Psychological and mental health problems are widely regarded, by both people with diabetes (PWD) and healthcare professionals (HCPs), as major barriers to improving diabetes outcomes. International guidelines consistently recommend monitoring the psychological well-being of PWD. So, why is mental health assessment not yet part of routine diabetes care?
Many guidelines convey broad recommendations for mental health assessment without offering practical strategies for implementation. Monitoring or managing newly identified mental health problems is hindered by barriers, both structural (e.g. time, resources) and individual (e.g. skills, confidence, attitudes). Changing clinical practice requires behavioural change.
The National Development Program (2012-2016) for “Mental Health and Diabetes” will focus on strategies to overcome barriers to monitoring mental health, taking into account HCPs’ needs and clinical context, supporting them in developing skills and providing resources. This program is funded by the National Diabetes Services Scheme.
Within the framework of the program we aim to develop:
1. an online and hard copy resource handbook for HCPs to improve understanding and capacity for identifying and managing mental health issues in PWD
2. resources to facilitate PWD to talk about their concerns and diabetes-related distress with HCPs
A mixed method design will be used to inform resource development:
• comprehensive literature review to identify needs, evidence-based strategies, and assessment tools
• interviews with key stakeholders, including PWD and HCPs
• A ‘handbook’ describing mental health problems associated with diabetes: how to monitor, how to address during consultations, when and how to refer to mental health specialists, with strategies to facilitate manageable discussions of mental health issues with PWD
• Online training for HCPs to develop skills and strengthen confidence in discussing mental health
• Online resources for PWD, to facilitate conversations with their HCPs about mental health issues
• Establishment of a national Diabetes and Mental Health Professional Network