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Sunday, October 12, 2014

Gay community faces mental health challenges


Gay community faces mental health challenges

Brian Hodder
 

Over the past few years, there has been a growing awareness in our society around the impact of mental health on all sectors of our population.

With a number of recent high-profile cases, including the recent suicide of actor/comedian Robin Williams, people are beginning to realize how serious this issue is and how powerful an impact mental health can have on an individual’s life.

This past week marked Mental Illness Awareness Week and Friday was also recognized worldwide as World Mental Health Day. This reflects this growing recognition of the impact of mental illness in our society.
As a group that has dealt with a history of discrimination, the gay community has been greatly affected by mental health issues and there remains much work to be done in this area.

A Canadian study released last month illustrates how seriously the gay community is impacted by mental health. In the study, which was published in the current issue of Critical Public Health, the authors examined suicide and HIV-related mortality information from Statistics Canada, the Canadian Community Health Survey and other sources from the years 2000 to 2011.

Among the primary findings was that more gay/bisexual men now die of suicide than from HIV-related illnesses; in 2011 — the latest year of data — 157 gay and bisexual men died from suicide compared to 97 who died as a result of HIV-related illnesses.

Overall, it was noted that while HIV-related deaths in Canada have declined steadily since 2000, suicide rates have remained relatively stable, surpassing HIV as a leading cause of death for gay/bisexual men in 2007.

The findings also revealed that gay/bisexual men are four times more likely to have attempted suicide than their straight counterparts.

These findings should raise the alarm to look at how health-related funding needs to be used when targeted at the gay male community. While traditionally HIV was seen as the greatest health threat facing our community — and it remains an important priority still — it is clear that there are other pressures impacting the health of our community which are not being addressed adequately. Most health-related services that are targeted towards the gay male community in our larger urban centres are based around our sexuality and sex with other men; however, it is clear from this study that the issues are much larger than that and that our approach to the health of our community needs to be broadened.

Another critical finding of this study relates to the age group in our community that is most affected by death through suicide. While the study found that suicide attempts are more common during adolescent years, the fatality rate increases with age. In fact, most of the gay men dying from suicide are over the age of 30.
While it is important to make sure that children have access to the services they need — and we are slowly doing a better job of this in Canada — it is clear that we also need to find a way to reach the men who do not come out until they are adults and are less likely to know where and how to access the help they may need. If we fail to acknowledge the mental health needs of our community, this trend of deaths through suicide is likely to continue.

What seems clear to me is that there needs to be more emphasis on mental health all through the year and not just during one week in October. While there are many causes of mental illness, research has shown that minorities that experience discrimination and violence are much more prone to developing these problems, and homophobia is still a major factor in our society for many.

While most health services developed and targeted towards the gay community have related to our physical health, it is time that our mental health needs were also recognized and services developed to address them.
A healthy body and a healthy mind is just as important for gay men as it is for the rest of the members of Canadian society.

 Brian Hodder is a past-chairman of
Newfoundland Gays and Lesbians
for Equality.

Geographic location: Canada

Friday, October 3, 2014

I never thought I would see 71 years old... I have a new outlook on Life

 Happy Belated Birthday
Nello Carlini

When I was diagnosed HIV+ and bipolar in 1996 I never in my life thought I would live to see 71 years old.  I told myself years later when I turned fifty five that I'd  love to see sixty six, the age my mom passed due to breast cancer.  I live and volunteer around seniors, just walked home with my loving neighbor Kay who's 91 years old, I call here Nana. Tonight as we walked up the small hill together I said, wow how it would be nice to live as old as Kay, my Aunt Jo, my Aunt Felice all 91 years old, but then drifted back to sixty-six years old knowing I'm living with bipolar disorder and am HIV positive.

I received POZ magazine today in the mail.  I opened it before going to bed, took all my medications and feel asleep with visions of growing older, knowing others also diagnosed HIV positive are living older, case in point, page 48 POZ magazine October/November 2014.   Happy belated birthday to Nello Carlini who's living out and out about his being HIV positive since diagnosed at age 71 years old.

