Scientists at the University of Cape Town's (UCT) psychiatry and mental health department are developing guidelines to help health care professionals identify and care for HIV-positive patients with mental health disorders. The guidelines, being written for nurses and counselors, will address how to manage, treat, and refer patients.

"HIV attacks the brain quickly, and we therefore see an increase of all mental disorders [in HIV-positive patients]," said John Joska, a UCT neuropsychiatrist and leader of the screening tool research team.

The first phase of the research will be complete by July, followed by presentations by Joska to the Western Cape health department and non-governmental organizations that train lay counselors.

The screening tool is designed to be the first step in establishing South African primary health facilities as a "one-stop shop" for HIV care -- providing voluntary counseling and testing, HIV treatment and care, treatment of opportunistic infections (including tuberculosis), and mental health care. The clinics also would have a referral system linking it to specialized and acute care.

Advocates say mental health resources as a whole are lacking in South Africa. The Department of Health spends less than 1 percent of the national health budget on mental health services and allocates only 9 percent of the country's hospital beds for psychiatric patients, according to the South African Depression and Anxiety Group, a support and advocacy organization.

HIV patients are in need of mental health services, said Joska. In addition to the direct effects of HIV on the brain, coping with HIV disease exacts a huge psychosocial toll, and the antiretroviral drugs used to treat HIV also can produce negative mental health effects, Joska noted.

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