title: Patterns of HIV and mental health service integration in New York State.
abstract: The Affordable Care Act (ACA) creates incentives to coordinate primary care, mental health (MH) care, and addiction services. Integration of clinical HIV and MH services has been shown to improve quality of life and physical and MH of people living with HIV/AIDS. However, few studies have investigated the practice of service integration systematically. We examined the practice patterns of 515 direct service providers in New York State who received training about HIV MH between May 2010 and July 2012. We sought to identify provider and treatment setting characteristics associated with an integrated spectrum of care. Using factor analysis and linear modeling, we found that patterns of service integration varied by type of health-care setting, service setting location, providers' HIV caseload, and the discipline of the provider describing the direct services. Understanding the existing capacities of clinicians providing care in a variety of settings throughout New York will help to guide staffing and linkage to enhance HIV MH service integration as significant shifts in the organization of health care occur.
authors.affiliation: a College of Physicians and Surgeons , Columbia University , New York , NY , USA.
authors.forename: Sunhee
authors.initials: S
authors.lastname: Kim
authors.forename: Marc
authors.initials: M
authors.lastname: Ades
authors.forename: Veronica
authors.initials: V
authors.lastname: Pinho
authors.forename: Francine
authors.initials: F
authors.lastname: Cournos
authors.forename: Karen
authors.initials: K
authors.lastname: McKinnon
mesh_terms: D019033:Delivery of Health Care, Integrated; D005163:Factor Analysis, Statistical; D006679:HIV Seropositivity / Q000523:psychology* / Q000628:therapy; D006801:Humans; D016014:Linear Models; D008603:Mental Health; D008605:Mental Health Services / Q000458:organization & administration*; D017146:Models, Organizational; D009518:New York / Q000453:epidemiology; D058991:Patient Protection and Affordable Care Act; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D011787:Quality of Health Care; D011788:Quality of Life
keywords: HIV; integrated care; mental health; practice patterns; provider roles