HIV and Mental Health

HIV & Mental Health

If you are living with HIV, you may have been given plenty of guidance and treatment to improve your physical health but looking after your emotional and mental health is just as important.
There are many different types of mental health issues, such as depression, anxiety disorders, low self-esteem or personality disorders. This section helps cover the basics, along with where to get the support you need.

Mental Health

Our mental health is equally important as physical well-being. In New Zealand, there are numerous organisations that provide support for mental health. There are also incredible amounts of information online and this can confuse us about what help we are looking for.
In 2019 the Ministry of Health and Disability recorded that 1 in 5 New Zealanders had used mental health and/or addiction services in the past 12 months.
In comparison, approximately 43% of people living with HIV met the same criteria (The Aotearoa New Zealand People Living with HIV Stigma Index, 2020). Some of the other overlooked stressors that are commonly experienced for people living with HIV are grief, shame, survivor’s guilt and PTSD.

While the statistics show the difficulties that many people living with HIV face, it does not really tell the whole reality, many other things can compound our feelings. Covid and lockdowns have made things much tougher for many people, even more when we are not feeling our greatest.

What can you do to nurture your mental health?

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Some ways for you to think about improving your mental health could be:
  • having healthy relationships
  • be part of your local community
  • learning new hobbies/skills
  • physical activity such as hiking, sports, yoga, etc. are always a good thing (work within your own limits, we are not all olympians!)
  • getting out into nature (if you live in a city, head to a park for some space)
  • a good night’s sleep always helps
  • finding positive role models to hang with can help lift moods into a positive place.
Pick things that you enjoy and that make you feel good!
For those who are feeling challenged, there are many options known to be effective for improving mental health. These can include attending a peer support group (or +Social event), counselling like “talk therapy”.

Talk therapy is one of the most widely used, effective, and efficient methods for reducing mental distress and for increasing mental and emotional wellbeing. It can be chatting to friends, family or support people, it's not only about seeing a professional like a counsellor. However, that’s not to say it’s the only way to support mental health, or that you can’t combine several different ways. In fact, it’s actually a very good idea to be open and curious to the various ways that you can nurture your mental health. Some people volunteer and go to social events as a way to helping their mental health while getting extra support on those darker harder days we all face at times.

Activities to release stress

Exercise and physical activity can increase endorphin levels and helps with dopamine production - natural drugs our bodies make to get that good feeling. This can help reduce stress, and help combat anxiety and depression. It doesn’t have to be a marathon of physical activity, just going for a walk by yourself or with a friend and chatting about what’s happening in life some days when things are getting a bit heavy.

Gardening and being out in nature can calm your body and it often feels good to be outside in general, even on a bad weather day. If you do not have a garden of our own, there are community gardens you can volunteer at - side benefits are the veggies & fruit, and you'll make new friends that have a common interest as well.

Yoga, a self-soothing exercise that makes you feel like a human pretzel also helps you practice breathing techniques and meditation. This can be a great way to help self calm when you get that tight feeling in your chest from stress or anxiety. Apps are available to download for free, so you can do this in private at home, or head to a park and use headphones to get that feeling of extra space around you.

Exploring your local community, getting out and about to the numerous parks or shops around your home. Again, you can go it alone or organise a friend or two to come alone for the adventure. Some of the most prettiest places, best new food places, book/music stores have been found by people exploring locally.
Remember to make some quiet time for yourself as well, even if you have a busy day of planned activities, take 30-60min out of your day to do something that doesn’t involve work. Let your mind be calm and have a rest.

Learning a new hobby that you haven’t tried before is another great way to de-stress. Lots of people like to cook dinner as a method of de-stressing from the day, and you get to see results of what you have done which can be extra rewarding.

There are numerous community activities and classes that take place weekly; Body Positive has +Social groups around the country. Or you could use the Meetup app to find whats going on in your area and what interests you. It's about what works for you.

When we are not in the best mental state, it can be easy to isolate ourselves from other people. We are creatures of connection so we desire to be heard and understood. To be heard when we are not feeling the best we need to find somewhere safe to talk about what’s going on in our mind.

