Around 85 per cent of adults with diabetes in the UK lack access to specialist psychological support and care, according to a new report by Diabetes UK. ‘Minding the Gap – The provision of psychological support and care for people with diabetes in the UK’ found that only 25 per cent of diabetes services can actually name and supply contact details for people who provide specialist psychological care. And in almost half of those services there is only local generic mental health provision, which is provided by professionals with no specific knowledge or experience in the area of diabetes.
Depression, eating disorders, needle phobias
There is consistent evidence of elevated rates of psychological problems in people with diabetes. Depression, which is doubled in people with the condition, and other psychological problems such as eating disorders and needle phobias lead to poor diabetes self-care, high blood glucose levels and subsequent medical complications such as blindness, heart disease, amputation, stroke and kidney failure.
Treatment can reduce risk of complications
However, it has been shown that treatment for psychological conditions can lead to reduced risk of these complications, improved blood glucose control and reductions in both psychological distress and overall healthcare costs.
Diabetes services found wanting
The report also found diabetes services lack basic elements of care relating to psychological needs.
Only one in ten use any screening and assessment tools for psychological problems and almost 80 per cent of services have no guidelines for referral of people with psychological problems.
On top of this, only two per cent of services complied with all psychologically relevant National Service Framework (NSF) standards and NICE guidance recommendations, and a quarter did not comply with any of them.
Life with diabetes can be challenging
Emotional and psychological support needed
“Living with diabetes can be challenging and the emotional stress of having to deal with this complex condition on a daily basis means specialist psychological services are crucial," said Bridget Turner, Head of Healthcare and Policy at Diabetes UK.
"People with diabetes need easy access to emotional support and some need more specific psychological support.
“Many psychiatric services in secondary care increasingly focus upon what has come to be known as ‘severe mental illness’ – in effect, psychotic conditions. The majority of people with diabetes who have significant psychological problems do not have severe mental illness and so need specialist diabetes, as opposed to generic, psychological help.
“The Government also needs to address waiting times for psychological care. Only 28 per cent of services can see routine patients within one month of referral and 17 per cent of services declared their waiting time for routine cases to be in excess of three months. Such a delay in receiving help should not be acceptable in any modern healthcare system.”
Diabetes UK calls for better psychological services
Diabetes UK is calling for psychological services to be needs-led, better organised and to avoid the current ‘postcode lottery’ set-up. The Government should take account of this, given its stated commitment to the emotional wellbeing of people with diabetes and its aim of improving access to psychological therapies.
Diabetes healthcare professionals also need to be trained to enable them to deliver this support themselves wherever possible.
Furthermore, greater prioritisation of care planning to support people with diabetes and healthcare professionals to work in partnership to identify and address emotional concerns would go a long way towards creating a more patient-centred service.
Need to talk? Call Diabetes UK Careline
The Diabetes UK Careline offers information and support on any aspect of managing diabetes.