Research indicates that depression is three times higher in adolescents with Type 1 diabetes, yet when it comes to treating youth with diabetes, there is often no standard process in place to help identify mental health and quality of life issues they may be struggling with. As a result, young patients and families often do not have the opportunity to discuss this important aspect of treatment with their health care providers, which poses a strong risk of leaving these issues unnoticed and untreated.
A new pilot program at Trillium Health Partners in Mississauga aims to improve the quality of care and life for young diabetes patients who are at increased risk for depression. Trillium Health Partners sees nearly 600 young diabetes patients every year. With the launch of the new program, they will treat young diabetes patients with co-occurring depression more holistically by blending physical and mental health goals right at the start of treatment.
“The most common challenges happen not because our young patients don’t know how to manage their blood sugars, but rather because they are unable to manage the mental and emotional burnout that is so often a part of living with diabetes,” says Elaine Wilson, Registered Nurse, Trillium Health Partners’ Paediatric Diabetes Clinic. “Successfully managing diabetes is so much more than simply checking blood sugar and taking insulin – it is also about the supportive mental health strategies that help my young patients cope with their condition.”
The pilot is supported by the Medical Psychiatry Alliance (MPA), a collaborative partnership between Trillium Health Partners, The Centre for Addiction and Mental Health (CAMH), The Hospital for Sick Children (SickKids), and the University of Toronto. The MPA was established in January 2014 and is dedicated to transforming care for Ontarians living with coexisting physical and mental health conditions.
At their initial visit to Trillium Health Partners’ Paediatric Diabetes Education Program (PDEP), patients and families complete a quality of life questionnaire that helps their care team identify appropriate support. Questions aim to assess how teens may be feeling about their weight and body, how their diabetes impacts their experience at school and their social activities, relationships with friends and family, what they consider to be most difficult about living with diabetes, and how their condition affects their general mood.
Through the pilot project’s innovative partnership with SickKids’ TeleLink Mental Health Program, Trillium Health Partners’ young diabetes patients displaying significant mental health symptoms are promptly linked to a psychiatric consultation by videoconference.
“We have a unique opportunity to more fully address the physical and emotional needs of teens with co-existing physical and mental health problems in more depth, and determine more innovative ways of meeting those needs,” says Dr. Ian Zenlea, Physician Co-lead Medical Psychiatry Alliance Child & Youth Project. “At Trillium Health Partners, we are excited to be a part of the MPA and to collaborate with our MPA partner SickKids on this innovative new program. Together, we can all work toward improving health outcomes and quality of life for these youth and their families."
With 5,000 patient visits annually, Trillium Health Partners’ Paediatric Diabetes Clinic is among the largest in Ontario and the first to trial this new innovative model of including quality of life screening as part of the treatment standard for all young diabetes patients between 13 and 18 years old. The pilot program began just ahead of Mental Illness Awareness Week 2016 (Oct. 2-8) and runs to 2017 at its Mississauga Hospital site, with plans to expand in the near future.