It’s ok to reach out to a family member or a friend who you feel safe with. If this is not for you, there are multiple organisations with trained counsellors you can talk to, either by phone, in person or online.
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Is this depression or anxiety?

Everybody goes through times of fear, worry and sadness (pōuritanga). But when those negative emotions are so intense that it feels you’re no longer in control of them, this is where support is most needed.

It is a huge range of negative feelings we can be experiencing and it can be overwhelming. Everyone’s experience is unique and personal to them.

Feeling down and miserable to feeling that there is no interest or pleasure in things, is a form of depression. Having times of panic, or always being on edge and worrying, is a form of anxiety. It’s quite common to experience a bit of both.

Whether you call it depression or anxiety, it doesn’t matter. What matters is that you understand what’s happening, and know what you can do to feel better.

Depression.org.nz has a self assessment tool as well as cultural specific wellbeing resources. The self assessment tool is easy to follow and really helpful to see at times that it's normal to feel depressed or have anxiety, but it's also good to know why and how to get help if we need it.
Life is not easy at times, how can we support ourselves?
Life is hard, but life can be harder still being isolated, having stigma thrown at us (internal and external), being discriminated against because of your gender, sexuality, culture and even more living with HIV.

This information is a way to help you work through the tough times and find ways to live life to its fullest and be happy for who you are not matter what others think or say to/of you.

Explore this website with the idea of find new adventures in life to be happy in yourself. It's a challenge, but you have made it this far, you can go even further still. Don't forget you are not on this journey alone, others have had their own journeys and made it through. If it gets too hard, lean on a friend, find a Peer Navigator/Support person or get in contact with Body Positive as we are here to help. Being happy is the challenge in life, we all want and deserve this in life.

Want more info on depression and anxiety?

There is plenty of information available about mental health:
Good Head is a great site that breaks down the ‘what, who, when, where, and why’ about mental health for Gay, Bisexual and other guys into guys. While it is a Canadian website, the information can be used in a New Zealand context.

Head over to Gender Minorities Aotearoa under the section of mental health where you can find numerous reports and documents that are focused on the Rainbow community.

Depression.co.nz breaks down symptoms and causes of depression. They also have a section about anxiety. They also provide self-tests which can easily be done within ten minutes for both Depression and Anxiety.

Wellbeyond50 is another great website to get some insight into how HIV can affect us as we get older. Both depression and anxiety have been found to be higher with PLHIV and the LGBTQ+2 communities than the over all population. It's a simple easy website to read and explore while also giving information about how to find ways to work with life's issues.
As part of the Government’s response to COVID-19, the Ministry of Health has funded some apps and online self-help tools to support New Zealanders to look after their mental health and wellbeing.

Self-help Tools & Apps

  • Mentemia was developed by All blacks legend and mental health advocate Sir John Kirwin and provides tools to make small daily steps that create big changes for your daily wellbeing
  • Just a thought offers a quick online course to help with stress during Covid and currently offers currently offers the following free cognitive behaviour therapy courses:  Generalised AnxietyDepression and Mixed Depression and Anxiety.
  • Melon Health provides a safe space to connect and support each other with self-care resources for our emotional wellbeing.
  • Small Steps has tools to help with feelings of anxiety, stress, or low mood. Each tool only takes a few minutes.
  • Whakatau Mai / The Wellbeing Sessions, by Changing Minds offer a wide range of free and online wellbeing sessions in real-time, helping to safely support your wellbeing from the comfort of your own space. These holistic sessions include topics such as yoga and fitness, art and poetry, journaling and meditation to mindfulness and various support groups, including one for LGBTQIA+. There are currently up to 11 sessions available per week.
  • Aunty Dee is a free online tool for anyone who needs some help working through a problem or problems. It doesn’t matter what the problem is, you can use Aunty Dee to help you work it through.
  • Headspace: Meditation and Sleep helps to teach you ways of mindfulness and meditation. There are plenty of guided meditations that helps with stress, anxiety, sleep, and personal growth.
Podcasts are a good way to hear about other peoples experiences. Here are a selection of some people living with HIV and others focused on mental health:
Positively Speaking (Audible.com) is a singular episode from Canada that shares lived experiences of people living with HIV and their mental health journey. Some of the discussed topics are substance abuse, challenges of accessing mental health services, isolation, effects of stigma and discrimination, and coping mechanisms.

