Q Exchange
Access to Psychological Support and Transition Improvement for Diabetic Teenagers
- Winning idea
- 2023
What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?
In recent Peer Review Reports for Somerset’s acute trusts, access to psychological support for diabetic young people (YP) and dropout rates for YP transitioning into adult services were highlighted as significant challenges. While the offer of a Somerset Paediatric Psychological Therapies Service is currently improving, historic recruitment and retention issues remain. Subsequently, YP are not always accessing psychological support at the right time, by the right person, and sometimes, YP are only accessing support when admitted due to poor diabetes control. Somerset has a large cohort of teenagers requiring intensive education, support and motivation to manage their diabetes effectively, with significant input from nursing staff to keep CYP out of hospital and in good health. Somerset is also known for its rurality and isolation; therefore we are choosing to use the moderated peer-support digital tool ‘Tellmi’ to support our YP in a way that is safe and familiar to them.
What does your project aim to achieve?
According to NICE, young people (YP) with diabetes are at high risk of anxiety and depression and it’s important they have early access to mental health support. This pilot will support YP with anxiety / concerns around their diabetes by empowering them to support each other in a safe, moderated environment with additional help from professionals.
The National Voices report ‘Peer Support: What is it and Does it Work? found peer support led to significant improvements for people with long-term physical and mental health conditions including increased knowledge, skills, confidence and motivation to manage self- care, improved physical functioning, quality of life and increased social functioning and perceived support.
Tellmi (ORCHA rating 86%) enables YP to access support anytime, anywhere. YP can connect anonymously to other users experiencing similar problems, reducing feelings of isolation, share personal stories and connect to an extensive range of tailored, local support services via an NHS portal.
How will the project be delivered?
- This pilot will deliver 100% pre-moderated, anonymous, age-banded, peer support and extensive diabetes support and psychoeducation to 450 YP aged 11-25 with a diabetes diagnosis in Somerset via the Tellmi app. Pre-emptive counsellor intervention supports high risk. YP with diabetes can connect to each other via the diabetes tab
- The Tellmi directory will be extended to include extensive diabetes psychoeducation, personal stories of lived experience, direct access to local support and diabetes youth workers
- Direct messaging reminders to encourage 18+ to engage with adult care
- Widespread engagement strategy. SMS text messaging from GPs. Collaboration with local diabetes support services. Social media marketing
- Integrate impact and outcomes survey. Data collected at a National scale. Somerset specific data extracted via postcode
- In-app and survey data analysis will measure the impact of the intervention on confidence, connectedness, self-esteem and motivation to self-manage diabetes and engagement with adult care post-transition.
How is your project going to share learning?
The learning from this project will be shared via webinars with all interested parties including the Q Community, young people, parents, regional diabetes groups and the wider health social care system including collaborating with the South West Academic Health Science Network. A full evaluation including the young persons’ voice, case studies from young people involved in the study and impact and outcome metrics will be made available online.
The pilot will also be used to inform a similar project in the North West of England, being led by the world-leading diabetes expert – Professor May Ng, Paediatrician & Paediatric Endocrinologist, who has been awarded an OBE for her work in improving diabetes care for children and young people.
We will also regularly update throughout the project and will be willing to attend meetings to update and discuss further.
How you can contribute
- We would like to request support from members around resolving any issues that may appear, the opportunity to share learning of similar projects and for members to provide any ‘expert by experience’ knowledge and diverse perspectives. We would also like for members to challenge when necessary.
Plan timeline
| 12 Jun 2023 | Share successful bid information with the Somerset Diabetes Transformation Group |
|---|---|
| 14 Jun 2023 | Identify key stakeholders and set up working group |
| 26 Jun 2023 | Develop project plan and marketing strategy |
| 24 Jul 2023 | Creation of all digital and physical engagement materials |
| 24 Jul 2023 | Develop engagement strategy with key stakeholders |
| 31 Jul 2023 | Develop impact and outcomes metrics |
| 2 Oct 2023 | Launch of Tellmi Pilot |
| 4 Mar 2024 | Start Evaluation |
| 2 Oct 2024 | Pilot Ends |
Comments
Rose Firth 16 May 2023
We're really keen to understand if any other Q members have any thoughts on this. If you have any ideas to progress with this idea, or if you have done / known of a similar project, please let us know! And if any locality has access to the Tellmi app, I'm more than happy to meet with you to understand how you have used it in your area; we've already got some fabulous outcomes!
Suzi Godson 16 May 2023
The evidence to support the need for this intervention is staggering. Adolescents with type-1 diabetes have have nearly double the rate of depression compared to young people who are not diabetic (Hood et al., 2006). The combination of diabetes and depression present a major clinical challenge as the outcomes of both conditions are worsened by the presence of the other. Eating disorders are twice as likely to occur in teenage girls with type 1 diabetes (Markowitz, 2010). Skipping insulin to lose weight can shorten life expectancy by 13 years (NEDA, 2018). Between the ages of 15 and 25 years, the risks of psychiatric disorders and suicide attempts are substantially higher compared to young people without diabetes. A Canadian study involving more than one million people aged between 15 and 25 found that diabetics were 325 per cent more likely to attempt suicide compared to young people without the condition (Robinson, 2020). Despite the clear link between diabetes, mental illness, and suicide, 85% of people with diabetes have no access to psychological care and support (Diabetes UK, 2008). The prevalence of mental health issues in young people with diabetes confirms the urgent need to moderate the psychological burden of the disease by providing immediate access to mental health support and education. Do please vote for this innovative mental health solution for young people.
Katy Crabbe 16 May 2023
We are delighted that our proposal has been shortlisted and would love to have the opportunity to answer any questions that you may have about our project. If you would like further information then please leave a comment below and we will respond.
Comments are now closed for this post.