Mental health services at UK's largest HIV clinic face massive cuts

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Mental health support for patients attending the largest HIV treatment centre in the UK is facing a drastic reduction after funding cuts of 60% were announced.

Cuts amounting to almost £500,000 over two years will substantially reduce the amount of psychological support given to patients attending the Kobler Centre at London’s Chelsea and Westminster Hospital.

Kensington and Chelsea Primary Care Trust, which funds the specialist mental health services provided to HIV-positive patients attending the Kobler Centre, is facing a deficit of £9 million in the current financial year. As part of its recovery plan the Trust is proposing to reduce funding for the Chelsea and Westminster Hospital’s HIV Psychotherapy Services by £228,000 in 2005/06 and a further £228,000 in 2006/7.

Glossary

psychiatry

A branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. Psychiatrists are doctors who trained in general medicine before specialising in mental health. They can prescribe medication.

depression

A mental health problem causing long-lasting low mood that interferes with everyday life.

referral

A healthcare professional’s recommendation that a person sees another medical specialist or service.

A third of HIV-positive patients registered at the Kobler Centre currently have referrals to the specialist HIV mental health service at the Chelsea and Westminster Hospital, which was established by Dr Jose Catalan in 1989. In 2004, 543 HIV-positive patients and individuals using sexual health services were referred for mental health assessment and treatment to Dr Catalan’s unit. A total of 2,537 follow-up appointments were provided for HIV and sexual health service patients. The specialist HIV mental health service at the Chelsea and Westminster Hospital have an international reputation and have been at the forefront of HIV psychiatry and psychotherapy since its foundation.

The current team of three psychiatrists, five psychiatric nurses (one specialising on HIV) and five clinical psychologists would be drastically reduced by the cuts.

As well as providing assessments with a psychiatrist, the specialist HIV mental health team currently gives ongoing psychiatric treatment to HIV-positive patients with depression and other mental health disorders, as well as cognitive behavioural therapy and support and treatment for patients with sexual dysfunction. However, it is extremely doubtful if anything other than the most limited of assessment services would be available if the cuts are implemented.

Kensington and Chelsea Primary Care Trust is justifying the proposed cuts by highlighting that the services provided by Dr Catalan and his team are used by HIV-positive patients from across London. This ignores the unique funding arrangement for HIV which allows patients to choose which hospital they receive their treatment at, irrespective of the area of their residence.

Cuts proposed by the Kensington and Chelsea Primary care Trust would also affect other HIV services. Funding for the Lighthouse, an HIV support centre, would be cut by £133,000 by 2007 and SW5, a health promotion agency working with young male sex workers is facing cuts of £13,000 by 2007.