July 14, 2006

"Mental health counseling helps me stay clean and maintain my health as a person living with HIV. The counseling is part of my foundation."—ASC client

Since 2003, ASC has offered onsite mental health services in collaboration with Gouverneur Hospital. Staffed by a licensed psychologist and a licensed clinical social worker, the Gouverneur Counseling and Support Team operates onsite at ASC, offering full-spectrum mental health services: individual counseling and psychotherapy; group, couples, and family counseling; home visits for severely ill clients; treatment adherence counseling; and coordination of care. In 2005, these services reached 163 men and women—most of whom are homeless, mentally ill, chemically addicted individuals.

Why are these services so essential? "Without mental health care, our patients fall right out of primary care, out of housing, out of every type of service that could help them survive," explains Dr. Genata Carol, who oversees the mental health services at ASC. "Nearly 100% of our patients have histories of trauma, neglect, sexual abuse, violence, chaos, instability—dire things that most people cannot conceive of."

For many, mental health services are a lifesaver. "Without this service, I would have found a way to drink myself to death. I was really that far gone," explains one client. "When I started seeing Dr. Carol, I was so depressed, I wouldn't leave the house, except for my weekly counseling appointment. She encouraged me, pulled me out of my shell. The counseling was my touchstone, my anchor. It's been a hard road, but week by week, I've stayed clean and sober."

According to mental health team member Douglas Ruest, LCSW, "For many people, an HIV diagnosis can surface as self-blame—the sense that they don't deserve to live. We work with people to process these feelings, because there is a direct correlation between how people feel about themselves and their ability to take their medications, see their doctors, and take care of themselves."

The Gouverneur mental health team serves people who cannot afford private mental health services and for whom hospital-based services are not an option. "The only way most of our clients will go to a hospital is on a stretcher," says Dr. Carol, "People with histories of incarceration or homelessness have huge problems with authority. Services have to be low-threshold, where they can get multiple needs met—clothing, a meal, help with housing, and other services—which is exactly how it works at ASC."

"ASC's partnership with Gouverneur is an excellent example of how interagency collaborations yield powerful outcomes for communities in need," says ASC Executive Director/CEO Sharen Duke. "Onsite access to multiple services through ‘one-stop-shopping' is the key to linking underserved populations with care."

In the eyes of one client, "They have everything at ASC—all the resources you need. My case manager is helping me with money management, advocating with my doctor, and moving to another apartment. She even reminds me of my appointments, since I have some HIV-related dementia. I also use the ASC Food Pantry. And the mental health counseling is helping me stick with my recovery. ASC is a blessing in my life."

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