The psychosocial impact of diabetes & severe mental illness: DAWN-SMI

People with a severe mental illness (SMI), e.g. schizophrenia or bipolar disorder, are almost three times more likely to have diabetes, and experience poorer health and healthcare than the general population. Diabetes has a major psychosocial impact, causing distress, poor quality of life and reduced capacity for self-management. People with SMI have additional psychological and social difficulties that are likely to increase their risk of diabetes distress and poor quality of life. However, very little is known about the impact of diabetes in this population.


This study will explore the psychological and social impact of having diabetes alongside SMI and experience of diabetes healthcare. The aim is to increase understanding of how to improve diabetes care, including diabetes self-management for this vulnerable population.


We will survey people with SMI and diabetes, their carers and healthcare professionals to examine the psychosocial impact of diabetes in SMI including diabetes distress, quality of life, and factors affecting diabetes self-management. Participants will be recruited through general practices and mental health services. We will compare findings with data from DAWN2, a global study of diabetes in the general population. We will also test whether questions to measure diabetes distress and psychosocial impact are appropriate for people with SMI. Multi-stakeholder workshops will be used to discuss findings and identify opportunities to increase support for diabetes management.


This study will provide insights on how diabetes can be managed more effectively for people with SMI. Study findings will be disseminated through our established research, clinical and service user networks to increase knowledge among clinicians and service providers, who sometimes make assumptions about why people with SMI experience poor diabetes outcomes (e.g. attributing blame to lifestyle and life choices). People with SMI and diabetes should experience better care, and improved physical and mental health outcomes as a result.