culture-Specific Mental Health Intervention The Mental Health HIV Services Collaborative (MHHSC) Program. Maria Madison, Abt Douglas Fuller, Abt. Session Participants. Maria Madison, Abt Vivian Brown, Prototypes

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Culture-Specific Mental Health Intervention The Mental Health HIV Services Collaborative (MHHSC) Program

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  1. Culture-Specific Mental Health InterventionThe Mental Health HIV Services Collaborative (MHHSC) Program Maria Madison, Abt Douglas Fuller, Abt

  2. Session Participants • Maria Madison, Abt • Vivian Brown, Prototypes • Eustache Jean Louis & Gemima St. Louis – Center for Community Health, Education & Research • Gabriela Garcia, Abt • Nelson Jim, Native Circle • Abdin Noboa-Rios, IQ Solutions • Douglas Fuller, Abt

  3. Presentation Goals • Describe the MHHSC Program • Components • Context • Relevance • Convey: • The process of this collaborative. utilization-focused evaluation • Accomplishments to date (products) • Uses of the outputs of products

  4. Substance Abuse Mental Health Services Administration(SAMHSA) • Center for Mental Health Services (CMHS) • Center for Substance Abuse Prevention (CSAP) • Center for Substance Abuse Treatment (CSAT)

  5. SAMHSA HIV/AIDS HISTORY • Prior to 2001: CSAT funds targeted capacity/HIV/AIDS Substance Abuse treatment programs for African American, Hispanic/Latino, and other racial/ethnic minorities. • 2001: CMHS funds a similar targeted/expanded capacity program for community based organizations (CBOs) serving African American, Hispanic/Latino, and other racial/ethnic minorities.

  6. HIV Infection among People with Severe Mental Illness Across all published studies, the rate of HIV infection among psychiatric patients is 10%, 25 times higher than that of the general population. Cournos & McKinnon, 1997;Krakow et al., 1998;Rosenberg et al., 2001

  7. Sexual Risk Behavior Among People With Severe Mental Illness: COMPARED TO GENERAL POPULATION, PATIENTS HAVE FEWER EPISODES OF SEX WITH A PARTNER, BUT THEY HAVE: •  Number of partners •  Number of risky or anonymous partners •  Frequency of sex trading •  Rates of coerced sex • McKinnon et.al., 1996, 1999

  8. Psychiatric Disorders and Risk for HIV Infection • Elevated risk for HIV infection in psychiatric • Patients • Risk factors: • Alcohol and other drug use • Unsafe sex • Environmental circumstances (poverty, institutionalization, etc.) • Substance use is associated with both psychiatric symptoms and HIV risk

  9. MHHSC Program • 21 Mental Health Service Sites – CBOs • at least 2 years experience in behavioral health care services • MH Centers, Substance Abuse facilities, • Primary Health Care &/or HIV/AIDS clinics • Abt Associates, Inc. = Coordinating Center

  10. MHHSC Program • Congressional requirement (CBC & CHC): provide these new HIV/AIDS-related mental health services in both traditional and non-traditional settings. • Funding for mental health treatment services and related case management only. • However, grantees are required to develop comprehensive integrated individual treatment plans and monitor primary and substance use treatment.

  11. WHO ARE THE SERVICE SITES? • New HIV/AIDS-Related Services • New services (no prior HIV/AIDS-related MH services)– 5 sites • Expanded services – 16 sites • Service Delivery Settings • Traditional (primarily clinic-based) – 13 sites • Non-traditional (e.g., mobile treatment, ) – 1 site • Both settings – 8 sites • Target Populations • African American -19 sites • Hispanic/Latino – 14 sites • Haitian – 1 site • Native American – 1 site

  12. Demographics – Gender

  13. Demographics – Race / Ethnicity Hispanic Latino/a = 30.65%

  14. Demographics - Age

  15. DSM IV Diagnoses

  16. DSM IV Diagnoses Categories

  17. MHHSC Program Goals • Expand • Effective • Culturally Competent • Mental Health Services • For PLWHIV • In Minority Communities

  18. MHHSC CULTURAL COMPETENCE Mission: To address cultural competence within the MHHSC program as it pertains to client services, program development and evaluation.

  19. MHHSC Cultural Competence • Engaging and utilizing key stakeholders: • Local site-specific evaluators • Local site clinicians • Program Administrators • Consumer Networking Committee (CNC)

  20. Rollout to Sites Recommendations Submission to Subcommittees and CNC Identification of Relevant Issues and Strategies For Addressing Issues MHHSC Cultural Competence Collaborative Process Cultural Competence Subcommittee (CCSC)

  21. MHHSC Cultural Competence • Mission: To address cultural competence within the MHHSC program as it pertains to client services, program development and evaluation.

  22. MHHSC Cultural Competence • Goals of evaluation: • Inform program development • Enhance services to consumers • Improve organizational and client level outcomes

  23. MHHSC Cultural Competence • Steps in creating evaluation approach: • Identified process and outcome measures of interest across the sites • Reviewed approaches used in site specific evaluations • Determined what was measurable and feasible; • Reviewed and identified measurement approaches

  24. MHHSC Cultural Competence • HRSA/Lewin Group Report: • Critical Areas • Focus Areas • Indicators

  25. MHHSC Cultural Competence • Recommendations – Phase 1 Analytical Framework: • Domains • Initial focus areas, • Questions • Indicators, and • Data collection sources

  26. MHHSC Cultural Competence • Next Steps: • Site Visit Protocols • Pilot Testing • Focus Groups • Cultural Competence Inventory/Survey • Next phase of analytical framework

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