LivLife provide positively thriving which is a frank and friendly content series made by people living with HIV for people living with HIV.

Bottoming is a podcast aimed towards the LGTBQ+ community in relation to mental health. The host, Brendan and Matthew, navigate difficult conversations and topics within their life while adding humour into it. Its about hitting rock bottom – not sex.

The Anxiety by Tim JP Collins talks about his own personal experience with anxiety, depression and panic attacks. The podcast holds numerous guests but also aim to answer questions that the listeners have sent through.

The Hardcore Self Help Podcast by Robert Duff who is a psychologist from Southern California . His work aims to take complex psychological issues and break them down into simple language to make the information more accessible and easier to understand.

Types of Mental Health Providers

There are different types of people who can help you care for your mental health.
Some mental health care providers in New Zealand are governed by professional associations, which means that they must have completed certain training requirements, abide by a code of conduct, and receive ongoing education to maintain their professional registration. The role of the professional association is to protect the public interest by ensuring that individuals receive competent and ethical professional services.

Other people and mental health professionals may not be regulated in this way but can still be helpful to you. Listed here are some of the options for mental health care providers in New Zealand.
Medical Doctors
Medical Doctors
Medical doctors, such as general practitioners (GP), family doctors or physicians can assess and diagnose mental health issues, prescribe medication, and refer you to more specialised mental health providers, including psychologists and psychiatrists. Going to a general practitioner is a great place to start if you are not sure what kind of mental health care might be right for you
Psychiatrists
Psychiatrists
Psychiatrists are medical doctors who specialise in diagnosing mental health disorders. They can prescribe medication and some offer psychotherapy in their practice, however they normally refer you to counsellor, a psychotherapist or a psychologist. Typically, you need a referral to be able to see a psychiatrist.
Psychologists
Psychologists
Psychologists assess and diagnose mental health disorders as well as prevent and treat mental health issues using psychotherapy. They’re also equipped to assess learning disabilities and ADHD. You can access psychologists through local mental health clinics and hospitals, but you will need a referral from a GP. GP referrals may also be necessary for insurance coverage (if you cannot access public funding). However, you can go through private practice without a referral. Some psychologists also have specialised training that allows them to practice in specific areas, such as neuropsychology, school psychology, or forensic psychology
Psychotherapists
Psychotherapists
Psychotherapists help people to overcome stress, emotional and relationship problems or troublesome habits, this includes: assessing, preventing and treating mental health issues. They aren’t able to diagnose or prescribe medication.

