What is mental health and mental illness?
Mental health refers to the overall condition of a person in terms of their moods,
thought processes, emotions, behaviors, and related psychological and psychiatric
dimensions. Mental illness refers to a serious disruption in the functioning of a
person’s mental health, and can be biological, behavioral, or psychological in origin. A
variety of adverse personal circumstances can contribute to poor mental health, and
many of those at highest risk of HIV infection face such difficult life situations. In
Mental Health and HIV
recent years, American society has become much more open in addressing mental
health problems and increasing numbers of individuals have begun to acknowledge
The status of a person’s mental health that they have experienced mental health problems.
can have a powerful impact on both
How do common mental health concerns relate to
their motivation and their ability to
vulnerability to HIV infection?
avoid HIV transmission through Persistent mental health problems, notably major depression and excessive anxiety, can
unprotected sex or injection drug use. compromise individuals’ efforts at self-protective behaviors across a range of life
activities, including sex or injection drug use. A weak sense of self-esteem can also lead
Mental health concerns cover a wide to a sense of disempowerment and even fatalism about HIV infection. Mental health
problems can also lead to increased use of alcohol and other drugs which can further
spectrum of conditions, ranging from impair judgement and lead to greater risk-taking. Among those who have already been
common, low-level problems of mood diagnosed with HIV, disease-related stress and neurological complications can also
lead to mental health problems, which in turn can complicate the process of accessing
and affect to severely impairing health care and adhering to medication schedules.
psychotic conditions. HIV/AIDS
How does serious mental illness relate to HIV transmision?
programs must take into consideration As mental health problems become more severe, particularly in the case of
the full mental health spectrum if they individuals with psychotic disorders such as schizophrenia, individuals’ lives become
increasingly disorganized. De-institutionalization with poor follow-up has left many
are to succeed in preventing new cases of mentally ill individuals on the streets or in other dire circumstances. Similarly, the
nation’s correctional system includes many inmates with mental health problems as
HIV infection. well as various risk factors for HIV. For these and others with serious mental illness,
even the most basic self-care behaviors, including protecting oneself and others from
HIV, become difficult or impossible.
How can mental health interventions help prevent HIV transmission?
For people facing considerable challenges in managing their day-to-day lives, HIV prevention can be a low priority. Major advances
in psychotherapeutic techniques and in the use of psychiatric drugs have begun to revolutionize the ability of the mental health
profession to effectively intervene and help individuals from harming themselves and assist them in achieving better lives. Mental
health interventions may include general educational materials, support groups, individualized counseling, intensive psychotherapy,
and appropriate use of medication. To be truly effective, HIV prevention programs for people with mental health problems require
comprehensive approaches that will address not only the narrow issue of HIV prevention but larger concerns. HIV prevention
programs must also link with services for the mentally ill to enhance access to this at-risk population and to link mental health care
clients to prevention services that may support the adoption of lower-risk behaviors.
National Alliance Of State And Territorial Aids Directors 444 N. Capitol Street NW . Suite 339 . Washington, DC 20001-1512
202-434-8090 . 202-434-8092 Fax . www.nastad.org
NASTAD HIV Prevention Fact Sheet Mental Health
State, Territorial, and Local Health Departments Respond to the Needs of People
with Mental Illness at Risk for and Infected with HIV
California — Youth Drop-In Centers: Youth drop-in Louisiana — Service Coordination: In the Fall of 1998,
centers, small storefront-style buildings located in active the Office of Public Health (OPH) entered into a
pedestrian areas near public transportation, provide harm collaborative agreement with a pilot health district in the
reduction-based prevention services in a private and Baton Rouge area, Capital Areas Human Services District
comfortable manner to low-income youth at high risk for (CAHSD). CAHSD is responsible for providing services
HIV infection. Street-based populations have greater access for mental health and addictive disorders and also
to services because the center is open every day of the week. distributes HIV prevention funding to community-based
The center provides HIV counseling and testing, organization (CBOs). Since the initiation of the cooperative
education, harm reduction, and referral to health services in agreement, all regional HIV-related activities in mental
a coordinated manner. Additional components are health facilities, substance abuse clinics, and CBOs are
extended support sessions, support groups, and incentives. monitored by CAHSD.
The drop-in centers maintain collaborative partnerships Maine — Street Outreach: The AIDS Project’s Street
with other service providers such as mental health, Outreach Project targets homeless people, developmentally
substance abuse treatment, and STD programs to ensure a disabled people, and people with mental illness in Portland
comprehensive health program for youth at risk. and Lewiston. Continued outreach through a soup kitchen
Delaware — A Coordinated Approach: The Delaware in Lewiston has enabled the outreach worker to develop
HIV Consortium, an interagency collaboration, is critical strong relationships with many targeted individuals.
in a small state like Delaware where there are not enough Maryland — Training for Service Providers: The AIDS
providers to deliver services to populations in need. Most of Administration partners with the Mental Hygiene
the agencies throughout the state that provide health care or Administration to provide HIV education to the staff of
prevention services related to HIV/AIDS are members of mental health inpatient and community facilities. A two-
the consortium and include mental health, medical, day workshop is offered three times a year. Staff trained
substance abuse and social service providers. through this program return to their facility and implement
District of Columbia — Collaborating with Community- HIV educational programs for staff and patients.
based Organizations: Barney Neighborhood House, a Vermont — Training Peer Educators: In 1998, a peer-
community-based organization that works with the based pilot program to address risky behaviors among
mentally ill, conducts small workshops, skills building people who are mentally ill was initiated at a group
group sessions, large community workshops, and provides residential facility. The program trained four people with
prevention case management to clients. A network of 22 mental illness to do presentations for their peers. The peer
organizations serve as outreach sites where male and female educator reached over 50 people with mental illness in the
condoms and educational materials are distributed to the first six months.
National Alliance of State and Territorial AIDS Directors, 444 N. Capitol Street NW, Suite 339, Washington, DC 20001-1512
Phone:202-434-8090 Fax:202-434-8092 www.nastad.org
This NASTAD fact sheet was developed with support from the Substance Abuse and Mental Health Services Administration (SAMHSA)