Moving Beyond "Don't Ask, Don't Tell": Mental health needs of adults with type 1 diabetes in rural and remote regions of British Columbia (BC).

Ashrafi, Shadan; Taylor, Deanne; Tang, Tricia S

AIMS To investigate the mental health needs of adults with type 1 diabetes (T1D) living in rural and remote regions of Interior, British Columbia (BC) and identify factors associated with accessing support. We also explored perspectives around using peer support and digital health strategies for delivering mental health support. METHODS This study recruited 38 adults with T1D to complete a self-report survey and participate in focus groups. We conducted six 90-minute focus groups that addressed the following: current and past mental health needs, social media use for T1D support, peer supporter recruitment and training, and support delivery features for virtual care platforms. Focus groups were recorded, transcribed, quality checked, coded, and analysed to develop themes and subthemes. RESULTS Four core themes emerged: (1) emotional challenges linked to T1D management, (2) unique T1D-related concerns in rural and remote communities, (3) previous support experiences and future support needs, and (4) diabetes-related mental health support interventions involving peer support and digital health strategies. Existing support services are inadequate in meeting the needs of T1D adults in Interior BC. Some have turned towards social media as a way to connect with the T1D community for support. CONCLUSIONS Though T1D adults living in rural and remote settings experience distress associated with the ongoing burdens, frustrations, and fears of managing a complex chronic condition, many have not been offered support and do not know how to seek services in the present/future. Peer support and digital health strategies are two potential solutions to address this care gap.