ob.gyn. departments: barriers to mental health referrals in HIV.(Gynecology)

MIAMI -- There are many barriers to mental health referrals for HIV-positive women screened in the ob.gyn. department at the University of Miami, according to a study that was presented at a conference sponsored by the American Foundation for AIDS Research.

For 15 years, the university's department of obstetrics and gynecology has provided primary medical care and psychosocial services to HIV-positive, minority women of low socioeconomic status. Services are offered through an outpatient clinic at Jackson Memorial Hospital.

Women are routinely screened for seven specific mental health disorders: depression, anxiety, panic attacks, psychosis, substance abuse, physical and/or sexual abuse, and cognitive disorders. Those who meet the criteria for at least one of these disorders are referred for psychiatric and psychological evaluations and treatment.

In October 2002, the university opened the Healing Place, an outpatient clinic that offers comprehensive mental health services for individuals and families living with HIV. Investigators did a study to see if the availability of the new clinic would increase the number of women who follow through and receive suggested mental health services, but they found "the referrals were not working," said Marta Tabares, a social worker with the university's ob.gyn department.

Many women screened in the ...