Last summer, Brain Canada and JDRF officially launched the JDRF Canada – Brain Canada Addressing Mental Health in Type 1 Diabetes Team Grants, a unique program that supports research on interventions that address mental health concerns in people with type 1 diabetes (T1D).
Living with a chronic illness like diabetes is hard. As a result of the burden of diabetes management, people with T1D are at an increased risk of developing mental health disorders such as depression, anxiety, suicidal ideation, eating disorders, and diabetes distress, a clinically validated term describing the powerlessness, stress, guilt, relentless worry, and denial that comes with living with diabetes and the burden of self-management. We know that people with T1D who develop mental health disorders, particularly depression and diabetes distress, have a lower quality of life, have worse glycemic control (i.e., higher HbA1c), measure blood glucose less often, suffer more frequent/severe hypoglycemia and diabetic ketoacidosis episodes, and are admitted to the hospital more frequently. Conversely, resilience, empowerment, a good support network, and wellness are linked with high quality of life and health outcomes in people with T1D.
Mental health is rarely a central aspect of day-to-day diabetes management and concerns often remain unidentified or unaddressed until they become serious and challenging to manage. Although mental health interventions are known to improve quality of life and outcomes for some people with diabetes, few are regularly implemented in standard care.
The JDRF Canada – Brain Canada Addressing Mental Health in Type 1 Diabetes Team Grants provide up to $250,000 over two years to fund the development and testing of three sustainable, scalable projects which aim to improve support for people in Canada who live with T1D and are affected by mental health disorders. These strategies could translate into better quality of life and diabetes-related health outcomes for people living with T1D.
Learn more about the three projects:
Dr. Tricia Tang
Using a virtual care platform to deliver peer-led mental health support to rural and remote communities in BC: A randomized wait-list controlled trial of the REACHOUT intervention
Dr. Tang and her team at the University of British Columbia will use a virtual care platform to deliver peer-led mental health support to rural and remote communities in BC, through an intervention called REACHOUT, created with support from a previous JDRF grant.
Given the shortage of mental health professionals who are trained in T1D, adults living in rural and remote settings experience the greatest challenge accessing the services they need. This gap in health care is why BC has identified “mental health care” and “rural and remote health care services” as two of the five provincial health care priorities. Dr. Tang’s team will seek to address three challenges of BC’s diabetes care: the availability, affordability, and accessibility of mental health support for adults with T1D living in settings with limited resources.
Peer support has been demonstrated to be a low-cost and viable approach to long-term self-management support. In addition, interventions that use technology (e.g., digital health platforms) have been found to improve mental and emotional health. As such, models that draw on both peer support and digital health strategies may prove promising in reducing health care disparities.
REACHOUT is a Mobile App developed in collaboration with adults with T1D, clinical psychologists, biomedical engineers, behavioural scientists, and rural health experts. REACHOUT uses digital health technology to “drive” mental health support to people living with T1D in the greatest need. If successful, this innovative approach that seeks to reach the “hard-to-reach” can be adapted for kids, teens, adolescents, and young adults with T1D in BC and across Canada.
Dr. Peter Selby
Technology-enabled comprehensive care for young adults with type 1 diabetes (T1D) experiencing diabetes distress
Dr. Selby and his team at the Center for Addiction and Mental Health in Toronto are bringing experts in mental health and T1D care together with those who have lived experience of T1D to co-develop a solution for diabetes distress that is accessible and acceptable to people with T1D, their caregivers, and health care practitioners. The program is geared towards younger adults between the ages of 18 and 29, a group disproportionately vulnerable to diabetes distress. The patient voice will be central throughout the project, from developing the proposal to developing the solution.
This project adapts proven approaches to managing diabetes distress to a virtual format (using video chat, telephone calls, and text messaging) supported and directed by mental health and T1D experts, thereby capitalizing on the digital literacy of this population and increasing accessibility to treatment. Participants will be invited to participate in the program which will comprise of 8 scheduled sessions, complemented by support from a care coach and/or peers.
The evaluation of the intervention will examine both the feasibility and acceptability of the program as well as its effectiveness in reducing diabetes distress. The impact on diabetes self-care, overall blood glucose levels, and episodes of low blood glucose will also be measured.
JDRF has committed to supporting and creating a holistic framework for mental health treatment and care for all people in Canada living with T1D. Their support for this project is another step in that direction.
Dr. Marie-Eve Robinson
Teaching Adolescents with type 1 diabetes Self-compassion (TADS) to reduce diabetes distress: A randomized controlled trial
Self-compassion is a practice that involves acting the same way towards yourself as you would with friends and loved ones, and that you are kind and understanding towards yourself. Since self-compassion is a skill that can be taught, the team believes that it could be a strategy to improve mental health issues in youth with T1D, like diabetes distress.
The aim of the study is to assess the effectiveness of a mindful self-compassion program on improving the diabetes distress experienced by youth aged 12-17 years with T1D. The mindful self-compassion program will consist of weekly virtual 1.5-hour sessions/workshops for 8 weeks, led by a trained facilitator. It will cover a variety of self-compassion practices, such as dealing with difficult emotions and developing a kind inner voice.
The team anticipates that symptoms of anxiety, depression, disordered eating, and suicidal ideation will be lower in the mindful self-compassion group compared to the control group. This study has the potential to lower diabetes distress, the most common mental health problem experienced by youth with T1D, by increasing their self-compassion. Ultimately, the team plans to advocate for the inclusion of such programs in standard care for youth across Canada, thereby directly impacting their mental health and blood sugar control.
The JDRF Canada – Brain Canada Addressing Mental Health in Type 1 Diabetes Team Grants have been made possible by the Canada Brain Research Fund (CBRF), an innovative arrangement between the Government of Canada (through Health Canada) and Brain Canada, and JDRF Canada.