Possible you've read statistics on what happens in 2015 and 2020 for folks living with HIV.  In 2015 50 %, I've also read 46% of those will be over 50+ years old.  Then in 2020 that % jumps as high as 71%.

Starting October 23, 2014  I will be taking 24 hours of training on HIV, Aging and Health Issues offered by the Council of Senior Centers and Services of NYC.   The following topics will be covered and I will write about each of these, sharing what I've learned, these are:

  • Intro to HIV and Aging
  • Aging, HIV and Co-Morbidities-- the presence of one or more additional disorders (or diseases)
  • Aging, HIV and Mental Health
  • Aging, HIV and Nutrition
  • Elder Abuse, Domestic Violence and HIV
I live in Public Housing, folks who live here are Veterans, Seniors and those with Disabilities, I'm out and open about being a gay man living with both HIV and bipolar disorder.  I'm well received by all, I volunteer here, chat with all neighbors who wish to chat, as socialization is pivotal to living a long healthy life.  I was in awe one day when one of my neighbors said when are we going to see you with a handsome fella, you have no idea how that made me feel, and at soon to be 56 and with folks like Nello Carlini who's 90 years old I may have a handsome fella within the next thirty four years or even older.  Love comes at any age.




RESOURCES:

HIV Among Older American

Aging with HIV
"If you are aging with HIV/AIDS, having a support system will help you stay physically and mentally healthier. You can find support systems through your healthcare provider, your local community center or AIDS service organization, or friends and family."


Wednesday, September 24, 2014

September HIV and Mental Health NEWS


"Slowly but Surely, Gay Conversion Therapy Is Coming Out of Mental Health Practices"  source: Autostraddle.  "



  "Depression among HIV positive people worrying " source: NTV News Uganda 

 


"Should Gays and Lesbians Seek Different Therapists Than Straight Patients?"   source: takepart.com



Depression among people infected with HIV  is on the rise in the country.  As it rises, so do new infections as the depressed do not use condoms, neither do they take their drugs which in turn leads to a rise in drug resistance. To the team from an ongoing research project dubbed INDEPTH Uganda including the Ministry of Health, there's need to worry because almost half of the people in the country living with HIV are depressed with many needing treatment yet integration of mental health care with HIV is still very low in the country. - See more at: http://www.ntvuganda.co.ug/news/lifestyle/23/sep/2014/depression-among-hiv-positive-people-worrying#sthash.zoexwJlG.dpuf

 


Depression among people infected with HIV  is on the rise in the country.  As it rises, so do new infections as the depressed do not use condoms, neither do they take their drugs which in turn leads to a rise in drug resistance. To the team from an ongoing research project dubbed INDEPTH Uganda including the Ministry of Health, there's need to worry because almost half of the people in the country living with HIV are depressed with many needing treatment yet integration of mental health care with HIV is still very low in the country. - See more at: http://www.ntvuganda.co.ug/news/lifestyle/23/sep/2014/depression-among-hiv-positive-people-worrying#sthash.zoexwJlG.dpuf
Depression among people infected with HIV  is on the rise in the country.  As it rises, so do new infections as the depressed do not use condoms, neither do they take their drugs which in turn leads to a rise in drug resistance. To the team from an ongoing research project dubbed INDEPTH Uganda including the Ministry of Health, there's need to worry because almost half of the people in the country living with HIV are depressed with many needing treatment yet integration of mental health care with HIV is still very low in the country. - See more at: http://www.ntvuganda.co.ug/news/lifestyle/23/sep/2014/depression-among-hiv-positive-people-worrying#sthash.zoexwJlG.dpuf


 

  




Monday, September 22, 2014

Physician Assisted Suicide, Aging with HIV and Chronic Mental Illness, My Choice

My Choice



In 2015, 50 % of those living with HIV/AIDS will be 50 years and older, by 2020 that number will be 70%. For others, the one in five who live with a chronic mental illness and HIV, we may or may not live that long due to aging, other illnesses and social isolation so severe you often contemplate taking your own life., but rather then doing that, I feel strongly that Physician Assisted Suicide be made legal in the United States, it is, but not all states. 

