JMIR Publications

ABSTRACT

Background:

Type 2 diabetes (T2D) affects over 1.2 million Australians and is strongly associated with increased risk of mental health conditions, including depression and anxiety. Despite this well-established comorbidity, psychological needs remain under-recognised and poorly integrated into routine diabetes care, contributing to suboptimal health outcomes.

Objective:

This scoping review aimed to identify and synthesise evidence on existing models of care for Australian adults living with T2D and coexisting mental health concerns, with a focus on their effectiveness, accessibility, and capacity to deliver integrated, person-centred care.

Methods:

A scoping review was conducted in accordance with PRISMA-ScR guidelines. Peer-reviewed literature was searched across Scopus, EBSCO, Medline, and a university library database, alongside grey literature sources including government and organisational reports. Studies published between 2015 and 2025 were included if they addressed both diabetes management and mental health in Australian adult populations. Data were extracted and analysed descriptively, with models of care categorised into three groups: general practitioner (GP)-led, integrated, and technology-assisted models.

Results:

Thirty-five sources (15 peer-reviewed studies and 20 grey literature documents) were included. GP-led models remain the most common but often inadequately address mental health due to time constraints, limited resources, and fragmented referral pathways. Integrated models, involving multidisciplinary collaboration or co-located services, demonstrated improved psychological outcomes, self-management, and patient satisfaction, though their scalability is limited by resource demands and workforce availability. Technology-assisted models, including telehealth and digital mental health interventions, showed strong potential to improve access, particularly for rural and underserved populations, but risk excluding individuals with low digital literacy or access. Across all models, no single approach fully met the complex needs of this population.

Conclusions:

Effective care for individuals with T2D and mental health concerns requires a flexible, hybrid approach that combines the strengths of integrated and technology-assisted models. A stepped, person-centred framework, supported by digital tools and coordinated clinical care, may offer the most promising pathway to improving both accessibility and outcomes. Further research is needed to evaluate implementation in diverse populations and real-world settings.