Who are our mental health and school researchers and what do they do?

Working with our colleagues in the Diabetes Department at Perth Children's Hospital, we are looking at:

Mental health and wellbeing: Maintaining optimal blood glucose levels can be stressful and cause anxiety. We are interested to understand how changes in blood glucose levels affect mental health and wellbeing. We are also monitoring how patients cope with the stress of diabetes so that interventions can be designed.

Schools and education: We aim to better understand the specific school experiences of children and adolescents with type 1 diabetes (T1D) and to support schools to develop the psychosocial wellbeing and resilience of these students.

Team members (pictured left-right):

• Dr Keely Bebbington, mental health and wellbeing theme research lead: Dr Bebbington is the McCusker Postdoctoral Research Officer in Type 1 Diabetes. Her work aims to understand and significantly improve mental health and psychosocial functioning in children and young people with T1D and their families. She has a particular interest in helping families adjust to living with T1D and reducing the burden of managing this chronic condition.
• Dr Leanne Fried, Schools and education research theme lead: Dr Fried is an experienced educator with a background in teaching in schools and university. Her research areas of interest include improving the psychosocial wellbeing of children and adolescents with T1D, with a focus on the school context. She uses the social-ecological model as a basis for research to investigate the many ways that children and adolescents with T1D can be supported by their families, peers and communities.
• Associate Professor Ashleigh Lin, Program Head of the Youth Mental Health team at the Telethon Kids Institute: Associate Professor Lin regularly collaborates with the Children’s Diabetes Centre on projects that aim to identify modifiable risk and protective factors for poor mental health outcomes in young people with T1D, as well as research that aims to develop and test interventions designed to alleviate psychological distress in this population.
• Dr Amy Finlay-Jones, the Starlight Fellow at the Telethon Kids Institute. Dr Finlay-Jones’ work focuses on improving positive mental health and developmental outcomes across the early life course. She is particularly passionate about supporting the wellbeing and quality of life of young people with chronic illness and disability and is collaborating with the Children’s Diabetes Centre on a pilot of a self-compassion program to promote physical and psychological wellbeing in youth with T1D.
• Jesse Ingram, Honours student: In collaboration with the Children's Diabetes Centre and Perth Children’s Hospital, Jesse’s research project is examining the relationship between stigma and metabolic control in adolescents with T1D.
• Maria Davey, PhD student: In collaboration with the Children’s Diabetes Centre and Curtin University, Maria’s research project involves developing an Acceptance Commitment Therapy based intervention to relieve stress and improve coping in parents of adolescents with T1D.

How will our current and future research make a difference to those living with T1D?

Mental health and wellbeing

• Exercise intervention study: Physical activity is associated with improved psychological wellbeing, fitness and quality of life and may mitigate the risk of poor glycaemic control but maintaining stable blood glucose levels is a challenge and can present a barrier to engagement in exercise. Consequently, participation and fitness levels in adolescents with T1D are lower than recommended. Our researchers are developing and piloting an exercise intervention aimed at improving mental health outcomes in this population. The intervention is designed to increase physical activity engagement to improve psychological and physiological outcomes.
• Diabetes stigma study: Many adolescents with T1D report feeling self-conscious about managing their diabetes in public and more than 60 per cent of adolescents with T1D report experiencing diabetes-related stigma. There is emerging evidence that the experience of diabetes-related stigma may lead to avoidance of self-management behaviours and in turn, negatively impact glycaemic control. The aim of this study is to further explore the experience of stigma in adolescents with T1D and determine if coping style mediates the relationship between experiences of stigma and both diabetes self-management and glycaemic control.
• Characterising moment-to-moment fluctuation in stress, anxiety and blood glucose levels in adolescents with T1D: It is now well documented that children and adolescents with T1D are at greater risk for psychological disorders than young people without diabetes. Our own population-based data shows that Western Australian youth with T1D are over twice as likely to experience severe anxiety disorder than healthy young people. In addition, high levels of psychological distress are associated with poorer metabolic control. Despite the observed link between stress, anxiety and glycaemic control, we still don’t understand how stress, anxiety and blood glucose levels may interact moment-to-moment. In the current study we used a novel method of measuring fluctuations in stress and anxiety throughout the day, using a mobile app and then combined this data with information from continuous glucose monitors. Data from this study is currently being analysed by our team.
• Transition of emerging adults with T1D from paediatric to adult care in Western Australia: For emerging adults with T1D the transition from paediatric to adult healthcare services presents a unique set of challenges. Transition occurs at a stage of immense physiological, emotional and social development. In addition to these significant challenges, the transition from paediatric to adult healthcare services requires the patient to assume greater autonomy for their diabetes management and to form new relationships with the clinical team, often in unfamiliar surroundings. As a result, many emerging adults disengage with healthcare services during this vulnerable stage, increasing their risk for poor physiological and psychological outcomes. This project will lay the foundation for the development of an intervention to improve outcomes for emerging adults as they transition to adult care.
• Piloting a self-compassion program to promote physical and psychological wellbeing in youth with T1D: Adolescents with T1D are at greater risk for poor mental health outcomes, relative to their peers without T1D. In turn, poor mental health can undermine self-management and contribute to poorer clinical outcomes. As a result, programs designed to promote resilience and improve psychological wellbeing are a priority for T1D research. The Making Friends with Yourself (MFY) program is a strengths-based intervention which aims to help young people be kinder to themselves through self-compassion training.  Self-compassion training has been shown to successfully reduce diabetes-related distress, depression and improve metabolic outcomes in adults with T1D. The aim of this project is to determine the capacity of a self-compassion program to improve psychological resilience and promote health outcomes in adolescents with T1D.

Schools and education

• Psychosocial support for children and adolescents with T1D at school: Research indicates that children and adolescents with T1D need support at school not only to carry out their management tasks but they can also need psychosocial support. We recently completed a research project that investigated the many ways that schools, identified as offering good support for children and adolescents with T1D, provide these students with management and psychosocial support. An outcome of this project was a web-based model that is designed to improve the psychosocial support received by children and adolescents with T1D at school. The model complements the work conducted by Diabetes Australia through the Diabetes in Schools program and is currently being reviewed by teachers, parents and students. Once this process is completed we will trial the use of the model in schools.
• T1D mentor project: Research has found that young adult and parent peer mentors can be role models who not only normalise the adolescent's or parent’s experiences of living with a chronic disease but can also act as symbols of hope for them. In a recent project, 10 parents of adolescents with T1D undertook training to be mentors at the Type 1 Diabetes Family Centre. The parent mentors were then paired with parents of newly diagnosed adolescents based on where they lived, age and gender of their children. Ten young adults with T1D were also trained to be mentors and they were paired with adolescents with T1D based on their gender and interests. Mentees were mentored for an eight-week period. Encouraging results were obtained from the pilot. We are now applying for funding to conduct a bigger trial for parents of newly diagnosed children and adolescents with T1D, and adolescents who feel they would like extra support with the view in the future of formalising mentoring support for the T1D community.

For more information on the studies or participation, please email diabetes.research@health.wa.gov.au