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）：严重精神的人 疾病（SMI），尤其是那些被诊断为合并症的人 使用障碍（SUD），几个严重的风险极高 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环境中的双重诊断客户中 有一种感染之一，共同感染的速度非常高。 但是，该领域缺乏对此做出回应的有效且可行的模型 问题，没有感染和高风险客户都会获得满足的服务 权威标准。确实，受感染的客户可能是最不可能的 所有患有SMI的人都可以接受足够的医疗服务。总体而言 健康提供者对这些问题没有很好的了解，也不 系统地提供必要的干预措施，以帮助客户理解 并应对这些风险和疾病。但是，提供者确实表达了兴趣 并愿意通过增加员工教育和增加服务来做出回应 为他们的高风险客户。迄今为止，尚未报告此类创新 任何州心理卫生系统，即使在已知高率的州 血清阳性。 已经确定了传播和提供最佳实践的障碍， 并包括提供商在他们服务的客户中低估问题的低估， 以及如何最好地响应有关客户风险和 感染状态。实施和维持最佳实践干预措施 这个脆弱的客户群，集成程序，以更改 社区心理的知识，态度，培训资源和实践 需要卫生提供者。处理血源的程序 病原体应成为多学科团队的标准部分 治疗。它们应包括一套非常基本的基于证据的实践 HIV，乙型肝炎和乙型肝炎，包括筛查，诊断，咨询， 降低风险，免疫，与适当医疗提供者的联系以及 通过治疗支持客户。我们建议在此探索性/ 发展赠款应用程序（R21），开发易于传播 干预措施，作为“工具包”包装，并得到实施的支持 协助，增强典型的知识，态度和实践 社区心理健康提供者，以便他们实现可持续，最佳 练习其感染和处于危险客户的标准。