Quality standard

Quality statement 6: Access to mental health professionals with an understanding of type 1 or type 2 diabetes

Quality statement

Children and young people with type 1 or type 2 diabetes are offered access to mental health professionals with an understanding of diabetes.

Rationale

Psychological issues (such as anxiety, depression, behavioural problems, eating disorders, conduct disorders and family conflict) and psychosocial issues have a significant and adverse impact on the management of type 1 and type 2 diabetes, and on the general wellbeing of children and young people and their family members or carers.

Children and young people with diabetes are at high risk of anxiety and depression, and it is important that they have early access to mental health professionals when they need it. Mental health professionals who have an understanding of diabetes and the particular problems it causes are essential for delivering psychological interventions and engaging with children, young people and their families.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that children and young people with type 1 or type 2 diabetes are offered access to mental health professionals with an understanding of diabetes.

Data source: Data can be collected from information recorded locally by provider organisations, for example from local referral pathways and service agreements.

Process

a) Proportion of children and young people with type 1 diabetes who are offered access to mental health professionals with an understanding of diabetes.

Numerator – the number in the denominator who have access to mental health professionals with an understanding of diabetes.

Denominator – the number of children and young people with type 1 diabetes.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

b) Proportion of children and young people with type 2 diabetes who are offered access to mental health professionals with an understanding of diabetes.

Numerator – the number in the denominator who have access to mental health professionals with an understanding of diabetes.

Denominator – the number of children and young people with type 2 diabetes.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

Outcome

a) Self-management of type 1 and type 2 diabetes.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

b) Adverse events (for example, severe hypoglycaemic episodes, diabetic ketoacidosis or self‑harm).

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

c) Quality of life of children and young people with type 1 or type 2 diabetes.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records and satisfaction surveys.

d) Satisfaction of children, young people and their family members or carers (as appropriate) with the intervention.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient satisfaction surveys.

e) Anxiety or depression in children and young people with type 1 or type 2 diabetes.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

f) School performance or attendance of children and young people with type 1 or type 2 diabetes.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records and school attendance records.

What the quality statement means for different audiences

Service providers (secondary care providers) ensure that systems are in place to offer children and young people with type 1 or type 2 diabetes access to mental health professionals with an understanding of diabetes.

Healthcare professionals (such as consultants) offer children and young people with type 1 or type 2 diabetes access to mental health professionals who have an understanding of diabetes and the particular problems it causes and can deliver psychological interventions and engage with children, young people and their families.

Commissioners commission services that offer children and young people with type 1 or type 2 diabetes access to mental health professionals with an understanding of diabetes.

Children and young people with type 1 or type 2 diabetes are able to see mental health professionals who understand the types of problems people with diabetes can have. The mental health professional should be one of the main members of the diabetes team.

Source guidance

Diabetes (type 1 and type 2) in children and young people: diagnosis and management. NICE guideline NG18 (2015, updated 2023), recommendations 1.2.107 and 1.3.68

Definitions of terms used in this quality statement

Access

Multidisciplinary paediatric diabetes teams should include a psychologist and provide access to them in an appropriate timeframe. Each child and young person with type 1 or type 2 diabetes should have an annual assessment by their multidisciplinary team to decide whether they need support from the psychologist. [Adapted from NICE's 2015 full guideline on diabetes (type 1 and type 2) in children and young people and expert opinion]

Equality and diversity considerations

Children and young people with diabetes and their family members or carers (as appropriate) should be provided with information from mental health professionals that they can easily read and understand themselves, or with support, so they can communicate effectively with health and social care services. Information should be in a format that suits their needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate and age appropriate. People should have access to an interpreter or advocate if needed.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.