Access to mental health and substance abuse services by people living with HIV/AIDS: The case manager perspective

There are deleterious consequences to untreated mental health and substance abuse concerns among people living with HIV/AIDS (PLWHA). Most research on this population accessing specialized services has been described from the clients' perspectives. However, case managers play an important role in PLWHA receiving services. This study examined HIV case managers' perspectives of the barriers and facilitators encountered by their HIV-positive clients when seeking mental health and substance use treatment. In addition, the study describes case managers' use of mental health and substance abuse assessment instruments. Cross-sectional survey data were collected from case managers (N = 113). Structural challenges, such as financial concerns and limited transportation, were found to be significant barriers to mental health and substance abuse treatment. Positive client-provider relationships, accessible services, and case manager availability were influential in PLWHA accessing specialized services. Service delivery systems recommendations include increased social support systems, colocated and integrated services, and training of case managers to motivate clients to seek mental health and substance abuse treatment.