International Journal of Emergency Mental Health and Human Resilience
Open Access

Abstract

Background: Adolescents living with HIV (ALHIV) on antiretroviral therapy (ART) experience major mental health challenges which negatively affect their psychological well-being, and HIV treatment outcomes. Lighthouse Trust introduced the Psychosocial program in 2019 to address mental health and psychosocial issues among people living with HIV including adolescents. The program encompasses assessment using Lighthousedeveloped Psychosocial Initial Assessment tool, psychotherapy and referral for medical treatment or psychiatric services. The assessment tool categorizes levels of risk of loss to follow up, as low, medium, and high risk. We aim to describe common psychosocial problems presented by ALHIV aged 10-19, at Lighthouse Trust ART clinic in Lilongwe, from January to December 2023. Methods: We reviewed routinely collected program data in psychosocial registers for adolescents living with HIV referred for psychosocial services at Lighthouse clinic. Descriptive statistics were done on client demographics, reasons for referral, psychosocial conditions, and risk categorization. Results: There were 284 adolescents living with HIV referred for mental health and psychosocial services, of which 175 (61.6%) were females. The median age was 15 years (IQR of 13-17 years). Reasons for referral included high viral load 125 (44%), client HIV status disclosure 56 (19.7%), self-referrals 43 (15.1 %), poor adherence 16 (5.6%), ART initiation 13 (4.6%), loss to follow up 12 (4.2%), missed appointments 11 (3.9%), and gender-based violence 8 (2.8 %). Upon assessment, 69 (24.3%) had social issues, 66 (23.2%) had anxiety disorders, 54 (19%) had stress, 37 (13%) depression, 15 (5.3%) had anger, 18 (6.3%) had stigma and discrimination and 11 (3.9%) had trauma, 8 (2.8%) had grief, 6 (2.1%) had alcohol and substance abuse. On the level of risk of loss to follow up, the assessment found 181 (63.7%) on high risk, and out of these, 97 (34.2%) had anxiety, depression, and substance abuse as the common mental health issues. All adolescents were then managed accordingly. Conclusion: Social related issues, anxiety, stress, and depression are the most common issues among adolescents referred for psychosocial care. Increased awareness of psychosocial services has also led to self-referrals in adolescents. Continued psychosocial support is recommended to prevent clients from experiencing negative health outcomes. Track: HIV Co-Morbidities (including hepatitis, tuberculosis, sexually transmitted infections, noncommunicable diseases and mental health conditions)

Biography

Majid Joseph Lungu is an experienced, value driven psychotherapist currently working as a Mental Health and Psychosocial (MHPSS) services coordinator for Lighthouse, a registered Public Trust established to manage Centres of Excellence (CoEs) and provide leverage for leadership and delivery of integrated HIV prevention, treatment, care and support services in Malawi. Joseph has over 20 years of counseling experience, now responsible for the overall coordination, leadership and service delivery of the mental health and psychosocial services in all the Lighthouse Trust’s CoEs in the central hospitals in all the four regions of Malawi. Joseph’s main objective of his career has been to facilitate the integration of mental health and psychosocial services in the health service provision in Malawi.