Psychotherapists can work in clinics, hospitals and private practice. These professionals have graduate level (Master’s) training but are not required to have medical or doctorate degrees.
Counsellors
Counsellors
Counsellors assist clients in finding solutions to address the issues in their lives by exploring options, locating information, and providing resources. They help clients identify strengths and needs, as well as develop coping strategies. In New Zealand, counsellors are either in public and private practices.
Social Workers
Social Workers
Social workers assess, evaluate and help you cope with your personal, family and work-related issues. If they have the appropriate training, they can practise some types of psychotherapy. Social workers can also connect you to other services and resources if their organisation does not provide them. Social workers work in hospitals, community centres, schools, social service agencies, and other governmental or community organisations.
Nurses
Nurses
Some nurses specialise in mental health care and can monitor medication. In New Zealand there are trained HIV nurses who are based in the Infectious Disease Departments in the DHB’s. Typically, you can find them working in local hospitals and clinics, schools, and other care facilities.
Occupational Therapists
Occupational Therapists
Occupational therapists assist with mostly physical or mental health problems that interfere with day-to-day self-care tasks, work or school attendance, and leisure activities. You can access occupational therapists in local hospitals and clinics, rehabilitation centres, community organisations, schools, and private practice.
Case Managers
Case Managers
Case managers/caseworkers/individual support workers, work within organisations to work with and walk beside individuals with mental health issues who need support in day-to-day activities. They can connect you to resources available in the community and to the mental health care system. There’s no standardised training requirement to be a caseworker. Caseworkers can be accessed through clinics, hospitals and community health care centres.
Peer Support
Peer Support
Peer support comes from people who have lived and faced the same issues who are willing to discuss the way they have navigated these challenges themselves. Some organisations train peer support workers to be better able to offer support. Typically, peer support workers have specific lived experiences that qualifies them as a peer with a unique perspective on the challenges you face. Peer support workers are most often found in community centres, and peer support groups often meet in churches, community centres, and mental health clinics. Body Positive Inc. has Peer Supporters who are trained in this role to support others living the experience.
Religious & Spiritual Leaders
Religious & Spiritual Leaders
Religious leaders can be a supportive, positive influence on your mental health. They’re also often able to refer people to faith-based resources, such as mental health clinicians who bring religion into their practice. Some religious groups are very affirming of sexual and gender diversity, while others are not accepting. Many groups will indicate if they hold an accepting, affirmative stance towards LGBTQ2+ communities, and if not, it is always possible to ask your community.
Community Leaders
Community Leaders
Like religious leaders, community leaders may also be a supportive, positive influence on your mental health. They often have information on useful referrals used by the community, such as mental health practitioners with culturally-based knowledge that informs their practice. For instance, in indigenous cultures, respected elders are very important community leaders who hold knowledge about community history, practices and activities. With this wealth of knowledge, respected elders have the ability to give guidance on personal and community issues within a cultural context.
Community Leaders
Community Leaders
Like religious leaders, community leaders may also be a supportive, positive influence on your mental health. They often have information on useful referrals used by the community, such as mental health practitioners with culturally-based knowledge that informs their practice. For instance, in indigenous cultures, respected elders are very important community leaders who hold knowledge about community history, practices and activities. With this wealth of knowledge, respected elders have the ability to give guidance on personal and community issues within a cultural context.

Accessing Mental Health Services

Finding the right mental health provider takes time and effort. But it can be well worth it!
Try not to be discouraged if you don't immediately find something that works for you. The relationship with your mental health care practitioner is important, but even the most competent, caring provider won’t be a good fit for every person.

Be curious about what’s out there and don't be afraid to advocate for yourself/ask for support to advocate for you to find the best provider for you. Most mental health care providers know that you need to find a good fit and they should understand if you need to try something different, somewhere else.
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Affordability / Cost

We believe that everyone who wants support should have easy access to a mental health care practitioner. Yet unfortunately, this is not always possible. People often face barriers to mental health care services including difficulty finding health care professionals, high costs, and long wait lists. In New Zealand there is access to funding for most people. Here are some things to consider when you are looking for affordable mental health care.
  • Check to see if there is funded programmes you can access.
  • If you are using private insurance, check if you have coverage for therapy or mental health care through extended health benefits, if you have them (e.g., if you are working or attending school). Many plans include a set amount per year that you can spend on mental health care.
  • Many workplaces also offer free counselling services through an employee assistance program (EAP). The EAP is an employee benefit program to assist employees with personal and/or work-related problems that may impact their ability to work, as well as their health and wellbeing. EAPs offer free, confidential assessments, referrals, short-term counselling, and follow-up services.
  • Another good place to look for low-cost services is through local educational or training programs for mental health professionals. For instance, many universities with clinical psychology or counselling psychology programs run a community clinic where you can see a student trainee, who is supervised by a registered professional, for a reduced fee.
  • With some private practitioners, you may be able to negotiate a reduced rate, also known as a “sliding scale fee.” However, if you can’t afford to see a private practitioner, there are also some options available at community health centres. There is a way to access a limited number of sessions paid for by WINZ if you qualify, you will need to ask the organisation if they use this process for their sessions. Although many of these services limit the number of sessions you will be able to attend, they can be great places to start. One downside, though, is that they can have long wait lists. Enquire with Body Positive Inc. how to apply for WINZ funding.
  • Many peer support groups are free to attend and can be a wonderful source of support if you or a loved one are dealing with mental health challenges.
  • It’s always helpful to have a close relationship with a general practitioner whom you trust. When you do have concerns about your mental health, you can ask them to help you sort through available options.
  • If you’re comfortable doing so, try asking your friends and peers for support and recommendations about mental health services.

