Hostname: page-component-7c8c6479df-ph5wq Total loading time: 0 Render date: 2024-03-29T10:59:27.831Z Has data issue: false hasContentIssue false

Diabetes and liaison psychiatry: what about transition?

Published online by Cambridge University Press:  02 January 2018

Ashish Rana
Affiliation:
Department of Liaison Psychiatry, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, email: peter.trigwell@leedsth.nhs.uk
Peter Trigwell
Affiliation:
Department of Liaison Psychiatry, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, email: peter.trigwell@leedsth.nhs.uk
Rights & Permissions [Opens in a new window]

Abstract

Type
The columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2009

There are very few diabetes centres in the UK with a psychiatrist as part of the team (Reference Dalvi, Feher and CaglarDalvi et al, 2008). Our service in Leeds is one of those few and has been in existence since 1998. Prompted by the Dalvi 12-month case-note review describing a service in London (Chelsea and Westminster) (Reference Dalvi, Feher and CaglarDalvi et al, 2008), we compared it with our service (for 2008).

There were several similarities, including the number of patients referred, their gender split, rates of non-attendance and range of interventions offered. The differences included referral source (usually consultant diabetologists in Leeds but diabetes nurse specialists in London), presenting complaints (broadly coping difficulties in Leeds, low mood in London) and who provides the various interventions (liaison psychiatrists in Leeds but, apart from initial assessment, the majority in London are seen by a clinical psychologist). The most striking difference, however, is with regard to the type of diabetes diagnosed in those referred and their age. In Leeds, 84% of referred individuals have type I diabetes, across a total patient age range of 18–74 years, whereas in London, 44% of those referred have type I diabetes and the age range is much more limited (31–71 years). There is great disparity between the two services as regards the percentage of younger people (age 30 years and younger) referred from the diabetes service to liaison psychiatry – 64% in Leeds, none in London. The fact that none of the patients seen in London are in their teens or twenties is surprising to us, particularly given the increasing focus nationally upon the relatively high prevalence of psychological and psychosocial difficulties experienced by people with diabetes in the stage of ‘transition’ (i.e. moving from childhood to adulthood with diabetes). National and regional working groups are calling for the provision of specific physical and mental health services for people aged 16–25 years, to come in line with existing requirements within the National Institute for Health and Clinical Excellence diabetes guidance (National Institute for Health and Clinical Excellence, 2004) and National Service Framework (Department of Health, 2001; 2007). Dalvi et al (Reference Dalvi, Feher and Caglar2008) do not mention any separate service for the psychological needs of younger people with diabetes in their centre – either they are not being identified as requiring specialist psychological help or they are not referred on for that help. If this is the case, and given the increasing recognition of the particular needs of this group, we would wish to raise the issue of this apparent gap in service provision.

References

Dalvi, M., Feher, M., Caglar, E., et al (2008) Liaison psychiatrist in a specialist diabetes centre. Psychiatric Bulletin, 32, 461463.Google Scholar
Department of Health (2001) National Service Framework for Diabetes: Standards. Health Service Circular (HSC 2001/026). Department of Health.Google Scholar
Department of Health (2007) Making Every Young Person with Diabetes Matter: Report of the Children and Young People with Diabetes Working Group. Department of Health.Google Scholar
National Institute for Health and Clinical Excellence (2004) Type 1 Diabetes in Children, Young People and Adults (NICE Guideline CG15). NICE.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.