HIV and Mental Health: “We Meet Them Where They Are.”

An evolution in holistic care – that’s how long-time staff members at LifeCare at IU Health Methodist Hospital see the attention given to clients with human immunodeficiency virus (HIV).

First it was care for just the patients but in the past 25 years that care has extended to family members – caregivers, spouses and domestic partners. The care has expanded from end-of-life care to a focus on testing and preventing the disease. The care for HIV patients and families has evolved from coping with a diagnosis to living life with a diagnosis.

Clients come to LifeCare from all walks of life – all genders, sexual orientations, and ethnicities. Today the program serves about 1,300 clients spanning the ages of 18 to 80, making it the largest HIV medical provider in the state. 

This month marks the 28th anniversary of the death of Ryan White – a young man who, at the age of 18, became the face of the disease that infects about 50,000 Americans a year. 

And as research and treatment evolves, LifeCare continues to expand its focus and outreach to clients. The program recently received a $1.1 million grant from the Indiana State Department of Health to allow for expanded behavioral health treatment, outpatient substance abuse treatment and medical case management.

“For 25 years we’ve been providing our clients with holistic care. Now we’re taking it to a new level, recognizing that behavioral health is primary health, and adding a psychiatrist to our program,” said Kyle Bonham, Ambulatory Manager of LifeCare. In the past, clients needing mental health services were referred to outside agencies. Now they will work with an in-house team that includes a newly contracted board certified adult psychiatrist Tracy Gunter, clinical social worker Linda Santoro, who has served as a case manger for LifeCare for 17 years, and pharmacist Jake Peters.

“We’re privileged to hear people talk about their lives,” said Santoro.  “When we work in collaboration with people and remain curious and open about how problems are affecting them, we also hear stories of possibility and change.”

Gunter, who is with IUHP Psychiatry and Behavioral Science, is also a board certified forensic psychiatrist. She first worked with HIV patients in the early 90s during an internship in her home state of South Carolina.

“One of the things that was happening at that point is people who had contracted HIV were coming home to die. When I learned of the opportunity to work with LifeCare, it was exciting because the disease that was a death sentence is now managed as a chronic disease. LifeCare patients are referred to mental health for various reasons ranging from addictions to anxiety and mood problems to crisis counseling.

“This clinic serves a lot of people who have had a lot of trauma. I’ve learned that you listen more than you talk and you stay willing to meet them where they are as opposed to demanding they meet you where you are,” said Gunter. “So far, clients have said, ‘I’m glad you are here.’ When they want to know what they should say or how they should come in I tell them ‘until you show up, until you trust us enough to see you good or bad, it will be hard to get started.’ Having the willingness to listen to the truth of their life experience goes a long way.”

— By T.J. Banes, Associate Senior Journalist at IU Health. 
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 T.J. Banes or on Twitter @tjbanes.