title: Utilization of psychiatric services among low-income HIV-infected patients with psychiatric comorbidity.
abstract: BACKGROUND
  HIV-infected individuals face a tremendous burden of psychiatric comorbidity. This study evaluates a community health care system's effort to screen for psychiatric disorders among patients at an HIV clinic and evaluate adherence to psychiatric service utilization.
  
  
  METHODS
  Standardized screening measures were used to identify participants who met diagnostic symptom criteria for post-traumatic stress disorder (PTSD), acute stress disorder (ASD) and depression. All participants who screened positive were referred for psychiatric follow-up. Rates of utilization were measured and barriers to adherence were investigated.
  
  
  RESULTS
  Of the 210 participants, 118 patients met screening criteria for PTSD, ASD, and/or depression, and 116 of these had medical records available for review. Of the 116 patients with psychiatric comorbidity, 46.6% saw a psychiatrist and/or were prescribed a psychiatric medication. Thirty-two percent of Latinos, 40.5% of African Americans, and 38.5% of heterosexuals utilized referred psychiatric services, and these rates were significantly less than their counterparts. One hundred patients were seen by a social worker.
  
  
  CONCLUSIONS
  While a large burden of psychiatric comorbidity exists among this population of HIV-positive patients, only half adhered to recommended psychiatric services referrals. Further research is warranted to examine cost-effective interventions to maximize psychiatric screening, referral, and follow-up with mental health services in this vulnerable population.
authors.affiliation: San Mateo County Behavioral Health and Recovery Services, Psychiatry Residency, San Mateo, CA, USA. mvsoller@gmail.com
authors.forename: Marie
authors.initials: M
authors.lastname: Soller
authors.forename: Neda
authors.initials: N
authors.lastname: Kharrazi
authors.forename: Diane
authors.initials: D
authors.lastname: Prentiss
authors.forename: Stephen
authors.initials: S
authors.lastname: Cummings
authors.forename: Gladys
authors.initials: G
authors.lastname: Balmas
authors.forename: Cheryl
authors.initials: C
authors.lastname: Koopman
authors.forename: Dennis
authors.initials: D
authors.lastname: Israelski
mesh_terms: D000328:Adult; D002140:California; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011203:Poverty; D015397:Program Evaluation; D012017:Referral and Consultation; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D040701:Stress Disorders, Traumatic, Acute / Q000150:complications / Q000175:diagnosis / Q000628:therapy*