Tele-Mental Health & Diabetes

Mark Heyman is a diabetes psychologist, person with type 1 diabetes, and Founder and Director of the Center for Diabetes and Mental Health. Here is his story with telemedicine.

A couple years ago,  I had a patient who lives about an hour from my office ask if we could  do our sessions over video. With traffic, coming to see me in my office would take almost half a day and even though he really needed help, he  just couldn’t make it into my office on a regular basis. Since he has  diabetes, and my practice focuses exclusively on the mental health needs  of people with diabetes, he didn’t feel like he had anywhere else to  turn. I’ll be honest, I was pretty skeptical about seeing a patient online. I had never done anything like that before and I had no idea what to expect. But my goal has always been to expand mental health treatment for people with diabetes and this was one tangible way to do  it.

Now I see patients online every week and I am a big believer that tele-mental health treatment can help meet many of the mental health needs of people with diabetes. When I first started, I was  worried that doing therapy online would be awkward. I’ll be honest, with each new patient it usually is awkward…. for about 2 minutes – and the  people I see online tell me they have the same experience. After a  couple minutes of getting used to it, talking over video becomes normal,  and it feels no different than an in-person session.

I’ve actually seen  a lot of people over video that I’ve never met in person, and I’m  confident that their outcomes have been just as good, and sometimes  better, than the people I see in person.

My goal is to make  diabetes related mental health services available to as many people as  possible no matter where they live and I’ve found that tele-mental health is an ideal way to expand my reach to areas where these specialized services aren’t available.

Tele-mental health is not without  challenges. One of the most common symptoms for anyone dealing with mental health challenges, diabetes-related or not, is avoidance. And avoidance rears its head in a lot of different ways like not showing up  to appointments, avoiding certain topics or not talking at all.  Avoidance is difficult to work with when someone is in the room with you  and it’s even more challenging when working with someone over video. In  fact, seeing a therapist over video can be an avoidance strategy – you  can tell yourself you’re checking the box of getting treatment while  using video as a way to avoid the hard work that therapy requires. These  challenges tend to be amplified when the patient and therapist aren’t  sitting in the same room.

Tele-mental  health has been a great way for me to increase access to specialized services to people who really need them and I’m always looking for ways  to keep expanding. In the near future, I plan on offering group therapy  online. If you are interested in talking more about diabetes-specific  tele-mental health for yourself or someone you know, please  send me an email (mark@cdmh.org) or connect on Twitter.

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