Mental health in diabetes: can’t afford to address the service gaps or can’t afford not to?

Tina Ambury

doi:10.3399/bjgp20X708365

I must admit that when the BJGP arrived, and I started this article,¹ I became cross and didn’t finish it. The paper version was of course recycled. But, a couple of patients whose issues piqued my curiosity in the first place brought me back to it online. It still irked and then a throwaway comment in the final paragraph seemed to suggest, ‘well all right then’.

I have no issues at all with the service described here but I think that final comment has things back to front. Yes, complex mental health issues in diabetes are an unmet need. Yes, this deserves to be funded properly. However, what is needed is not a diabetes-focused, or even long-term-condition-focused, mental health service. What is needed and has been for a very long time (I’ve been a doctor for 34 years, a GP for 27 of those, and I can’t remember a time when mental health was adequately provided for) is a comprehensive, flexible mental health service.

If such were available, then I wouldn’t have to fight for every single child or young person referral to be accepted and Adverse Childhood Episodes would be better managed. If such were available, then all of my patients with long-term conditions would get the support they need to optimise their management. For far too long the mind–body (false) dichotomy has failed to grasp the interdependence of physical and mental wellbeing. Funding is indeed needed in a sustainable fashion for mental health services and not just for people with diabetes.

REFERENCE

1.↵
1. Sachar A,
2. Willis T,
3. Basudev N
(2020) Br J Gen Pract, Mental health in diabetes: can’t afford to address the service gaps or can’t afford not to? DOI: https://doi.org/10.3399/bjgp20X707261.