Mental health and diabetes management

Scarborough Health Network (SHN) has launched the Mental Health Diabetes Clinic, which offers comprehensive mental health support alongside regular disease monitoring and management for diabetes patients, particularly those at risk for chronic kidney disease (CKD).

SHN’s diabetes and mental health programs are working together to improve patient care for individuals with diabetes.

The new clinic allows diabetes patients to receive referrals to SHN psychiatrists for support with psychiatric symptoms such as depression, anxiety, and post-traumatic stress, which can impact self-management and engagement in care, as stated by Toni Thomas, a registered nurse for SHN’s diabetes program.

The clinic exemplifies SHN’s comprehensive approach to diabetes management, treatment, and prevention. As a leader in the field, SHN ensures timely access to high-quality services in the most suitable setting for patients. The clinic will also provide support for eligible CKD patients, as diabetes and kidney disease are closely interconnected.

The new service expands on the support offered by SHN’s diabetes and kidney disease (DKD) program, which aims to slow CKD progression and delay the need for dialysis. By integrating diabetes and nephrology management in a single appointment, the program collaborates with SHN’s regional nephrology program, catering to over 6,000 patients each year.

In addition, the DKD program is paving the way for a future Metabolic Clinic, envisioned as a comprehensive “one-stop shop” for patients, encompassing services such as mental health, cardiology, and foot care, among others.

Thomas highlighted that diabetes is the leading cause of chronic kidney disease. Managing a chronic disease like diabetes and kidney disease can be demanding, both physically and mentally.

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The daily responsibilities, such as medication, diet, and regular life activities, can have an impact on mental health. Thomas emphasized the importance of addressing mental health as a crucial aspect of managing these conditions.

At its current pilot stage, the program is exclusively accepting referrals from SHN doctors and utilizing the diabetes distress scale (DDS) to identify eligible patients for the clinic. The DDS, a 17-item scale, assesses four key dimensions of distress: emotional burden, regimen distress, interpersonal distress, and physical distress.

Thomas further emphasized that diabetes itself poses numerous challenges for patients, and when combined with chronic kidney disease, additional issues can arise. By ensuring patients receive the necessary care and promoting collaboration among clinicians, the goal is to provide the best possible care for patients while also enhancing their mental well-being.

In Ontario, approximately 1.2 million individuals have been diagnosed with either Type 1 or Type 2 diabetes, both of which can lead to chronic kidney disease (CKD).

There is a significant prevalence of diabetes and kidney disease among individuals of Asian, South Asian, and Caribbean descent, which make up a substantial portion of Scarborough’s population.

Acknowledging the demand for healthcare in Scarborough, Thomas highlighted that patients now have more choices available than ever before when it comes to treatment, monitoring, and accessing mental health support.

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