By Grace Silverio, BSN, RN, CDCES, CCM
May is mental health awareness month and an appropriate time to look at what kind of support you offer clients. In my experience working with people with diabetes, specifically those with type 2 diabetes, there is a lot of shame with the connection to lifestyle and the struggle to reach or maintain a healthy weight. Many share their stories about how they didn't have the support they needed from family or providers. The frustration of everyone else around them eating whatever they want and not having to consider how it would affect their day. Or feeling guilty for wanting the same food everyone else was enjoying, only to have someone say that if they would stop eating as much, exercise and lose weight, their diabetes would go away. As if it were that easy and diabetes were that simple.
Diabetes doesn't play by the rules and the struggle to manage glucose levels is a constant challenge for many. Even if my clients did the same thing down to eating the same food, their glucose levels would vary greatly. This lack of consistency can be a source of frustration and it is no surprise that with the day-to-day challenges, studies show depression and diabetes distress are widespread.
People with type 2 diabetes are more likely to become depressed and report depressive symptoms twice as often as the general population. Diabetes distress in ethnic minorities in the U.S. and other countries experience more distress than white persons with diabetes, with African Americans reporting the lowest depressive symptoms and Hispanic individuals reporting the highest (Schmidt et al., 2017). The CDC shows that interpersonal and structural racism, the root problem for much of this, negatively affects the mental - and physical - health of millions.
To address these symptoms, we must first identify what causes them. Cost and access are two significant barriers that are often not being met. For example, an estimated 40% of Hispanic individuals identified the cost of treatment as a significant barrier to mental health services (Parra-Cardona et al., 2016). Access to resources like internet can also reduce positive outcomes. Research shows that internet access is associated with increased utilization of physical and mental health services offered online and helps guide improved decision making (Parra-Cardona et al., 2016). Having access to these resources can reduce anxiety, increase feelings of self-efficacy, and help reduce health disparities experienced by ethnically diverse and underserved populations (Parra-Cardona et al., 2016).
Adopting health coping strategies is the first step to improved mental and physical health. If clients are provided with resources for their mental health, they can eventually focus on their physical health. We have an opportunity as diabetes care and education specialists to help them take this first step, to be thoughtful, culturally aware, and supportive advocates for mental health.
May is Mental Health Awareness month, but it doesn't stop here. Learn more about your role in supporting behavioral health strategies to improve mental health at DiabetesEducator.org/MentalHealth.
ADCES Perspectives on Diabetes Care
The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.
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