Objective To describe the introduction of social work services in New York City Department of Health & Mental Hygiene Bureau of STD Control (NYC DOH) clinics.
Background Each year the NYC DOH STD clinics serve over 120 000 patients. Services include free and confidential testing for HIV and other STDs, STD treatment, emergency contraception and the hepatitis vaccine. Social work services were introduced at the STD clinics in 2008 to address mental health and social service needs that often drive high risk sexual behaviour, such as substance abuse, domestic violence and untreated mental illness. Social work services include short-term counselling and referrals to outside agencies.
Methods Patients are routinely screened for social work and mental health needs during interviews with physicians or disease intervention specialists (DIS), and are referred to a social worker or mental health counsellor assigned to the clinic. As appropriate, patients are provided with behavioural interventions utilising motivational interviewing techniques and short term counselling. Patients are also referred to local resources for additional services.
Results Since July 2009, 471 patients were referred to the on-site social worker or mental health counsellor and 460 (97%) were evaluated. 40/460 patients (9%) received short-term counselling at a NYC DOH STD clinic. 200/460 patients (43%) were referred to local agencies specialising in domestic violence/sexual assault, public health benefits/health insurance to legal and housing services. 100/460 patients (22%) were referred to a health clinic and 120/460 (26%) patients were connected to mental health agencies. All 40 patients who received short term counselling at a DOH STD clinic returned for follow-up social work visits, independent of STD care.
Conclusion In a busy STD clinic, social work services can be introduced and utilised by patients, allowing physicians and DIS to focus on clinical patient issues. Offering more comprehensive care may be expected to improve patient outcomes and care. Follow-up data are required to measure the long-term impact of these services on sexual risk-taking and on rates of STDs and HIV.
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