Positive Outlook: Working with HIV, Depression and Rehabilitation

Funded by the Public Health Agency of Canada, this project builds capacity for front line AIDS and other health care and rehabilitation workers to identify and appropriately address depression among people living with or vulnerable to HIV or other episodic illnesses.

Through developing and piloting a course with front line HIV and rehabilitation workers in locations across Canada, the Positive Outlook project will provide strategies to manage depression, evaluate the effectiveness of the course content and process, and develop a network of all course participants as a mechanism for ongoing support and sustainable learning.

Depression has long been recognized as a primary health concern among people living with or vulnerable to HIV (WHO 2008). In Canada and internationally, depression is an issue that affects PHAs in all geographical locations (BC Prevalence Study 2004, Williams 2005 and WHO 2008).

This is often a difficult and challenging issue for front line workers who, in most cases, are not provided training on how to deal with this potentially debilitating condition. (Trap Doors, 2008)  Often front-line HIV workers and rehabilitation clinicians who are the most likely to encounter people living with mental health issues resulting from long term illness or trauma are the least likely to have any training on mental health interventions. It is difficult to proceed with the original intended rehabilitation interventions or service provision as the client may have little motivation and experience difficulty focusing. Front line HIV workers and rehabilitation clinicians, then, in turn, experience frustration at their lack of ability to assist in addressing their client’s mental health issues and themselves experience diminished workplace satisfaction.

The Positive Outlook Project seeks to address these issues through developing and offering targeted training to front-line HIV workers and rehabilitation clinicians on intervention techniques and resources appropriate to working with clients experiencing episodic illnesses and showing signs of depression.

Project Objectives:

• To increase capacity of front-line HIV service workers (from AIDS Service Organizations (ASO), other community programs and health clinics) and front-line rehabilitation professionals (e.g. Physiotherapists, Occupational Therapists and Social Workers) through the provision of training on how to recognize and assist people living with or vulnerable to HIV who show signs and symptoms of depression.
• To promote improved access to mental health services and support for PHAs through interprofessional collaboration and partnerships among the above named frontline workers in response to depression among people living with or vulnerable to HIV and other episodic disabilities.
• To develop and evaluate a course for frontline workers as a model for capacity building to address depression among people living with and or vulnerable to HIV and other episodic disabilities.
• To promote sustainability of capacity building among front-line workers on issues of depression and HIV and other episodic disabilities.

Activities:

The Positive Outlook Project will achieve these objectives through the following activities:

• Assessing the needs related to depression in local communities, through interviews with identified course co-facilitators in communities where course sessions will be held
• Developing a new curriculum and interventions for front line workers related to depression among people living with or vulnerable to HIV and other episodic disabilities, to be integrated into an existing interprofessional learning course offered by CWGHR, focusing on rehabilitation in the context of HIV
• Piloting the proposed curriculum across Canada in course sessions for front line workers (ASOs, other community organizations and rehabilitation programs) who work with people living with or vulnerable to HIV and who may present with depression
• Establishing an ongoing online network/forum for course participants and facilitators to continue engagement and support for work related to depression and HIV and other episodic disabilities
• Evaluating the course as a model for capacity building for front line workers in addressing depression among people living with or vulnerable to HIV and other episodic disabilities
• Submitting abstracts on the course and this project for conference presentations, articles for journals/other publications  and other knowledge exchange opportunities

Desired Outcomes:

The overall desired outcome for this project is improved care for people living with or vulnerable to HIV and other episodic disabilities who are experiencing depression.  This overall outcome will be realized through achieving the following desired outcomes in this project:

• Improved capacity of front line HIV workers and rehabilitation clinicians to recognize and appropriately address depression among people living with or vulnerable to HIV and other episodic disabilities.
• Reduced stress and burnout among front line workers who work with people living with/ vulnerable to HIV and other episodic disabilities and depression.
• Increased collaboration, networking and support among front-line workers to address depression in the people who use their services and collaborate on ways to assist one another in the care and support of people living with or vulnerable to HIV and other episodic disabilities who also experience depression.  
• Course sessions will provide training for front line workers on how to identify and assess depression, and respectfully interact with the people with whom they work. The course curriculum will include practical tools for engaging people presenting with signs of depression that will allow front line workers to confidently and appropriately address people experiencing depression. 

Achieving these objectives will ultimately translate to positive health impacts for people living with or vulnerable to HIV and other episodic disabilities.  PHAs will have their depression addressed and feel better about working with the front line worker on their presenting/ other current concerns.  The benefits for the front line workers are that they will be more effective in their role and less overwhelmed to assist people who display depressive symptoms.

Project Updates:

August 2011

After two successful workshops in Winnipeg, several new workshops are being planned:
Halifax NS: September 15 - 16
Vancouver BC: September 21 - 22

May 2011

The Positive Outlook Project has recently gathered community input into the development of the content for the workshops for front-line and rehabilitation workers through an online Needs Assessment conducted in English and French. The results from the Needs Assessment are currently being analyzed and will be used to used to inform the curriculum development process and to ensure that content covered in the workshops is targeted to meet the needs of the communities in which it is offered.

Additional Information:

Should you have any questions about the Positive Outlook Project, please contact Jordan Lewis, Senior Mental Health Specialist at 416-513-0440 ext. 249 or jlewis@hivandrehab.ca