State of Behavioral Health Integration in U.S. Diabetes Care: How Close Are We to ADA Recommendations?

Abstract

In December 2016, the American Diabetes Association (ADA) published a position statement on psychosocial care in diabetes, with evidence-based guidelines for psychosocial assessment and care of individuals with diabetes (1). As a part of this position statement, it is recommended that diabetes practitioners identify and coordinate with qualified behavioral/mental health providers who are ideally embedded in the diabetes care setting and knowledgeable about diabetes treatment and psychosocial aspects of diabetes. These comprehensive recommendations were reiterated in the ADA Standards of Medical Care in Diabetes—2018 (2). Despite the documented benefit of psychosocial intervention and the ADA recommendation, we believe that behavioral health integration is not yet standard care. Moreover, little is known about the prevalence of behavioral health integration. Here, we targeted U.S. academic adult diabetes practices in order to understand the current state of behavioral health integration in diabetes care across the U.S. We identified diabetes practices by their membership to one of two well-known diabetes groups and administered surveys to clinic leadership. Respondents identified as …