Where to start looking

There are many different types of mental health care services available—you can find them in various clinics, private practice offices, community centres and more. But where should you start looking?

In New Zealand some HIV/AIDS service organisations offer counselling services that can be relevant to you. Even if your mental health concerns are not specific to HIV or sexual health, getting connected with a counselling service can be a very effective gateway to support. These organisations are specially trained to deal with a range of issues affecting People Living with HIV. They may be able to help you navigate a complex mental health system and access services.

Professional associations are good options. Professional Associations are organisations that practitioners have to belong to in order to have the right to practice. Most Professional Associations publish directories of their registered, licensed practitioners. Professional Associations are not where people go to school, but they are organisations designed to protect the public from malpractice. So, any complaints of unprofessional, inappropriate or abusive care can be made directly the Professional Association. These associations typically have up-to-date directories of licensed practitioners. In New Zealand you can also lay a complaint with The Human Rights Commission, Health & Disabilities Services, and or directly with District Health Boards (DHB) depending on who the complaint is about and who they work for.

Who to contact for help?

In an Emergency

If you or someone you know has thoughts of a suicide please know that there are people here to listen.
  • Lifekeepers 1737 call or text 24/7
  • Ministry of Health Crisis Assessment Teams (click here for the number to call in your area)
  • Healthline (CATT Team) 0800 611 116 who are able to listen and provide immediate support.
  • Suicide Helpline and Depression - 0800 111 757
  • Lineline Aotearoa - (call 0800 543 354), who are available 24/7 for support
  • Emergency/Ambulance/fire/police – 111
If you are concerned about someone else who is suicidal, Lifekeepers 1737 call or text 24/7 and the Ministry of Health websites have suggestions on how you can hold the conversation with others.
General Contacts 
Body Positive Inc
0800 448 5463
bodypositive.org.nz
An organisation that provides support for PLHIV in New Zealand who are finding barriers within their lives: whether that be in relation to mental health, residency, work and income, treatment, and connecting with other PLHIV plus other services. Office hours: Monday to Wednesday 10am-5pm, Thursday 10am-6pm and Friday 10am-4pm.
Depression and Anxiety Helpline
0800 111 757 or txt 4202
depression.org.nz
Free phone call or text to trained individuals who focuses on depression and anxiety. They work alongside people of different ages and ethnicity and are available 24/7.
Anxiety NZ
0800 269 4389
anxiety.org.nz
Is a non-profit organisation that seeks to provide support for individuals with anxiety disorder or are impacted by anxiety. Their phone line is available 24/7 for anyone that wants a safe space to talk.
OutLine
0800 688 5463
outline.org.nz
A nation-wide helpline that is available 24/7. OutLine is an all-ages rainbow mental health organisation providing support to the rainbow community, their friends, whānau, and those questioning.
Lifeline
0800 543 354 or txt 4357
lifeline.org.nz
If you are wanting a safe space to talk, contact the Lifeline who have trained counsellors that are available 24/7.
RainbowYouth
09 376 4155
ry.org.nz
Provides support for youth (up to the age of 27) in the Rainbow Community. Contact them for a confidential chat, they are happy to listen and provide you with information if needed.
Healthline
0800 611 116
health.govt.nz
The Government-organised phone line is available 24/7 and works to support anyone who is concerned about their mental well-being and their physical well-being.
Need To Talk?
txt or call 1737
1737.org.nz
A trained counsellor is available 24/7 to talk to you whenever you need it. There is an option to ask for peer support who have also experienced mental distress.
Samaritans
0800 72 66 66
samaritans.org.nz
This organisation is a registered charity that is run by the community for the community. Their aim is to give a safe space for people to talk about what’s on their mind. They are confidential and are available 24/7.
