NEW PROGRAM AIMED AT OFFERING HELP TO HIV-INFECTED PEOPLE

In the future, those who provide services for HIV-infected Missourians will be specially schooled in a program developed at Southeast Missouri State University.

The university's College of Health and Human Services has contracted with state health and mental health services to develop a statewide education program for Missouri's Ryan White HIV/AIDS service coordinators.

The three-year project, developed in cooperation with the Missouri Departments of Health and Mental Health, is aimed at improving medical and mental health care access for HIV/AIDS clients. It primarily focuses on how to refer HIV/AIDS patients to the mental health system, said Paul Keys, dean of the College of Health and Human Services.

"Mental health is the missing piece in the services now being provided to these clients," Keys said.

The new education program will help service coordinators know when to refer clients for mental health treatment.

"Right now a lot of these clients are having trouble accessing mental health services, so they're spending a lot of time being angry and frustrated over their situations," said Kaitlin Post, special projects coordinator for the college. "We hope that by better coordinating physical and mental health services, we can help improve their total quality of life."

The curriculum focuses on issues such as the social stigma faced by HIV/AIDS patients, mental health diagnoses, drug interactions between psychotropic drugs and AIDS medications, chemical dependency and working with difficult behaviors.

"These people are upset," Post said. "They have a terminal disease. Sometimes when they come in, they start acting out. They come to the counseling sessions drunk or something. How do you deal with that? How do you help them understand where the client is and how do you help them work with them?"

The college has developed and is teaching a curriculum geared toward "people with multiple diagnoses, such as people with AIDS and mental illness or AIDS and alcoholism," Post said. It is now being taught in Kansas City and western Missouri.

The project will start in St. Louis early next year, Keys said, "and we'll probably start seeing services in Southeast Missouri a few months after that."

There are three HIV/AIDS service coordinators in Southeast Missouri, said Nanci Gonder, a spokeswoman for the Missouri Department of Health.

Peggy Montgomery, community health adviser for the state health department in Poplar Bluff, said service coordinators work with patients to assess their needs and to determine what state or federal services they are eligible for. Those may include housing and energy assistance, food stamps, health and mental health care and travel vouchers.

"We address all sorts of needs," Montgomery said. "Even though we can't directly meet all of their needs ourselves, we link them up with someone who can."

As of Sept. 30, the number of people diagnosed with HIV or AIDS in Southeast Missouri was 145, she said.

"We serve a majority of those people. We try to make sure they have a person they can rely on and trust, so they don't feel so alone," Montgomery said.

Because of the nature of HIV/AIDS, clients' needs will change as they move through different stages of their illness, she said.

"It's what I call a long-term, progressive disease," she said. "We already know that a person can be dealing with it for 10, 12, 15 years. It's a living-with disease; they learn to live with HIV and AIDS. We help them do that."

In addition to developing the curriculum, the college will evaluate the impact of coordinated care on the quality of life for HIV/AIDS clients. Southeast is one of 27 sites approved for the project.

The results of the project evaluation will be available for national dissemination. The Missouri model will help other states to improve the delivery of mental health services to HIV/AIDS clients.