Definition for Mental health:

A state of well being in which a person can realize his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. There is however no one set definition as Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined.

Definition of Learning Difficulties:

“Learning disability is a diagnosis, but it is not a disease, nor is it a physical or mental illness. Unlike the latter, so far as we know it is not treatable” (WHO)

Valuing People, the 2001 White Paper on the health and social care of people with learning disabilities, included the following definition of learning disabilities.

‘Learning disability includes the presence of: a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with;

• a reduced ability to cope independently (impaired social functioning);
• which started before adulthood, with a lasting effect on development.

The challenge

It is estimated that 41 per cent of people with diabetes will experience poor psychological well being.

The impact of diabetes on emotional and psychological wellbeing can be profound, and there is increased prevalence of conditions such as depression and anxiety among people with diabetes. This can affect the ability of an individual to self manage their condition and can also have a negative impact on blood glucose control. In turn this increases the risk of developing the devastating and costly complications.

Nine million people in the UK have learning difficulties and it is estimated that 270,000 of them have Type 2 diabetes. People with learning difficulties are at higher risk of developing diabetes than the wider population.

People with learning difficulties are more likely to experience diagnostic overshadowing – reports of physical health being viewed as part of their learning difficulty and so are not investigated. A report by the former Disability Rights Commission found that in England and Wales people with learning difficulties and mental health problems were more likely to have significant health risks and major health problems, including diabetes.

What NHS Diabetes is doing?

NHS Diabetes recognises the emotional and psychological needs of people with diabetes and the importance of supporting diabetes services for people with learning difficulties. Our work includes:

• We have provided firm recommendations through our guidance document, produced in partnership with Diabetes UK, on how to offer emotional and psychological care. The report, called Emotional and Psychological Support and Care in Diabetes (PDF 6MB) sets out the findings of a working group established to examine the current challenges and seek solutions to them. It provides guidance and makes recommendations in a number of areas, including commissioning, organisation of care, provision of services and workforce.
• Commissioning guides for mental health (PDF 3MB) and learning difficulties (PDF 393MB) services have been published by NHS Diabetes. The guides include intervention maps detailing all of the elements needed for the services as well as a contracting frameworks and service specification templates. They support our commissioning approach which offers a step-by-step guide in how to deliver high quality, efficient and cost effective diabetes services.