2023-09-28 14:46:10 +00:00
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abstract: 'ContextIn 2019, NHS England and Diabetes UK convened an Expert Working
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Group (EWG) in order to develop a Model and recommendations to guide
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commissioning and provision of mental health care in diabetes pathways
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and diabetes care in mental health pathways. The recommendations are
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based on a combination of evidence, national guidance, case studies and
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expert opinion from across the UK and form other long term conditions.
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The case for integrationThere is good the evidence around the high
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prevalence of co-morbidity between diabetes and mental illness of all
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severities and, the poorer diabetes and mental health outcomes for
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patients when this co-morbidity exists. Detecting and managing the
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mental health co-morbidity improves these outcomes, but the evidence
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suggests that detection of mental illness is poor in the context of
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diabetes care in community and acute care settings and that when it is
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detected, the access to appropriate mental health resource is variable
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and generally inadequate. The Model of integrated care for diabetesThe
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EWG developed a one-page Model with five core principles and five
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operational work-streams to support the delivery of integration, with
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examples of local case studies for local implementation. The five core
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principals are: Care for all-describing how care for all PWD needs to
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explore what matters to them and that emotional wellbeing is supported
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at diagnosis and beyond; Support and information-describing how HCPs
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should appropriately signpost to mental health support and the need for
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structured education programmes to include mental healthcare
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information; Needs identified-describing how PWD should have their
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mental health needs identified and acted on; Integrated care-describing
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how people with mental illness and diabetes should have their diabetes
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considered within their mental health care; Specialist care-describing
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how PWD should be able to access specialist diabetes mental health
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professionals. The five cross cutting work-streams for operationalising
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the principles are: Implementing training and upskilling of HCPs;
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Embedding mental health screening and assessment into diabetes pathways;
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Ensuring access to clear, integrated local pathways; Ensuring addressing
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health inequalities is incorporated at every stage of service
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development; Improving access to specialist mental health services
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through commissioning. Discussion and conclusionsThe Model can be
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implemented in part or completely, at an individual level, all the way
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up to system level. It can be adapted across the life span and the UK,
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and having learnt from other long term conditions, there is a lot of
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transferability across all long term conditions There is an opportunity
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for ICBs to consider economies of scale across multiple long term
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conditions for which there will be a significant overlap of patients
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within the local population. Any local implementation should be in
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co-production with experts by experience and third sector providers.'
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affiliation: 'Sachar, A (Corresponding Author), Imperial Coll Healthcare NHS Trust,
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Charing Cross \& Hammersmith Hosp, Liaison Psychiat Serv, London, England.
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Sachar, A (Corresponding Author), West London NHS Trust, London, England.
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Sachar, Amrit, Imperial Coll Healthcare NHS Trust, Charing Cross \& Hammersmith
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Hosp, Liaison Psychiat Serv, London, England.
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Sachar, Amrit, West London NHS Trust, London, England.
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Ng, Sze May, Southport \& Ormskirk NHS Trust, Paediat Dept, Southport, England.
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Ng, Sze May, Univ Liverpool, Dept Womens \& Childrens Hlth, Liverpool, England.'
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author: Sachar, Amrit and Breslin, Niki and Ng, Sze May
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author-email: amrit.sachar@nhs.net
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author_list:
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- family: Sachar
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given: Amrit
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- family: Breslin
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given: Niki
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- family: Ng
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given: Sze May
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da: '2023-09-28'
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doi: 10.1111/dme.15029
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earlyaccessdate: JAN 2023
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eissn: 1464-5491
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files: []
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issn: 0742-3071
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journal: DIABETIC MEDICINE
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keywords: 'commissioning; diabetes pathway; integration; mental health; mental
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illness; psychological; self care'
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keywords-plus: 'IMPROVE GLYCEMIC CONTROL; PSYCHOLOGICAL INTERVENTIONS;
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PSYCHIATRIC-DISORDERS; RISK; PEOPLE; ADULTS; METAANALYSIS; DEPRESSION;
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OUTCOMES; ILLNESS'
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language: English
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month: APR
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number: '4'
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number-of-cited-references: '55'
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orcid-numbers: Ng, Sze/0000-0002-3449-0541
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papis_id: 90eac81200ca20cbfa1d66e4d50d5f25
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ref: Sachar2023integratedcare
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researcherid-numbers: Ng, Sze/E-2646-2012
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times-cited: '1'
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title: 'An integrated care model for mental health in diabetes: Recommendations for
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local implementation by the Diabetes and Mental Health Expert Working Group in England'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000913167500001
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usage-count-last-180-days: '3'
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usage-count-since-2013: '3'
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volume: '40'
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web-of-science-categories: Endocrinology \& Metabolism
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year: '2023'
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