Training sessions regarding mental health were the main method we used for building capacity among our medical staff. The topics of these trainings were tailored to meet the needs of medical staff based off pre-implementation interviews and included how to recognize, diagnose, and treat depression, suicide and violence risk assessment, identifying and treating post traumatic stress disorder (PTSD) and identifying and treating bipolar disorder in people living with HIV. These trainings were given in the form of educational seminars and were attended by social workers, nurses and physicians.
Overall, there were a total of 1092 re-measurements among the 524 patients. Of these 1092 re-measurements, 791 (72.4%) resulted in a score that indicated the need for treatment augmentation as defined by the algorithm (see Figure 1). Treatment was augmented at 340 (42.7%) of these occurrences, and was not augmented at 451. Reasons why patients’ treatment plans were not augmented when the algorithm indicated a change, include being unable to meet with the BHC, continuing adherence to previous recommendations, the patient being unwilling to meet with the BHC, the PHQ 9 being performed somewhere other than the HIV clinic, and that the patient was already engaged with mental health services elsewhere (Table 2).