Background: The Australian National Diabetes Audit is a National Association of Diabetes Centres (NADC) led biennial quality activity, undertaken voluntarily by member specialist diabetes centres. The data collected is pooled and various reports provided allow national benchmarking by comparison between an individual site and all other sites. Individual sites are also provided with 3 years of comparative data summarising selected variables, with a breakdown of each variable by diabetes type and site ranking. A guide is also provided to assist sites in using their individual site data in quality improvement initiatives.

The Diabetes Referral Centre (DRC) has participated in this national quality activity for many years. We identified an increased risk of depression in people with type 2 diabetes and a very low psychologist referral rate from our ANDA 2014 site report. The addition of a psychologist to our multidisciplinary diabetes team is currently unlikely due to budgetary constraints.

Aim: To improve identification of clinic patients with diabetes distress and mental health concerns, including suicidal thoughts, and develop strategies to improve referral for mental health services. 

Method: Validated psychological screening tools were identified for use in outpatient consultations. Mental health services in our region, both internal and external to our organisation, and a selection of on-line and telephone services were contacted to update our knowledge about their current services and referral requirements and processes. This information informed the development of a crisis referral pathway that is available to all DRC clinical staff. There is an increased awareness, when communicating to the General Practitioner (GP), to suggest they consider implementing a GP mental health care treatment plan.

Conclusion: ANDA site data assisted us to identify a significant issue in our service that required improvement. We overcame barriers to successfully develop and implement resources and strategies for staff use in the outpatient setting, benefitting patients with mental health concerns.