Helping Mental Health Specialists Better Serve People With Diabetes
A teenager with diabetes visited a therapist with his parents. Years of daily diabetes management had taken a mental toll on all three. They were dealing with a condition known as diabetes burnout, but the counselor was clearly not familiar with the stress, anxiety, and lack of motivation that often comes with diabetes. The therapist’s advice? Take a break for a week. Stop checking blood glucose. Forget about monitoring levels. Skip the insulin. In short, the therapist handed the family a very dangerous license to stop managing diabetes.
It’s a true story, one that the family relayed to Cynthia Muñoz, PhD, MPH, at their first counseling session with her. “People wish they could take a break,” says Muñoz, a pediatric psychologist with Children’s Hospital Los Angeles. “But it’s not an option.”
People with diabetes have an elevated risk for mental health issues. They’re more likely to experience anxiety and eating disorders. One in four experiences symptoms of depression. And many are familiar with diabetes distress: worry, anger, frustration, or guilt that crops up at times.
Mental health issues can, in turn, make diabetes management more difficult. Yet people with diabetes have trouble finding mental health providers who specialize in—or even have a working knowledge of—their condition.
To address that gap, the American Diabetes Association (ADA) partnered with the American Psychological Association to create the Mental Health Provider Diabetes Education Program in 2017. “The idea was to provide [mental health professionals] with sufficient knowledge and background information about diabetes so … they can incorporate that into their practice,” says Mary de Groot, PhD, an associate professor at Indiana University School of Medicine who serves on the program’s advisory committee.
The program is divided into two parts. First, an intensive seven-hour workshop for mental health professionals provides a basic overview of diabetes, including information on nutrition and exercise. It also addresses myths and preconceptions.
After attending the workshop, participants spend an additional five hours with an online course. Those who complete the two-part program or already have proven knowledge of diabetes are included in the ADA’s Mental Health Provider Directory Listing. “This is a first-of-its-kind directory,” Muñoz says. “Now you have all these individuals going into a single, searchable directory that can be accessed by anybody across the country.”
At present, the directory includes 150 mental health specialists in over 30 states, but the ADA expects that number to grow. One listed therapist is Andrea Pihlaskari, PhD, who runs a private practice in Houston. She has several clients with diabetes, and they have complained about wasting sessions explaining their condition to previous therapists. “When patients find me, they’re relieved and happy to know there’s someone who has training and a background in diabetes,” she says.