For Something More Specific 
Safetotalk
0800 044 334 or txt 4334
safetotalk.nz
If you have experienced sexual harm and want to talk to someone about it, Safetotalk is a confidential phone service that gives you a safe space to talk. They can also provide you more information such as referrals or the procedure to a police report.
Relationship Aotearoa
0800 735 283
relationships.org.nz
Relationship Aotearoa has an expertise in couples counselling, family therapy, working with abuse and violence, working with youth at risk, and workplace issues. They have multiple trained counsellors and offer courses as well to help build strength in relationships.
Problem Gambling Foundation
0800 664 262 or txt 5819
pgf.nz
If gambling is taking/has taken a toll on your life, give this organisation a call between 8.30am to 5.00pm from Monday to Friday. Their site has an option to chat to someone online. There is a test available to see if your gambling has become harmful.
Alcohol & Drug Helpline
0800 787 797 or txt 8681
alcoholdrughelp.org.nz
Call or text to have a confidential chat with a counsellor who will be able to provide you support. There are other helplines dedicated to youth, Pasifika, and Māori in this page
Alcoholic Anonymous
0800 229 6757
aa.org.nz
Their website has lots of useful information about what the program holds and has a quiz that can help you figure out if alcohol is causing you and/or your loved ones harm.
Victim Support
0800 842 846
victimsupport.org.nz
Victim support holds space for people who have been affected by suicide, trauma, and crime. Their aim is to support their clients through their healing process. Their phone lines are available 24/7.
MethHelp Team (Drug helpline)
0800 6384 4357
drughelp.org.nz
Give them a call to find out how to control your meth use or visit their website where you can take a test to see how meth has impacted you.
Burnett Centre (NZAF)
0800 802 437
nzaf.org.nz
This organisation has counselling available for PLHIV. To make a counselling session/appointment go to their website and complete the information.
Positive Woman Inc.
0800 769 848
positivewomen.org.nz
An organisation for women living with HIV.
Are You OK?
0800 456 450
areyouok.org.nz
An organisation there to help support with Family violence issues/matters.
Shine
0508 744 633
2shine.org.nz
New Zealand based organisation to help those in domestic abuse situations. 
Whakatau Mia / Changing Minds
wellbeingsessions.nz
They have sessions that strive to create a safe space for you to learn, share, discuss and connect with other people from all over Aotearoa, in real-time. Their aim is to create an accessible and inclusive space for all our guests. All their sessions are hosted on Zoom and are live.
Mentemia [Smartphone App]
Mentemia
Developed by The Ministry of Health. While this app is aimed at helping people cope with the Covid-19 pandemic, it has ideas and tools to help you learn how to be well and stay well throughout life. It helps you deal with common stressors (such as poor sleep, anxiety and stress).
Centre for Clinical Interventions
cci.health.wa.gov.au
This website provides cognitive behavioural self-help resources for a range of difficulties such as depression, worry, health anxiety, sleep, self-compassion – to name just a few. They provide quick information guides, worksheets and comprehensive modules
Beating the Blues
beatingtheblues.co.uk
Beating the Blues is the most widely used evidence-based online CBT programme for relieving depression.
Just a Thought
justathought.co.nz
Just a thought Free online CBT and therapy for all New Zealanders. Courses for anxiety, depression and COVID related stress. 
Aunty Dee
auntydee.co.nz
A CBT-based approach for wellbeing, anxiety and stress that has been adapted for Pasifika cultural groups by LeVa
Sparx
sparx.org.nz
A New Zealand CBT-based online resource for young people. It is a interactive game-world, designed to help young people who are feeling down.
Well Beyond 50
wellbeyond50.livingpositivevictoria.org.au
This Australian based website discusses issues that affect PLHIV and ageing. It gives great insight into mental health issues, personal stories, sexual health, ageing conditions wellbeing, plus other topics.
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