Literature Collection

Diabetes mellitus is associated with a high burden of mental health issues, including both formal psychiatric disorders, such as depression and anxiety, and diabetes-specific psychological challenges like diabetes-related distress, psychological insulin resistance, and fear of hypoglycemia. These mental health difficulties significantly impair self-management, treatment adherence, and quality of life, increasing the risk of complications and mortality. The paper reviews the bidirectional relationship between diabetes and mental disorders, driven by biological and behavioural mechanisms. It highlights the high prevalence of depression, anxiety, cognitive impairment, and eating disorders among people with diabetes. The consequences of untreated mental health conditions include poor glycemic control, greater healthcare costs, increased hospitalization, and lower health-related quality of life. The review presents a range of evidence-based management strategies, including early screening, psychological and pharmacological interventions, lifestyle changes, and integrated collaborative care models. Particular emphasis is placed on the role of physicians and endocrinologists in recognizing and managing psychological difficulties. The paper also discusses challenges in low-resource settings and underscores the need for culturally adapted accessible interventions. It argues for a paradigm shift towards integrated, person-centred care models that address both physical and mental health needs in diabetes, offering practical recommendations for clinicians and policymakers.

Early identification and intervention are critical to prevent physical and mental health complications, chronicity, and premature death associated with eating disorders. However, primary medical and behavioral health care clinicians often do not feel confident or competent to diagnose and manage patients with eating disorders. This pilot study describes an innovative telementoring project (Project ECHO® Eating Disorders) that builds a geographically defined collaborative learning community to bridge the knowledge gap between eating disorder specialists located in eating disorder service sites and community-based practitioners, often living in remote areas. We describe the program and recruitment strategies and review baseline participant evaluation findings. Continuing Medical Education (CME) evaluation findings are presented as a measure of practitioner acceptability and satisfaction. Content analysis of CME participant evaluation comments provides an understanding of the impact of the program on participant knowledge and intended practice changes. We end with implications for training, practice, and research.

The integration of behavioral health (BH) services within pediatric primary care has been utilized as a way to address young children's social-emotional needs. This study aimed to examine whether linking at-risk young children to BH services is associated with a reduction in "non-urgent" emergency department (ED) visits. BH teams integrated in a pediatric clinic conducted socio-emotional screening in children 6-65 months of age and tracked ED utilization for children with positive screening. The results indicated that children with positive screening are less likely to have a non-urgent ED visit than children with negative screening with concerns (NWC) and are more likely to be connected to services. Among children in the NWC group, those connected to services were less likely to have non-urgent ED visits than those not connected to services. These findings suggest that integrated behavioral health care has the potential to reduce non-urgent ED visits among at-risk children.

The integration of behavioral health (BH) services within pediatric primary care has been utilized as a way to address young children's social-emotional needs. This study aimed to examine whether linking at-risk young children to BH services is associated with a reduction in "non-urgent" emergency department (ED) visits. BH teams integrated in a pediatric clinic conducted socio-emotional screening in children 6-65 months of age and tracked ED utilization for children with positive screening. The results indicated that children with positive screening are less likely to have a non-urgent ED visit than children with negative screening with concerns (NWC) and are more likely to be connected to services. Among children in the NWC group, those connected to services were less likely to have non-urgent ED visits than those not connected to services. These findings suggest that integrated behavioral health care has the potential to reduce non-urgent ED visits among at-risk children.