6.3.0.0 Screen­ing

Key op­por­tu­ni­ties for psy­choso­cial screen­ing occur at di­a­betes di­ag­no­sis, dur­ing reg­u­lar­ly sched­uled man­age­ment vis­its, dur­ing hos­pi­talizations, with new onset of com­pli­ca­tions, or when prob­lems with glu­cose con­trol, qual­i­ty of life, or self-‍man­age­ment are iden­tified (1). Pa­tients are like­ly to ex­hib­it psy­cho­log­i­cal vulnerabil­i­ty at di­ag­no­sis, when their med­i­cal sta­tus changes (e.g., end of the hon­ey­moon pe­ri­od), when the need for in­ten­sified treat­ment is ev­i­dent, and when com­pli­ca­tions are discov­ered.

Providers can start with in­for­mal ver­bal in­quires, for ex­am­ple, by ask­ing if there have been changes in mood dur­ing the past 2 weeks or since the pa­tient’s last visit. Providers should con­sid­er ask­ing if there are new or dif­fer­ent bar­ri­ers to treat­ment and self-‍man­age­ment, such as feel­ing over­whelmed or stressed by di­a­betes or other life stres­sors. Stan­dard­ized and val­i­dated tools for psy­choso­cial mon­i­tor­ing and as­sess­ment can also be used by pro­viders (187), with pos­i­tive find­ings lead­ing to re­fer­ral to a men­tal health pro­vider spe­cializing in di­a­betes for com­pre­hen­sive eval­u­a­tion, di­ag­no­sis, and treat­ment.