Staff Tools

MIDUS Staff Tools

Use the materials and information we’ve provided in this section to facilitate the development of a shared vision for Collaborative Care.

Integration of Behavioral Health Care into HIV Care

People living with HIV/AIDS experience higher rates of mental illness (than the general population), increased rates of substance abuse, and are more likely to have experienced trauma within their lifetime.

Depression, in particular, has a detrimental effect on physical well-being. Patients struggling with depression have higher viral loads, lower retention rates, poor medication adherence, and overutilization of emergency room visits for care.

Access to mental health services remains a challenge nationally. Novel approaches to providing expert mental health care are desperately needed.

Screening for behavioral health can identify potential issues, but screening is often inconsistent, underutilized and lacks standardized practice to link patients to appropriate resources.

MIDUS HIV Care Continuum

The collaborative care model has been used in other primary care settings to bridge the gaps in depression care. These models have been shown to:

  • Improve access
  • Improve process
  • Improve outcomes

To optimize the MIDUS HIV Care Continuum, it is imperative to integrate behavioral health care into primary HIV settings. After reviewing similar models, we built a collaborative care model which unifies our systems and maximizes the impact on depression for patients living with HIV. Our model includes:

  • Universal annual screenings using PHQ 2/9
  • A positive screen score: 10 or higher
  • Incorporating a Behavioral Health Care Manager (BHM)
  • Use of the PHQ 9 to measure symptoms and response to treatment
  • Proactive telephone calls by BHM to the patient following intervention
  • Electronic registry to systematically monitor outcomes
  • A psychiatrist to provide consultation
  • Stepped care approach: intensifying treatment when symptoms persist