Barriers to Self-management of Serious Mental Illness and Diabetes
Open accessAbstract
OBJECTIVES: Individuals with serious mental illness (SMI) (major depressive disorder, bipolar disorder, schizophrenia), and diabetes (DM), face significant challenges in managing their physical and mental health. The objective of this study was to assess perceived barriers to self-management among patients with both SMI and DM in order to inform healthcare delivery practices. METHODS: We conducted 20 in-depth interviews with persons who had diagnoses of both SMI and DM. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. RESULTS: Transcript-based analysis generated 3 major domains of barriers to disease self-management among patients with both DM and SMI: (1) personal level barriers (stress, isolation, stigma); (2) family and community level barriers (lack of support from family and friends); and (3) provider and health care system level barriers (poor relationships and communication with providers, fragmentation of care). CONCLUSIONS: Care approaches that provide social support, help in managing stress, optimize communication with providers, and reduce compartmentalization of medical and psychiatric care are needed to help these vulnerable individuals avoid health complications and premature mortality.
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Mental distress from managing and living with diabetes (type 1 or type 2) impacts daily living and social experiences.
“Unsurprisingly, the mental distress from managing and living with diabetes (type 1 or type 2) impacts daily living and social experiences [6, 7].”
From Emotional, Psychological, and Social Well-being Experience of Long-Term Living with Type 1 Diabetes Mellitus: A Patient–Psychiatrist–Endocrinologist Perspective (2024) · cites this paper as [6]
The Results (Personal level barriers; page not provided) describe stress, disrupted daily routines, and feelings of social isolation associated with managing diabetes and serious mental illness. The Methods (Sample and Setting; page not provided) specify that all participants had both conditions. The paper therefore supports the impact on daily and social life in that group, but not the claim as stated for people with type 1 or type 2 diabetes generally. (LLM, conf=0.86)
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References 35 · Cited by 90
Research works printed but not linked: 3
- [23]Polkinghorne DE Phenomenological research methods Valle RS Halling S Existential-Phenomenological Perspectives in Psychology New York, NY Plenum Press 1989 41 60
- [27]Goulding C Grounded theory, ethnography and phenomenology: a comparative analysis of three qualitative strategies for marketing research European Journal of Marketing 2005 39 3/4 294 308
- [32]Lloyd C Smith J Weinger K Stress and diabetes: a review of the links Diabetes Spectr 2005 18 2 21 127
- Authors
- Blixen, C. E., Kanuch, S., Perzynski, A. T., Thomas, C., Dawson, N. V., & Sajatovic, M.
- Affiliations
- MetroHealth Medical Center (US)
- University Hospitals Cleveland Medical Center (US)
- Venue
- American Journal of Health Behavior
- Publisher
- JCFCorp SG PTE LTD
- Published
- 2016-03-01
- Volume
- 40
- Issue
- 2
- Pages
- 194-204
- ISSN
- 1087-3244 (ISSN-L)
- 1945-7359
- PMC
- PMC4928189
- OpenAlex
- W2412736786
- Cited by
- 90
- References
- 35
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 12 · 2023: 10 · 2022: 9 · 2021: 7 · 2020: 9 · 2019: 12 · 2018: 10 · 2017: 8 · 2016: 2
- FWCI
- 10.72
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Health Behavior (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000439)
- National Institute of Mental Health (R01MH085665)
- National Center for Research Resources (UL1RR024989)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- severe mental illness, diabetes mellitus, disease self-management, barriers to self-management, comorbidities, social support, stigma, isolation, stress, family support, provider-patient communication, care fragmentation
- MeSH terms
- Bipolar Disorder, Depressive Disorder, Major, Major Depressive Disorder, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Schizophrenia, Schizophrenic Psychology, Self Care, Diabetes Complications
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