New directory lists mental health providers with diabetes expertise

[May 08, 2018] By Carolyn Crist

(Reuters Health) - The American Diabetes Association and the American Psychological Association have created a new public directory of mental health providers with diabetes-specific education or experience, the organizations announced recently.

Coping with diabetes can be a stressful and sometimes life-long burden that may contribute to anxiety, depression and other mental health issues.

The two professional groups built the ADA-APA Mental Health Provider Diabetes Education Program in 2017 to give therapists the tools to treat the unique mental health challenges that diabetes patients face.

Moore than 100 professionals completed the program last year and are now listed in the online directory (https://bit.ly/2qwpecx).

"It is critical for people living with diabetes to have access to comprehensive support and care in order to manage this chronic illness," said Dr. William Cefalu, ADA's chief scientific, medical and mission officer.

"Diabetes is unique because it is managed on a daily basis by the person with diabetes, requiring that individuals make hundreds of health decisions - from food choices to medication administration - each and every day," he told Reuters Health by email.

This puts people with diabetes at an increased risk for anxiety, depression and eating disorders, as well as patient burden while managing the disease. In particular, depression rates are twice that in the general population, and some common medications used to treat depression interact with diabetes treatments, said Doug Tynan, APA's director of integrated care.

"We know the complex relationship between diabetes and depression symptoms," he told Reuters Health by phone. "We wanted better information for both prescribing therapists and non-prescribing therapists such as social workers to understand the interactions with behavior and emotion that they may see."

The education program is a seven-hour, in-person course offered at both the ADA and APA's annual meetings, followed by a five-hour online course. Licensed providers can also be included in the directory if they can demonstrate at least two years of professional experience addressing the mental health needs of patients with diabetes.

Registration filled to capacity for the first two programs in 2017, and now more than 100 providers from 26 states are part of the directory. Two additional trainings will be held this summer at the ADA's Scientific Sessions on June 21 and at the APA's Annual Meeting on August 5. During the training, professionals learn how to test their blood, count carbohydrates during meals and live with diabetes management, Tynan said.

"Are you treating the patient for two separate disorders or one with both physical and emotional manifestations?" he said. "If your blood sugar is poorly controlled and you need to get up several times in the night, is your sleep disturbed due to diabetes or depression? To us, it's all the same."

The ADA first recommended routine mental health screenings for patients with diabetes in 2016. The organization released a position statement about psychosocial care to emphasize the critical mental health element of diabetes care. The group also added mental health recommendations to the 2017 Standards of Medical Care in Diabetes, the ADA's annual guide to diabetes care.

"To truly understand diabetes in the life of a patient, it requires understanding the ins and outs and the daily demands that go into managing diabetes," said Cynthia Munoz, a pediatric psychologist at the Children's Hospital of Los Angeles. Munoz, an ADA board member, serves as one of five experts on the steering committee that oversees incoming applications and training for the directory.

"It's a relentless condition with blood glucose checks, insulin doses, and food and drink intake," she said in a telephone interview. "People don't realize the math involved with diabetes and all of the calculations and monitoring required."

The recommendations remind healthcare providers to consider the life circumstances of the patient with diabetes when considering treatment, particularly for those at lower socioeconomic levels who have limited access to both diabetes services and mental health professionals, she noted.

"Many people want to be supportive of our diabetes community but lack the expertise to provide support," Munoz said. "The providers in the directory understand what diabetes is - and what it's not - and can work with patients as a team to provide that support."

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