P-187: Routine mental health screening and related-support in pediatric diabetes care: a global survey of patient and caregiver experiences and perceptions
J Forster, L Sawatsky, S Berry, K Abel, D R Barber, D J Craft, D C Piona, P A Chobot, D L Cudizio, D A Gomber, P T Skinner, O James, D A Lejk, D M Saiyed, D K Bebbington, D D Gunes Kaya, D S JamesAbstract
Introduction
ISPAD guidelines recommend monitoring of psychological health and quality of life in youth with diabetes.
Objectives
We examined experiences and perceptions of youth (aged 12-18 years) with diabetes and their caregivers regarding routine mental health screening and support in pediatric diabetes care.
Methods
Youth with diabetes and caregivers responded to an anonymous mixed-methods online survey (Google forms), advertised by ISPAD and Breakthrough T1D across newsletters and social media.
Results
A total of 110 people (43 youth with diabetes [62.7% female] and 67 carers [88.1% female]) from across 10 countries and four continents participated; mostly Europe (80%). Mean ± standard deviation age and diabetes duration of youth were 15.8±1.5 and 5.3±3.2 years; for caregivers, 47.4±5.8 and 5.7±4.0 years. Care was mainly government funded (65.5%), with 50.9% reported no psychologist on staff; among these, 48% of youth with diabetes and 74.2% of caregivers perceived needing one (p=0.04). Most (75%) reported no standardized psychological screening. Where screening occurred, around half (53%) used standardised tools: the Patient Health Questionnaire (PHQ-9/PHQ-4) (33.3%), Readiness Assessment of Emerging Adults with Type 1 Diabetes Diagnosed in Youth (READDY) (22.2%), Diabetes Strengths and Resilience Measure for Adolescents (DSTAR-TEEN) (22.2%), and Generalized Anxiety Disorder (GAD-7) (11.1%); 22.2% of youth reported completing ≥4 tools in routine diabetes-related visits. Perceived screening frequency varied, with caregivers favoring shorter intervals than youth, including screening for depression and diabetes distress (p<0.05). Where screening occurred, 34.9% of youth and 34.3% of caregivers reported low confidence discussing mental health concerns; facilitators included non-judgmental, empathetic communication and provider understanding of lived diabetes experience.
Conclusions
More consistent, accessible, and empathetic mental health integration is needed to meet ISPAD recommendations.