title: Barriers and enablers of type 2 diabetes self-management in people with severe mental illness.
abstract: People with diabetes and severe mental illness (SMI) experience poorer outcomes than those with diabetes alone. To improve outcomes, it is necessary to understand the difficulties that people with SMI experience in managing their diabetes.
  
  
  
  To identify barriers and enablers to effective diabetes self-management experienced by people with SMI and type 2 diabetes.
  
  
  
  Qualitative methodology using semi-structured interviews was employed. Development of the interview topic guide and analysis of the transcripts were informed by the Theoretical Domains Framework for behaviour change, which consists of fourteen theoretical domains that have been found to influence behaviour.
  
  
  
  Fourteen people with SMI and type 2 diabetes took part in the study. Participants considered diabetes self-management to be important, were aware of the risks of poor diabetes control but struggled to follow recommended advice, particularly if their mental health was poor. Support from family and health professionals was considered an important enabler of diabetes self-management.
  
  
  
  New approaches are required to support diabetes self-management in people with SMI. This study identified some of the important domains that may be targeted in new interventions.
authors.affiliation: Centre for Health Services Research, School of Health Sciences, City, University of London, London, UK.|East London NHS Foundation Trust, London, UK.
authors.forename: Kathleen
authors.identifier: 0000-0002-6003-3029
authors.initials: K
authors.lastname: Mulligan
authors.affiliation: Centre for Health Services Research, School of Health Sciences, City, University of London, London, UK.|East London NHS Foundation Trust, London, UK.
authors.forename: Hayley
authors.initials: H
authors.lastname: McBain
authors.affiliation: Centre for Health Services Research, School of Health Sciences, City, University of London, London, UK.|Centre for Mental Health Research, School of Health Sciences, City, University of London, London, UK.
authors.forename: Frederique
authors.initials: F
authors.lastname: Lamontagne-Godwin
authors.affiliation: East London NHS Foundation Trust, London, UK.
authors.forename: Jacqui
authors.initials: J
authors.lastname: Chapman
authors.affiliation: East London NHS Foundation Trust, London, UK.|Centre for Mental Health Research, School of Health Sciences, City, University of London, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Haddad
authors.affiliation: Centre for Research in Primary and Community Care (CRIPACC), School of Health and Social Work, University of Hertfordshire, Hatfield, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Jones
authors.affiliation: East London NHS Foundation Trust, London, UK.|Centre for Mental Health Research, School of Health Sciences, City, University of London, London, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Flood
authors.affiliation: East London NHS Foundation Trust, London, UK.|Centre for Mental Health Research, School of Health Sciences, City, University of London, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Thomas
authors.affiliation: East London NHS Foundation Trust, London, UK.|Centre for Mental Health Research, School of Health Sciences, City, University of London, London, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Simpson
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D010347:Patient Care Planning; D010349:Patient Compliance / Q000523:psychology*; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology; D000073278:Self-Management / Q000379:methods / Q000523:psychology*; D012720:Severity of Illness Index
keywords: Theoretical Domains Framework; diabetes; self-management; service users; severe mental illness