INTRODUCTION
Mental health difficulties are the norm in diabetes not the exception.1 They span from dementia and depression to anxiety and addictions, and of course diabetes distress and diabulimia. All mental illnesses can negatively affect a person’s ability to self-manage and self-management is the central tenet of diabetes care.
It is not surprising then, to learn that addressing mental health difficulties not only improves mental health outcomes but diabetes outcomes too.2
We need to embed and integrate mental health care into the entire diabetes care pathway. But in diabetes commissioning, mental health is usually an afterthought and often seen as a ‘nice to have’ part of the pathway rather than an integral component. Can we really afford to leave it there?
FROM THE HORSE’S MOUTH
The Too Often Missing report1 is an extensive survey of people with diabetes (PWD), GPs, and other professionals about mental health and wellbeing in diabetes. It found that 70% of PWD feel overwhelmed by the demands of their condition. Of these, three-quarters said that their self-management was affected by their emotional struggle and three-quarters felt that they could not access the specialist mental health support they needed.
The report also found that healthcare professionals often lack confidence in raising the issue of mental health and wellbeing with PWD and so they avoid it.1 In particular, they struggle to support people who are not engaged with their management plan (often referred to as ‘non-adherent’ or ‘non-compliant’) and they are concerned …