Friday September 19, 2014

It was lovely night this past Friday in Manhattan, rather then leaving the city for my bus ride home, I did what so many others did, I went out to enjoy the warm evening as soon fall/winter and cooler/colder evenings will be knocking at our doors.

I went to the Highline, sat there and couple after couple gay and straight walked by and I'm strong enough to get out alone, but for what ever reason that night I just started to cry, natural when something troubles you, causes pain.

I'm working hard on this, have been since I lost my dad, my closest friend Ed Holle last February. I meet people, amazing people in talking they share I have a partner who is Bipolar, or I have a partner who lives with HIV and the partner not living with either of these. I thank them as I know how hard it is and I have hope when I hear of these relationships knowing that someday I may have a companion.

I know that love comes at any age, I know that I'm not the only single only bipolar and HIV+ person on the planet, but these adversities make it very hard. I can't do anything but accept this, but now comes age, and sickness and fear of dying alone and it's that one thing that has me wanting to not do it in pain, in a hospital but rather peacefully with the knowledge of my doctor or Physician Assisted Suicide

Am I a weak person for wanting this, not at all. When it comes, it will be somewhere where I can watch sunsets and sit by a campfire at night,, it will involve hiking and friends who wish to join me and their pets, It will be both sad and joyful, what it won't be is alone and in pain.



Resources: 

" Interest in physician-assisted suicide among ambulatory HIV-infected patients"  source: American Journal of PsychiatryAm J Psychiatry 1996;153:238-242.

http://ajp.psychiatryonline.org/article.aspx?articleid=171545


http://en.wikipedia.org/wiki/Assisted_suicide_in_the_United_States




Thursday, September 18, 2014

Mental Health and Substance Abuse in Older HIV Infected Adults, Are we as a Community Prepared?




National HIV/AIDS and AGING AWARENESS DAY * SEPTEMBER 18, 2014

Aging: The New Challenge 

Source AIDS.gov

At the start of the epidemic, people who were diagnosed with HIV/AIDS could expect to live only 1-2 years after that diagnosis. This meant that the issues of aging were not a major focus for people with HIV disease.
But new medications and treatments have changed that. Life expectancy for people with HIV disease has increased dramatically—which means that they now have to face the challenges of aging with HIV/AIDS.
Normal aging is associated with risks for many different conditions, from osteoporosis to heart disease, but having HIV can increase those risks. Some illnesses or conditions which can be worsened by aging and HIV (or treatments for it) include:
  • Dementia
  • Depression
  • Insulin resistance
  • High cholesterol and triglycerides
  • Infections
  • Medication interactions
**********************************************************
Mental Health and Substance Abuse in Older HIV Infected Adults, Are we as a Community Prepared?

What I'm not reading enough on or being talked about is mental health and substance abuse in older HIV infected adults.

 As a consumer on SSDI and living in a major metropolitan area my clinic Callen-Lorde has opened a new building to keep up with the demand for all with HIV/AIDS living with chronic mental health issues, I'm fortunate to have this, but as you get away from the bigger cities, these services are not readily available and if you find them many are not LGBT affirmative keeping many away from being properly diagnosed.  Thanks to local chapters of (NAMI) National Alliance on Mental Illness and (DBSA) Depression Bipolar Support Alliance the gap does have some resources.  In Brooklyn we are fortunate to have the only LGBT Outpatient facility in the nation called Rainbow Heights Club, we need a Rainbow Heights in each state, we need trained LGBT hospice care workers, our community at large to me has been dormant on the issue of mental illness in the gay community as a whole, so I'm hoping that the emphasis on HIV/AIDS and aging awareness now in it's 7th year, coupled by the Affordable Care Act and the Mental Health Parity Act we will see more long term mental health GLBT affirmative facilities in the existing AIDS service organizations pop up.



