TABLE 5.

Situations That Warrant Referral of a Person With Diabetes to a Mental Health Provider for Evaluation and Treatment

  • If self-care remains impaired in a person with DD after tailored diabetes education

  • If a person has a positive screen on a validated screening tool for depressive symptoms

  • In the presence of symptoms or suspicions of disordered eating behavior, an eating disorder, or disrupted patterns of eating

  • If intentional omission of insulin or oral medication to cause weight loss is identified

  • If a person has a positive screen for anxiety or fear of hypoglycemia

  • If a serious mental illness is suspected

  • In youth and families with behavioral self-care difficulties, repeated hospitalizations for diabetic ketoacidosis, or significant distress

  • If a person screens positive for cognitive impairment

  • Declining or impaired ability to perform diabetes self-care behaviors

  • Before undergoing bariatric or metabolic surgery and after surgery if assessment reveals an ongoing need for adjustment support