Posted May 2021
DOORWAYS, 4385 Maryland Avenue, St. Louis, MO 63108
The Anthem Foundation awarded DOORWAYS a Healthier Generations grant to enable the agency to focus on delivering mental health services to those who are vulnerable and disenfranchised—people at the intersection of poverty, homelessness, and HIV. This population experiences high levels of mental health challenges, which have been found to be both the cause and the result of their circumstances.
People living with HIV are twice as likely to have depression. Mental illness can lead to risky behaviors that expose individuals to HIV. Mental health conditions may also lead to homelessness, and the added stress of homelessness may lead to mental health conditions. A study by the National Institute of Mental Health estimated at least 45% of the homeless population experiences mental health conditions with 20-25% suffering severe mental illness (https://www.hcs.harvard.edu/~hcht/blog/homelessness-and-mental-health-facts).
Combining HIV, mental illness, and homelessness leads to significant deterioration and limited progress in all three areas. “Due to this critically intertwined relationship, we estimate 70% of our clients would benefit from mental health services, with 25% severely affected by untreated mental health conditions and, in some cases, undiagnosed mental illness,” explained Pat Plumley, Chief Program Officer at DOORWAYS. “The path to stability is challenging for all of our clients, but significantly more difficult for those in need of mental health services.”
In fact, program progress reviews revealed mental health conditions were actually weakening client outcomes within the entire DOORWAYS matrix of services—managing and retaining housing, food security, maintaining a source of income, developing skills and experiences instrumental to daily living, plus participating in goal setting activities that can lead to viral suppression and improved health.
“Like housing, good mental health is an essential part of the foundation our clients need to build a self-directed life in which they may achieve improved health outcomes and a better quality of living,” noted Opal M. Jones, President & CEO of DOORWAYS. “Referrals to counselors have always been an important aspect of our coordinated care plan, but client ability to follow through was overwhelmed by navigational barriers such as mental illness, physical illness, lack of transportation, no childcare, and a sense of hopelessness. It was time for a new model of care with onsite access.”
Jay Moore, M.D., the Chief Clinical Officer, Emerging Business Group at Anthem and immediate past president of the DOORWAYS board of directors, added “Today, HIV is treatable. As our clients stabilize, they are better able to manage their HIV medication regimens, which leads to reductions in viral load counts. At this point, clients not only feel better but, when they achieve undetectable status, they also render the virus untransmittable, reducing new cases of HIV.”
With the pivotal role mental health plays in strengthening client progress toward gaining stability, funding from the Anthem Foundation contributed towards hiring two counselors to provide easily accessible mental health services. “We are extremely grateful for this grant from the Anthem Foundation to support the launch of our onsite Behavioral Health Program,” noted Jones. “We are now able to seamlessly deliver mental health and substance use counseling onsite, increasing quality of life and life spans for individuals plus reducing the HIV epidemic in the community. Decreasing disparities in mental health care within this vulnerable population can directly contribute to bringing an end to HIV.”
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