In the News today :


I did find one Op-Ed in the Advocate, a good read but with very little or should I say not once did I read the word mental illness, I did read, "Like other seniors, many older persons living with HIV also have other common diseases, such as heart disease and diabetes. Living with multiple health conditions can be very challenging both physically and emotionally."  And another mention, "When you couple that with the stigma that some older LGBT people face when they move into senior living communities, it can be a difficult psychological burden," for the entire article read here.





For more resources on  Mental Health and Substance Abuse in Older HIV Infected Adults:

HIV, Psychiatric Comorbidity, and Aging


Authors: 
Julia L. Skapik, BS, and Glenn J. Treisman, MD, PhD

Read complete article:
http://www.consultant360.com/articles/hiv-psychiatric-comorbidity-and-aging

Psychosocial, mental health, and behavioral issues of aging with HIV
http://www.natap.org/2014/HIVAGE/061614_02.htm


Psychosocial, mental health, and behavioral issues of aging with HIV  Rueda, Sergioa,b,c; Law, Stephanied; Rourke, Sean B.a,b,e

http://journals.lww.com/co-hivandaids/Abstract/2014/07000/Psychosocial,_mental_health,_and_behavioral_issues.7.aspx

 

Aging with HIV and AIDS: A growing social issue

Date:
June 25, 2014
Source:
St. Michael's Hospital
http://www.sciencedaily.com/releases/2014/06/140625132443.htm

ASA, American Society on Aging (source)
Mental Health and Substance Abuse in Older HIV Infected Adults, by Lisa Cox


Wednesday, September 10, 2014

Health, Home, Purpose and Community. I have all of that yet still feel isolated from my Queer Community

Health, Home, Purpose and Community
So why do I still feel isolated from my Queer Community


From SAMHSA's: Leading Change A plan for SAMHSA's roles and Actions 2011 - 2014.

"Recovery is a unique journey for each individual, and each person in recovery must choose the range of services and supports ranging from clinical treatment to peer services.   To facilitate resilience, recovery, and social inclusion, persons with mental health and substance abuse use disorders will also need to receive treatment for their co-occurring health problems.  Access to services must be paired with shared decision-making process between people in recovery and providers to determine how best to select, structure, and delivers services.  Like other aspects of health care and unless adjudicated by courts of law, people have the right to choose and determine what services and treatments best meet their needs and preferences.  Self-determination is the foundation of person-centered and consumer-driven recovery supports and systems, including such approaches as person-centered planning, shared decision making , and peer-operated services.  People in recovery should be meaningfully involved in all aspects of behavioral health services, including planning, policy development, training, delivery, administration, and research."

A mouthful for sure, but me me as a person with mental health and substance abuse use disorders while receiving treatment for my being HIV+, while being disabled I often question is my recovery 100% or half way or held back do to being on social security disability insurance that keeps me feeling isolated from my own queer community after following the goal of recovery that is exemplified through a life that includes:
  • Health----Overcoming or managing one's disease(s) as well as living in a physically and emotionally healthy way;
  • Home----A stable and safe place to live that that supports recovery;
  • Purpose----Meaningful daily activities, such as a job, school, volunteerism, family, care taking, or creative endeavors, and the independence, income, and resources to participate in society; and
  •  Community----Relationships and social networks that provide support, friendship, love and hope. 
I've mastered all of these things, managing my health, through disability as both a bipolar and HIV+ aging gay man secured affordable housing.  Secured through volunteering a job in itself, to that of a part-time job thanks to social security who has a model that supports part-time employment  with hopes of full time employment, a joggling act in itself as you need the Medicare and Medicaid if you qualify to pay for health care expenses and medications that exceed some $56,000+ a year, most of that costly medications.  Then lastly as a gay man who's aging, soon to be 56 years old, shunned by my peers do to the combined multiple stigmas from within my own LGBT community who if I'm on disability, managing my health, have a home, then why is it so hard to find community, relationships, social networks, love and hope and friendship.

