Danes with diabetes would like more referrals for mental health services
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In a nationwide survey, nearly 1 in 5 people with diabetes living in a country with free, high-quality medical care reported they would like to be offered a psychological referral in relation to the diabetes, according to study data.
“This corresponds to other data showing 1 in 5 experience daily distress, worries and limitations, and more than one-third say they are not getting the support for dealing with thoughts and feelings related to diabetes they need from the health care system,” Søren E. Skovlund, MSc, Dgr, senior research scientist, postdoc and patient-reported outcomes lead in the Value-Based Diabetes Care Programme in the department of clinical medicine at Aalborg University and Steno Diabetes Center North Denmark, Aalborg University Hospital in Denmark, told Healio.
Skovlund and colleagues analyzed data from 8,918 people with diabetes (71% with type 2 diabetes, 26% with type 1 diabetes) and 761 caregivers who responded to the Life with Diabetes 2019 survey emailed to members of the Danish Diabetes Association. The survey was designed by the Danish Diabetes Association, Steno Diabetes Center North and Aalborg University and included a mix of open-ended and Likert-scale statements. Respondents were representative of the regional, sex and age makeup of the general population in Denmark, according to the researchers.
Among respondents with diabetes, 19% reported diabetes distress and that the disease took up “too much of daily life”; 24% of women vs. 12% of men reported they felt they needed but were not offered a referral to a psychologist; and 36% reported needing more support for emotions related to diabetes. Among caregivers, 21% reported they did not receive the support they needed for diabetes-related emotions.
“It’s surprising that we demonstrate these major gaps in support for people with diabetes in Denmark as the country is well-known scientifically for having a very high standard of free medical diabetes care for the entire population,” Skovlund said. “The findings reveal that despite highly developed and publicly available care access in Denmark, the fact that reimbursement of mental health services for people with diabetes and integration of psychosocial aspects into all aspects of individualization of care are not yet a reality, results in significant negative implications for up to 20% of people with diabetes.”
The researchers found that greater perceived need for mental health services was associated with female sex, insulin use in type 2 diabetes or having type 1 vs. type 2 diabetes, being unemployed or experiencing forced retirement. Less perceived need for mental health services was associated with access to a person-centered health provider. Analyses of open-ended responses revealed that improvement was needed related to access to new technology, quality of care in primary practice, and lifestyle care beyond medicine.
“Clinicians can act on the results now,” Skovlund said. “Invite their patients to prepare well for their coming diabetes visit: consider their life situation and how it impacts ability to manage diabetes, their daily experience and approach to managing diabetes and priorities and needs in order to live a good life with the condition. Review with the well-prepared patient both physical/clinical, social and psychological well-being and care/support needs to ensure [these] carefully reflect the whole person and what matters most to the person.”
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Skovlund SE. 20-OR. Presented at: American Diabetes Association Scientific Sessions; June 12-16, 2020 (virtual meeting).
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