INTEGRATED DUAL DIAGNOSIS/INFECTIOUS DISEASE TREATMENT

综合双重诊断/传染病治疗

• 批准号: 6392893
• 负责人: STANLEY D ROSENBERG
• 金额: $ 19.88万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-01 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6392893
• 关键词: HIV infections; clinical research; communicable disease diagnosis; comorbidity; educational resource design /development; health services research tag; hepatitis B; hepatitis C; human subject; infection; medical education; mental disorders; mental health personnel; substance abuse related disorder

DESCRIPTION (adapted from the applicant's abstract): People with severe mental illness (SMI), and particularly those dually diagnosed with comorbid substance use disorder (SUD), are at extremely elevated risk for several serious blood-borne infections, including HIV, Hepatitis B and Hepatitis C. One third of dually diagnosed clients in many mental health service settings are likely to have one of these infections, and the rate of co-infection is very high. However, the field lacks effective and feasible models for responding to this problem, and neither infected nor high-risk clients receive services that meet authoritative standards. Indeed, infected clients may be the least likely of all people with SMI to receive adequate medical care. By and large, mental health providers are not well informed regarding these issues, and do not systematically provide the necessary interventions to help clients understand and cope with these risks and diseases. Providers do, however, express interest and willingness to respond by increasing staff education and by adding services for their high-risk clients. To date, no such innovation has been reported in any state mental health system, even in those states with known high rates of seroprevalence. Barriers to dissemination and provision of best practices have been identified, and include providers' underestimation of the problem in clients they serve, and confusion about how to best respond to information about clients' risk and infection status. To implement and sustain best practices interventions for this vulnerable group of clients, integrated procedures to change the knowledge, attitudes, training resources and practices of community mental health providers are required. Procedures for dealing with blood-borne pathogens should be structured to be a standard part of multidisciplinary team treatment. They should include a very basic set of evidence based practices for HIV, Hepatitis B and Hepatitis C, including screening, diagnosis, counseling, risk reduction, immunization, linkage with appropriate medical providers, and support for clients through treatment. We propose, in this Exploratory/ Developmental Grant application (R21), to develop an easily disseminated intervention, packaged as a "toolkit" and supported by implementation assistance, to enhance the knowledge, attitudes and practices of typical community mental health providers so that they will achieve sustainable, best practices standards for their infected and at-risk clients.

描述（改编自申请人的摘要）：患有严重精神疾病的人 疾病（SMI），特别是那些双重诊断患有共病物质的人 使用障碍（SUD），几种严重的风险极高 血源性感染，包括艾滋病毒、乙型肝炎和丙型肝炎。三分之一 在许多精神卫生服务机构中，双重诊断的客户可能会 其中一种感染，并且同时感染的几率非常高。 然而，该领域缺乏有效可行的模型来应对这一问题 问题，受感染的客户和高风险客户都无法获得满足要求的服务 权威标准。事实上，受感染的客户可能是最不可能的 所有患有 SMI 的人都能获得足够的医疗护理。总的来说，心理 卫生保健提供者对这些问题了解不多，并且不 系统地提供必要的干预措施来帮助客户理解 并应对这些风险和疾病。然而，供应商确实表达了兴趣 以及通过加强员工教育和增加服务来应对的意愿 对于他们的高风险客户。迄今为止，尚无此类创新的报道 任何州的精神卫生系统，即使是在那些已知发病率很高的州 血清流行率。 已查明传播和提供最佳实践的障碍， 并包括提供商低估了他们所服务的客户的问题， 对于如何最好地应对有关客户风险和风险的信息感到困惑 感染状态。实施和维持最佳实践干预措施 对于这一弱势群体的客户，综合程序可以改变 社区心理知识、态度、培训资源和实践 需要卫生服务提供者。处理血源性疾病的程序 病原体应成为多学科团队的标准组成部分 治疗。它们应该包括一套非常基本的基于证据的实践 HIV、乙型肝炎和丙型肝炎，包括筛查、诊断、咨询、 降低风险、免疫、与适当的医疗提供者联系，以及 通过治疗为客户提供支持。我们建议，在本探索性/ 发展补助金申请（R21），开发易于传播的 干预，打包为“工具包”并得到实施的支持 帮助，提高典型的知识、态度和做法 社区心理健康服务提供者，使他们能够实现可持续的、最佳的 为受感染和有风险的客户实施标准。