Evaluation of a system to increase access to mental health services for people living with HIV/AIDS at a community-based AIDS service organization

Background: Mental health services are important for improving psychological functioning and maintaining physical health for people living with HIV/AIDS (PLWHA). Many PLWHA face multiple barriers to accessing mental health treatment including procedural issues at provider organizations, such as the failure to identify and engage clients who could benefit from mental health services and delays in scheduling appointments. This study evaluates the implementation of a Rapid Response (RR) system, in an AIDS service organization, designed to eliminate agency barriers to mental health treatment. Methods: Sociodemographic and appointment-related data were collected for 313 clients served by RR from April 2008-December 2008 and analyzed using SPSS 15.0. Results: There was an increase in mental health service enrollments post-RR implementation compared to the same period before the system was implemented (396 vs. 262). Of the 278 people who scheduled initial mental health intakes through RR, 64% enrolled in mental health services. Enrollment in mental health services was significantly associated with fewer days between the RR contact and the date of the initial mental health intake (4 days, enrolled vs. 6 days, non-enrolled). Race was a significant predictor of enrollment, and women were less likely to enroll in mental health services than men, although this relationship was not statistically significant. Conclusions: RR has provided the agency with an efficient system to engage clients in mental health treatment. Results suggest that efforts to minimize the time between the initial referral and the first appointment with the mental health program explain the increase in enrollment post-RR implementation.