The relationship between type of mental health provider and met and unmet mental health needs in a nationally representative sample of HIV-positive patients

This study examined mental health service utilization among a nationally representative sample of adults with HIV and psychiatric disorders or perceived need for mental health services. Data are from the HIV Cost and Services Utilization Study (HCSUS) mental health survey (n = 1489) conducted in 1997–1998. Most (70%) needed mental healthcare. Of these, 30% received no mental health services in the previous 6 months, 16% received services from general medical providers (GMPs) only, and 54% used mental health specialists. Clients with perceived need for care were more likely to receive any mental health services and services from mental health specialists (versus GMPs) than clients having mental disorders without perceived need. More patients using specialists versus GMPs received psychotherapeutic medications and psychiatric hospitalizations, controlling for psychiatric symptom severity. The findings underscore that the differential mental health service provision between specialists and GMPs existing in the general population also is present among persons with HIV.