Some people think HIV is now just a physical illness that can be managed with medication. The medical advances of the last twenty years have certainly improved the outlook for people with HIV, with many living long and productive lives, but there is a flip side: as efforts to fight the physical effects of the virus have borne fruit, the mental health implications of a HIV diagnosis are continuing to wreak havoc with people’s lives.
People living with HIV are disproportionately affected by depression, anxiety and a range of other mental health issues. That isn’t because the virus itself causes neurological damage – it’s primarily because of the stigma that still exists around HIV. We hear stories from members about dentists who refuse to treat them because they are positive, and doctors or nurses who put on two pairs of medical gloves to treat them – ultimately a silly measure that says more about some medical professionals’ ignorance about the virus than it does about the likelihood of infection. Experiences like this can warp members’ sense of the world around them and cause them to isolate themselves, to hide away from the rejection and disapproval they get from society. This isolation, coupled with the stress of living with a chronic condition, can create a dangerous breeding ground for mental distress.
The first thing we do when people come to Body & Soul is to integrate our members in a community. When people isolate themselves, they can end up in a vicious cycle of low mood and negative thoughts which, when accompanied by a positive diagnosis, can lead to depression. To combat this, we create an atmosphere that nurtures a sense of belonging – for example, every Tuesday evening members come together in our centre in Clerkenwell and eat dinner together as a community of friends, meeting people and chatting in a supportive environment. After dinner they can access a range of practical services as well as complementary therapies such as shiatsu, massage and acupuncture.
Perhaps the most important thing that Body & Soul offers its members is time. From the very beginning, new members are given time – time to feel comfortable in a new environment, time to establish relationships with staff, volunteers and other members, and time to share their experiences and feelings. Because of the constraints that the NHS is under, the professionals who work there just aren’t able to give people the time required to establish such a deep level of trust and understanding. We at Body & Soul have the luxury of spending time with our members week after week, month after month, year after year – time for them to express themselves as best they can, time for us to understand them as best we can.
The aim of World Mental Health Day is to raise awareness of mental health issues. This chimes nicely with the work we do here at Body & Soul to increase members’ awareness of the ways that mental health can manifest itself. One of our aims to open the minds of members to the things they can do to take care of themselves. At tomorrow’s service evening we will reintroduce all of the therapies available at Body & Soul to our adult members to remind them of the range of options at their disposal. The idea is to empower them to make their own decisions about the kind of support that works best for them, an approach that we know from experience leads to better mental health.
Adrian Deen is head of adult services at Body & Soul. He has a degree in biology and a master’s in the history and philosophy of science. He is particularly interested in the social construction of illness.