It's my GLBT community that causes me to struggle as I don't meet their expectations of someone who's not just housed and has purpose, but in their eyes living in poverty as the model keeps you in poverty to have all of these things and be fully recovered is where I'm at soon to be 56 years of age.

Much is written on disparities and poverty, low income and I will pick up on this topic  and look at what's being done for the Lesbian, Gay, Bisexual and Transgender community over all health and those of us living in the commmunity living with both substance abuse and behavioral health care and co-occurring  HIV+ diagnoses, all three each a hurdle in itself, combined I'm often told when out speaking, sharing my story what are you doing as a consumer of all of the above to survive.

If this is you, if you feel have followed an excellent model, one that I advocate for as well as advocate for treatment for both, and are aging and feeling isolated, I'd love to hear from you.

I also want to share with you a story that happened recently.  I ran into a friend, fellow HIV/AIDS cyclist from years ago, we exchanged our hello's and quick catching up when an articulate panhandler approached, this was on ninth avenue in Manhattan, 10:30 AM.  He showed us a $1 and said he was short $.50 cents of which both myself and my friend each had a quarter and gave to him.  He said thank you and then added, what' the best nation in the Country, I said not the United States, can it be France...his response was a donation.  That was both funny and for the short time this individual was talking to two others, he felt socially connected (social inclusion), not social exclusion.

Moral of this story, be safe, I know it's hard, but if you don't have change a simple hello, or acknowledgement that there is a person asking you will go a far way in his or her day.  And if you do, even a quarter or dime will help. Social inclusion, not social exclusion has to start somewhere.




Tuesday, August 26, 2014

August 2014 HIV and Mental Healh in the News


With a Mandate for Change, a Longtime HIV/AIDS Leader Steps Up as Chief Officer for NYC's Massive Human Service Agency by (Julie "JD" Davids, theBody.com August 25, 2014)

Read More:

http://www.thebody.com/content/74898/with-a-mandate-for-change-a-longtime-hivaids-leade.html

"Tasked with managing all that HRA's 14,000 staff members do to provide direct services to New Yorkers, Tietz now oversees a broad range of programs, including Adult Protective Services; the HIV/AIDS Services Administration; Domestic Violence; Shelters and Services; Disaster Assistance and Crisis Management and Customized Assistance Services for public assistance recipients."

 

Opinion: Shining a light on mental illness (Robert T. Foster, Edmonton Journal

Read More::

http://www.edmontonjournal.com/opinion/Opinion+Shining+light+mental+illness/10137796/story.html

 "Almost five per cent of admissions to hospitals are related to mental health issues, including anxiety, bipolar disorders, major depressive disorders, low-grade depression, schizophrenia, personality disorders, obsessive-compulsive disorders (OCD), impulse control, eating disorders, substance abuse and suicidal behaviour. Such disorders comprise the second highest cost of running a hospital in Canada."

"Suicide is responsible for about 25 per cent of all deaths among 15- to 24-year-olds and 16 per cent among 25- to 44-year-olds. It’s one of the leading causes of death from adolescence to middle age"


With advances in HIV care, survivors face other disease risks  Contact: Connie Hughes Connie.Hughes@wolterskluwer.com
646-674-6348 Wolters Kluwer Health 

Read More:

http://www.eurekalert.org/pub_releases/2014-08/wkh-wai081314.php 

"Research and Planning to Meet Health Needs of People Living with HIV"

"Large-scale HIV treatment and prevention programs have substantially lowered the rates of HIV infection and deaths from HIV/AIDS. Dr Narayan and coauthors write, "Today, with over 35 million people living (and aging) with HIV and over two million becoming infected every year, we are faced with a new challenge: addressing morbidity and mortality from NCDs—heart disease, stroke, diabetes and metabolic complications, renal disease, cancers, liver disease, and mental illness—that increase with age and may be related to HIV and its treatment."

 

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