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

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: Local data collection and 2013–14 National Paediatric Diabetes Audit.

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: Local data collection and 2013–14 National Paediatric Diabetes Audit.

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: Local data collection and 2013–14 National Paediatric Diabetes Audit.

Outcome

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

Data source: Local data collection.

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

Data source: Local data collection.

c) Quality of life.

Data source: Local data collection and 2013–14 National Paediatric Diabetes Audit.

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

Data source: Local data collection.

e) Anxiety or depression.

Data source: Local data collection.

f) School performance or attendance.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

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 (NHS England regional teams and clinical commissioning groups) 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.

What the quality statement means for children and young people and their parents and carers

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

Definition 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 Diabetes (type 1 and type 2) in children and young people: diagnosis and management (2015) NICE guideline NG18 (full guideline) and expert opinion]

Equality and diversity considerations

Particular care should be taken when communicating with children and young people with type 1 or type 2 diabetes and their family members or carers (as appropriate) if they have, for example:

  • physical, cognitive or sensory disabilities

  • difficulties speaking or reading English

  • an increased risk of psychological difficulties.