A joint blog by Rosie Walker, Successful Diabetes and Keith Meadows, Health Outcomes Insights
An excellent recent paper culminating from a working group convened by Diabetes UK and NHS England, makes recommendations for supporting emotional health in diabetes care. It articulates 5 core principles and 5 work streams, showing how these cross-cut and can be realistically brought into being by the new Integrated Care Systems (ICSs) (Sachar, Breslin and Ng, 2022)
One of the most striking things about which this paper provides a reminder, from a 2019 publication ‘Too Often Missing’, (Diabetes UK, 2019) is that only 10% of services appear to be making assessments for diabetes related emotional health
The paper also builds on and references several other important pieces of work commissioned and published, for example by Diabetes UK, especially showing where emotional health matters have tended to lack importance compared with the attention the physical aspects of diabetes receive. A clear call to rectify this, from the voices of people living with diabetes is made throughout all these papers. More, the evidence presented shows that virtually any intervention – from prioritising ‘how are you feeling about your diabetes?’ at the start of a consultation, to more complex therapies such as cognitive analytical or behavioural therapy and medications for depression and anxiety – works to lessen diabetes distress and other emotional difficulties, enabling people having to live with this multifaceted, always-in-your-face condition, to get on with the job more successfully
While the exact percentage of services providing assessments might have changed in recent years, with the emphasis and new attention on mental health matters, for example the publication of Diabetes UK’s Emotional Health Guide (Diabetes UK, 2019) and the impacts of Covid-19, this is still a vanishing small number, given that everyone with diabetes has an emotional life as well as a physical one, and that diabetes is very well known to have a specific impact on this. Physical checks and assessments are accepted to be necessary at least annually. If that is the case, the question must be asked ‘why not also assess for emotional health impacts too?’
One reason why such assessments are not made, might be that while well-validated and easy tools exist for the purpose, healthcare staff might not be familiar or even confident in administering them or, perhaps more importantly, not sure about how to interpret the outcomes, take appropriate action themselves or make referrals – or, as we have often heard many people put it ‘opening a can of worms and not being able to close it’. This is completely understandable, given the lack of attention to these matters described above, but as the recommendations from this working group suggest, more training and skill development is as essential for this as it is for knowledge and skills in physical checks
To us, who have worked for many years to highlight and measure the emotional side of diabetes, and also specialise in providing such training, the content of this paper is so welcome in recognising not only the skills required for supporting emotional health, but also for making assessments of it. As the saying goes, ‘what gets measured, gets done’. This is why we have created our unique workshop for diabetes health professionals and other staff,to provide skills and confidence in both practical assessment and providing verbal and non-verbal emotional support in everyday practice, bringing to life these recommendations
One drawback, as is seen in many areas of care today, is the cost, both in terms of time and money, to access such training. Some such training is provided free of charge and providers are helpfully mentioned in the paper. However, as we all know, there isn’t really such a thing as a ‘free’ training – somewhere along the line it needs to be paid for, by commissioning or funding, even self-funding, for both the provision and the time. As a charging provider, we nevertheless believe our training is highly cost-effective
Another saying is ‘where there’s a will, there’s a way’ and we urge all ICSs, diabetes services, teams, practices, to find such a way, for example from, local training or diabetes budgets and through commissioning or external educational grants or sponsorship, for investment in a few simple hours. Hours which are virtually guaranteed to make their lives, and more importantly, the lives of people living with diabetes, demonstrably easier
Successful Diabetes and Health Outcomes Insights provide ‘Supporting and Assessing Emotional Health in Adults with Diabetes’ workshops, monthly, online, for £50pp: details here
Bespoke workshops for teams or groups of staff can also be commissioned and provided either face-to-face or online: All enquiries:
Rosie Walker
Successful Diabetes
enquiries@successfuldiabetes.com
07885 499943
References
Sachar A, Breslin N, Ng SM. An integrated care model for mental health in diabetes: Recommendations for local implementation by the Diabetes and Mental Health Expert Working Group in England. Diabet Med. 2023;00:e15029. doi:10.1111/dme.15029
Diabetes UK. Diabetes and Emotional Health: A practical guide for healthcare professionals supporting adults with Type 1 and Type 2 diabetes. 2019
Diabetes UK. Too Often Missing. 2019
